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First Year Cleveland

Case Western Reserve University School of Medicine
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Home Solutions March of Dimes 2019 Report Card

March of Dimes 
2019 Report Card

Cuyahoga County Infant Mortality Rate Steadily Decreasing;
Prematurity Continues to Drive Results 

March of Dimes Report Card Shows More Work Needs to Be Done to Reduce Premature Births

Since the public-private collaborative First Year Cleveland (FYC) was established in December 2015, overall Cuyahoga County infant mortality rates have declined by more than 20 percent through the end of 2018 (156 infant deaths in 2015 versus 120 in 2018). But more needs to be done to attain our goal of ensuring that all babies in Cuyahoga County reach their first birthday, especially in the area of prematurity.

The March of Dimes 2019 Report Card was released November 4, 2019. The report uses data from 2017 to illustrate county and city preterm birth rates throughout the United States.

Prematurity, defined as a birth that occurs before 37 completed weeks of gestation, continues to be the leading cause of infant deaths in both Cuyahoga County and the City of Cleveland, especially among African Americans. As indicated in the March of Dimes report, preterm birth rates in the City of Cleveland increased slightly, from 14.4 percent in 2016 to 14.5 percent in 2017.

First Year Cleveland is keenly aware of this problem and is working diligently to tackle it. Specifically, FYC has identified “addressing extreme prematurity,” babies born at or before 22 weeks gestation, as one of its three priority areas. The goal for this area is to achieve the March of Dimes’ target rate of less than 10 percent of births being preterm by the end of 2020. Other priority areas include reducing racial disparities and eliminating sleep-related deaths.

More than 400 people from over 100 organizations throughout Cuyahoga County participate in this growing community movement to save our babies. They are involved in the FYC Community Action Council, the Executive and Policy and Advocacy Committees, and 12 Action Teams. The work of the Action Teams focuses on addressing FYC’s three aforementioned priority areas.

Five of the Action Teams focus their efforts on addressing prematurity. Working in separate but interrelated areas, the Teams are launching learning circles with researchers and local birth hospitals — Cleveland Clinic, The MetroHealth System and University Hospitals — and expanding the CenteringPregnancy® model. Other Action Team highlights include:

  • 1,200 new Home Visiting and birth worker positions were added to four highly effective organizations throughout Cuyahoga County, resulting in 3,600 new expectant parents being served within the last three years, 98 percent of whom were African American. Home Visiting is one strategy used to improve a range of maternal-child health outcomes, including preterm birth, in high-risk populations.

  • CenteringPregnancy® slots throughout Cuyahoga County increased by more than 1,300 over the last few years, with 80 percent of those slots 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, representing seven health care entities, is projected to be the third largest Centering Coalition in the United States.

  • Leaders from Cleveland Clinic, The MetroHealth System and University Hospitals are meeting and have formed an unprecedented collaboration that is resulting in enhanced identification and resolution of issues contributing to infant deaths in our community.

First Year Cleveland has also been active on the state policy front, working with the Speaker of the House to draft House Bill (HB) 11. The goal of the legislation is to reduce infant mortality and improve the health of the mother and child. “We applaud the comprehensive approach to HB 11 which addresses four elements of prenatal health: smoking cessation, dental hygiene, increase lead-based paint education and group prenatal care. This bill will play a key role in reducing preterm births throughout our state,” stated Bernadette Kerrigan, First Year Cleveland’s Executive Director.

Dr. Arthur James is an OB-GYN with more than 30 years of experience in both maternal and infant health, as well as racial equity work. James is a founding FYC Executive Committee Member and currently serves as an advisor. “Reducing infant mortality and, in particular, the racial disparities that impact it, is hard work. It’s transformational work that requires intense, ongoing effort. We remember that we’re doing this work together to save babies. To not stay engaged would be to allow these numbers to be worse, and that is unacceptable,” James says.

James notes that policies — both historical and modern — have a dramatic impact on social determinants of health, or the ways that quality of life affects and influences health.

"Policy can impact a community member's quality of life, including things like access to education, employment, health care, healthy food and transportation. If improvements are made in communities through policy changes, those improvements can in turn positively impact things like infant mortality rates. When you're trying to influence population health, policy is critical. In the words of C. Everett Koop, former U.S. Surgeon General, 'Health care is vital to all of us some of the time, but public health is vital to all of us all of the time,’" James notes.

The full March of Dimes Premature Birth Report Card for 2019, which uses 2017 data, can be found here.

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