Summarized below are several highlights from the first several months of 2019. Much collective work has been done to decrease infant deaths in Cuyahoga County, particularly African American infant deaths, and much more will be executed in the remaining months of 2019 and beyond. Our thanks to all those who work alongside us to tackle these challenges, achieve our goals and save our babies!
- Structural Racism: First Year Cleveland (FYC) was one of the first infant mortality collaboratives in the state to call out structural racism as a key factor in our local and state high infant death rates. FYC has presented our collaborative anti-racism work at national and out-of-state conferences to lend our expertise and technical assistance so others may gain and learn from our collective work.
- Anti-Racism and Workplace Bias Training: We received one of the only systemwide anti-racism infant mortality grants from the Ohio Department of Medicaid (ODM) which enabled us to certify 28 local trainers throughout multiple local systems using a highly effective, evidence-based Cook Ross Workplace Bias Training curriculum. By the end of 2019 over 1,000 key employees throughout several systems will be attending this impactful training session to discover how their own biases may be impacting poor infant and maternal health outcomes. In the two-hour training, one learns effective, proven interventions to become more aware of their biases and how to "check them at the door" so they don't negatively impact people of color whom we serve. This systemwide approach is aggressively addressing racism and biases within the provider systems. Please note these are not "one and done" training sessions; rather, they are ongoing, strategic racial bias training and HR transformation efforts to address structural racism. FYC Action Teams will continue to lead additional systemwide structural racism efforts over the next several months with new posters and videos created using key messages extracted from focus groups of expectant parents and parents of color. If your organization would like to be included in the fall training and access the new posters and videos, please contact me at Bernadette.Kerrigan@case.edu.
- Programs for Parents and Expectant Parents: FYC has been active in leading the efforts to scale up effective consumer programs targeted to African American expectant parents and parents. Working together, our community strategically:
- Provided an additional 1,200 home visiting and birth worker slots in Cuyahoga County, resulting in 3,600 new expectant parents being served within the last three years. These 3,600 new slots were made possible by ODM grants to four highly effective agencies: Birthing Beautiful Communities, MomsFirst, Moms and Babies First and Nurse Family Partnership. Ninety-eight percent of these additional slots were filled by African American expectant parents, and each of these high-performing programs led to a significantly lower infant death rate compared to the county infant mortality rate of African American expectant parents not served by these programs.
- We increased Cuyahoga County CenteringPregnancy® slots by more than 1,300 over the last several years, and 80 percent of those slots were filled by African American expectant parents. National data shows that African American expectant parents served through a Centering program have a 41 percent reduction in premature births. By the end of 2019, the FYC Centering Coalition will be the third largest Centering system in the United States and we strive to continue to increase enrollment over the next five years.
- Our important fatherhood and faith-based programs are being integrated throughout our home visiting programs, bringing value-add program components that are key to reducing infant deaths.
- Advocacy and Public Policy: We activated FYC's Community Engagement and Public Policy strategic plan and are working with Advocacy and Communication Solutions (ACS) and Center for Community Solutions (CSS), seeking long-term Medicaid billable solutions so the effective programs outlined above have continuous financial sustainability rather than being dependent on limited grant funds. We applaud ACS who played a key role in statewide advocacy and lobbying on behalf of FYC, resulting in ODM recently releasing a $26 million ODM Vitality Grants Request for Application with up to $4.8 million being earmarked for Cuyahoga County. Due to the significant work ACS led in coordinating testimonials, attending hearings and providing written documentation for FYC and our statewide partners, elected officials and statewide departments now have a better understanding of infant mortality and the factors impacting racial inequities.
ACS also scheduled and conducted dozens of meetings with legislators and staff, executive agency leaders and staff, and Governor DeWine's office. They coordinated an unprecedented advocacy partnership with Akron, Columbus and Cincinnati IM prevention collaboratives that brought even greater strength to the advocacy effort. And, finally, they worked with the Speaker of the Ohio House to draft HB 11, and then built and supported the introduction of the bill via testimony of IM partners, including development of testimony templates and content, and engaging members of the House and Senate to advance and support the bill. HB 11's goal is to reduce infant mortality and improve the health of the mother and child.
