EDITOR'S NOTE: This article is part of an ongoing series on infant mortality in Richland County and has been supported by the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems.
MANSFIELD – A baby’s first birthday is a monumental event to everyone except the baby.
Birthday decorations present themselves as colorful items meant for destruction. The taste of sugar means birthday cake icing euphorically smeared across the cherub's cheeks.
As such, the day of March 20 was just like any other day for Serville Chambers, teetering around his home with sparkling dark eyes and a mess of dark curls on top of his head.
The fourth child of Mansfield native Amber Parker, Serville differs greatly from his 2-year-old troublemaker sister Makenzi and his 4-year-old independent brother Sincere.
“Serville, he’s just always happy,” Parker said, smiling beneath a “Happy Birthday” banner as her toddler chased a balloon in the living room. “He’s just a happy kid.”
A graduate of the Interactive Media & Construction (IMAC) Academy in Mansfield, 27-year-old Parker is a stay-at-home mother while her fiancé holds a job as a warehouse worker.
“We were supposed to get married in August, but … we had to push it back to next April,” Parker says.
She rests a hand on her stomach, perfectly round and continuing to grow with her youngest child, Seronni. She is due on May 17 – almost two months to the day after Serville’s birthday.
The first anniversary of Serville’s birth is a particularly joyous occasion for community health worker Kimberly Phinnessee.
“Seeing that baby make it to his first birthday is incredibly rewarding,” Phinnessee said.
Phinnessee is a frequent visitor of Parker’s yellow house on Western Avenue. She greets the children like an old family friend and wishes the baby a happy birthday, lamenting that she forgot to bring him a birthday present.
This is the role of community health workers – meeting their clients on the same level, bridging the gap between their communities and healthcare services. Phinnessee has been a community healthy worker for 18 years, and honed her ability to translate medical jargon into a perspective relatable to her clients.
“We’re connected to the community -- be it through church, living in the community or just going to the same grocery store,” Phinnessee said. “We’ve been in doctor’s appointments and delivery rooms, it’s not as intimidating when you’re not alone.”
Serville’s first birthday has a second meaning for Phinnessee. It means he has escaped becoming a statistic in Richland County’s infant mortality rate, defined as the death of a live-born baby before his or her first birthday.
Between the years 2005 and 2015, there were 14,877 live births in Richland County and 108 deaths, according to the Ohio Department of Health. This equals an infant mortality rate of 7.3 infant deaths per 1,000 infants born.
Rate is calculated as the number of babies who died during the first year of life per 1,000 live births. A 10-year aggregation is used due to Richland County's low annual birth numbers rendering a yearly infant mortality rate statistically invalid.
As a community health worker for Third Street Family Health Services, Phinnessee’s main goal is to see the number of infant deaths decrease in Richland County.
“I work with women here in Richland County, helping link them up to resources and services in the community to eliminate barriers that may cause them to have a preterm delivery,” Phinnessee explained.
According to Child Fatality Reviews in Ohio, 46.6 percent of infant deaths in 2013 were due to premature and pre-term births, 15 percent of infant deaths were due to sleep-related causes including SUID, asphyxia or other undetermined causes, and 13.8 percent of deaths were due to serious birth defects.
The numbers hold true in the preliminary Ohio Child Fatality Review data for 2016 in Richland County. There were 12 infant deaths in 2016 for an infant mortality rate of 10.4; five deaths were due to premature birth, four due to congenital birth defects, two due to unsafe sleep environments, and one undetermined cause.
Phinnessee’s job is to reduce barriers that may cause preterm delivery, the most common cause of infant mortality – barriers that may include employment, education, smoking cessation, food security or housing. All of which can be significant sources of stress in a woman’s life.
“Stress weighs really, really heavy on a pregnant woman,” Phinnessee said. “It can also cause preterm delivery because if she’s stressed out, then the baby becomes stressed, and it’s a snowball effect.”
With three kids at home and one on the way, Parker is no stranger to stress.
“I’m always at home with my kids, I am a 24-7 mother,” Parker said. “Sometimes I need a little relief, and I don’t get that all the time. I have to be a mom, a doctor, a teacher, the cook, the maid … everything.
“My fiancé works to make us stable around here, so it’s not like we’re needing for anything,” she continued. “It’s just … as far as me in my personal time and my personal feelings, it’s stressful.”
The youngest of six children, Parker is no stranger to raising children. When her older sister had her first child, Parker was 13 years old.
“I was with her daughter all the time, it was like she was my child,” Parker said. “I feel like I’ve been a mother for 20 years.”
On a normal day, Parker is up at the crack of dawn and on her feet most of the day taking care of her children while tending to herself and her pregnancy. This most recent baby was a surprise – she discovered she was 28 weeks pregnant while at the doctor’s office to discuss going on birth control.
“Serville was a surprise, but it was like OK, we got this,” Parker said. “And then it’s like … just another one right after. Now what are we doing.”
That’s where Phinnessee comes in. By using the Community HUB Pathways Model created by Drs. Mark and Sarah Redding, co-founders of the Community Health Access Project (CHAP), Phinnessee is able to help Parker and other clients by reducing their risk factors that may lead to a poor birth outcome.
Once identified, community health workers address these risk factors with appropriate pathways connecting an individual to primary care, prevention programs, mental and behavioral health facilities, housing, food, clothing, and adult education and employment.
“We talk about (Serville’s) development and me being pregnant, and she helps me keep up with my appointments and different things, like quitting smoking,” Parker said. “I have trouble asking people for different things so (Phinnessee) is a good source to help me as far as my emotions, or if I need anything.”
Reducing stress is a huge part of a community health worker’s mission, according to Phinnessee.
“Knowing you might wake up and your lights are going to be turned off … or you’re about to be evicted so where are you and your children going to sleep tomorrow?” Phinnessee said. “That’s why we focus on eliminating stress, if we can take away one thing you’re worrying about that may help you have a healthy baby.”