MANSFIELD -- The need for action to decrease Richland County's infant mortality rate was apparent on Friday as more community health organizations rallied around a baby box initiative.
Richland Public Health hosted an infant mortality community meeting on Friday to update local health agencies on infant mortality data for the county, the state of Ohio and the nation.
"You're not going to like the number you see," warned Amy Schmidt, director of nursing at Richland Public Health, "because our births were down, and our deaths were up."
Schmidt shared that in 2016, Richland County's infant mortality rate was 10.4 per 1,000 live births. This equates to 12 infant deaths out of 1,157 live births in Richland County in 2016.
It's an increase from the 10 infant deaths in 2015 for an infant mortality rate of 7.12, and nearly twice the eight infant deaths and infant mortality rate of 5.9 in 2014. However, Schmidt cautioned these numbers were not an accurate view of infant mortality in Richland County.
"That's what it looks like if you do the math, but these numbers are unstable because the numbers are so small," she said. "If you have one or two deaths, it shoots the rate up through the ceiling, and that's happened to us."
Because of the low numbers of births and deaths in Richland County, the county often looks at a 10-year aggregation for a more accurate representation of the infant mortality rate. Between the years 2005 and 2015, there were 14,877 live births in Richland County and 108 deaths, an infant mortality rate of 7.3 infant deaths per 1,000 infants born.
Nationally, the infant mortality rate in the United States is 6.0 per 1,000 live births. The lowest infant mortality rate in the nation is 4.3 in Massachusetts, the worst is 8.9 in Mississippi. Ohio’s 2016 infant mortality rate is 7.1 and ranks among the 10 worst states.
Another troubling statistic presented on Friday was the disparity in infant mortality rates between white babies and black babies. In the state of Ohio, the black infant mortality rate in 2015 was 15.1 per 1,000 live births, versus the white infant mortality rate at 5.5. That trend continues nationally.
Richland Public Health Commissioner Martin Tremmel was not pleased with these particular numbers.
"There is no fair and legitimate reason other than the social disparities that we know and recognize that our black infants in this country are dying at twice the rate of our white infants," Tremmel said. "That should be troubling to us. This needs to be a significant issue for our messaging."
The infant mortality community group first convened in July 2014 and continues to meet to fight the types of statistics presented on Friday.
"We met a couple times that summer and early fall, and identified four topics that warranted independent work groups that met several times and came up with ideas and strategies," Schmidt said.
These topics include preventing prematurity, preventing birth defects, preventing sleep-related deaths, and improving health system performance.
The last infant mortality community meeting was held in July 2016, discussing a public awareness campaign, tobacco and substance abuse cessation, community education for parents and grandparents, early and ongoing prenatal care, safe sleep education, and establishing best practices.
Updates on these strategies were given at Friday's meeting, including the mention of the Richland Source solutions journalism piece "Healing Hope" as one method of marketing and advertising to make the community aware of infant mortality as a problem.
The solution of a baby box program was also introduced on Friday, as several community agencies have come on board as baby box distributors in the near future.
The organizations on board include Richland Public Health, the Mansfield Area Y and the Community Health Access Project (CHAP), and several others expressed interest at Friday's meeting. The boxes will be distributed through Baby Box University, the educational companion to The Baby Box Company based in California.
"(Baby boxes) are just another tool in the toolbox," said Tremmel on Feb. 15.
Schmidt remarked that the introduction of baby boxes amps up the community need for continued and enhanced education. No matter the method, Schmidt stressed that whatever the community moves forward with in fighting infant mortality should be consistent across all agencies.
"There's so much research out there and all this evidence-based stuff that we do, but we all do it at different levels and from different agencies," she said. "I know this group has struggled before with what is the same message ... this is a community issue, and we need to approach it as a community."
Still, Tremmel praised the strides made in these infant mortality community meetings from its conception.
"We talked about community issues, consistency in message, and advertisements and publicity," he said. "There is really some remarkable work that has been done in the community. Having said that, we have a long way to go."