- Paid Family Leave: The Center for Community Solutions has been working to outline options for a paid family leave policy in Cuyahoga County. This has involved reviewing paid family leave policies currently being offered in other Ohio political jurisdictions, reviewing national model paid family and medical leave policies, identifying any legal barriers to implementing a paid family leave policy and ultimately looking at the evidence connecting paid family leave policies to improved maternal and infant health.
- Tobacco21: Three additional local cities are working with the Cuyahoga County Board of Health to launch Tobacco21 efforts, a highly effective anti-smoking public policy initiative that has proven results. Decreasing smoking rates in expectant parents and parents has proven to decrease infant deaths.
- Parent and Infant Loss: We have activated an African American parent-led movement which has accomplished so much in less than a year. A Grief Recovery Institute has been established, which is building a pregnancy and infant loss grief support capacity among African American licensed professionals and paraprofessionals; annual infant death remembrance events are continuing to be hosted (save the date for the October 15th Wave of Light event); and the independently-produced film "Toxic" will premiere Wednesday, September 25th. Please see our events page for registration and more information.
- Safe Sleep: More than 1,000 Safe Sleep heroes have been recruited and trained as a sustainable community engagement effort in reducing preventable infant sleep-related deaths. The MetroHealth System has launched a community-wide safe sleep movement, recruiting neighbors, friends and co-workers to spread the important message of putting an infant down to sleep safely by following the ABCDs of Safe Sleep: Alone, on their Back, in a Crib and Don't smoke.
- Hospital Collaboration: For the first time, in a coordinated effort to improve infant death rates, all three labor and delivery hospitals' OB and NICU leaders are meeting together on a frequent basis to review charts, share lessons learned and discuss what is working and what is not.
- Housing Vouchers: We are working with Cuyahoga Metropolitan Housing Authority to secure important housing vouchers for high-risk pregnant women in need of stable housing to ensure better infant and maternal outcomes.
- National Equity Conference: FYC and The YWCA Greater Cleveland are proud to co-sponsor “400 Years of Inequity: A Call to Action.” This two-day summit will be held November 8th and 9th and will commemorate the 400-year anniversary of slavery in this country and the specific, urgent action we must all take to address structural racism which is playing a key role in our high infant mortality rates. We have secured nationally recognized speakers including john powell, Darrick Hamilton, Stacey Stewart and Harriet Washington; and state and local experts will also speak and facilitate breakout sessions. You will not want to miss this historic two-day equity event and movement. Click here for additional information and registration options.
- FYC Action Teams: By the end of 2019, we will have fully activated ten FYC Action Teams as well as public policy and engagement strategies. Our current action teams continue to make significant progress. Please take a moment to review their recent accomplishments:
- Infant Mortality Rate: In 2018, the Cuyahoga County overall infant mortality rate decreased from 10.5 in 2015 to 8.6, and the infant mortality rate for the black non-Hispanic population decreased from 18.5 in 2015 to 15.5 in 2018.*
- Sleep-Related Infant Deaths: There were 27 sleep-related infant deaths in Cuyahoga County in 2015. This has decreased to 19 sleep-related deaths in 2018.*
- Equity Lens Integration: We are proactively integrating an equity lens into all of FYC's efforts to double down our collective efforts to reduce infant deaths. This will lead systems to proactively implement anti-racism and systems changes in addition to service delivery changes.
Please note there is urgency and action in our work. We have noted progress in reducing infant deaths within each race but the needle is moving too slowly. We continue to see numbers fluctuate, and acceleration needs to occur on all levels. We have the right road map and we must continue to work strategically and collectively in leading both system changes and scaling effective programs for African American expectant parents in order to achieve our goals, save our babies and eliminate racial inequities. Our goal is to have no racial inequities between African American and Caucasian babies by 2025. We appreciate all your efforts to ensure continued progress. Our sincere thanks for your hard work and dedication!
*2018 infant mortality data is preliminary and unaudited.