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Exploradio brings you captivating stories about science worth discovering and examines powerful questions worth answering.

First Year Cleveland Targets the Racial Disparities Behind Infant Mortality

JEFF ST.CLAIR
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WKSU

Northeast Ohio has some of the best medical care available in the U.S., but parts of Cleveland also have some of the nation’s highest rates of infant mortality.

First Year Cleveland is a new effort to reverse those trends.

In this week’s Exploradio, WKSU’s Jeff St.Clair looks at how race factors into infant mortality and what’s being done to change it.

Dr. Jennifer Bailit is head of obstetrics at MetroHealth hospitals in Cleveland.

She’s seen the impact of infant mortality first hand…“It’s hard not to have your heart moved when you see folks and you’re intimately involved in their lives when they lose a baby.”

She says the statistics in Cleveland are alarming.

“And you realize it’s not just your individual patient who’s being devastated, it’s all over the city and we’ve got some of the highest rates in the country, and in some neighborhoods comparable to some third world countries.”

Credit MOM LOVES / CC FLICKR
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CC FLICKR
While infant mortality rates for white babies has dropped significantly since the 1970's, the rate for black babies remains three times the national average. Researchers are narrowing in on structural racism as one its root causes.

Infant mortality is never easy to talk about.  But Bailit is part of an effort to bring public awareness to the issue and find solutions.  It’s called First Year Cleveland.

Bernadette Kerrigan is director of the group, now in its second year.  She had assumptions about the causes of infant mortality coming into the job.

“I thought this was going to be heavily drug and alcohol abuse, heavily homeless, heavily poverty-related, it has some elements of that, but that is not the primary thing that’s going on here.”

She says the data is pointing in a different direction. 

What's Race Got to Do With It?
Cuyahoga County black babies are three times more likely on average to die before their first birthday than white babies. In some neighborhoods it’s six times the national rate.  Kerrigan says it’s impossible to ignore the racial component of infant mortality.

“Our learning hypothesis is it could be stress of being an African-American in this country,” and the sources of stress, she believes, include racial disparities built into the system.

Part of First Year Cleveland’s mission is to erase decades of disparities that contribute to unacceptably high infant mortality rates among African-Americans.

“Babies should not be dying because of race,” says Kerrigan.

She and her backers are not mincing words.

“We are pretty clear here, we are moving on this issue and we’re holding ourselves accountable to move on this issue.”

First Year Cleveland has launched a three-year plan that begins with trying to better understand the stressors that affect black women.

Helping Stressed Moms
Kendra Harris is a mother of four.  She lives just a few blocks from the Cleveland Clinic.

For her, just crossing the street with her six year-old, two year-old, one year-old and infant takes courage.

“When we’re walking there’s always a group of people who wants to fight and wants to shoot, and it’s kind of hard to pay attention when you have four kids."  

Credit JEFF ST.CLAIR / WKSU
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WKSU
Bernadette Kerrigan is executive director of First Year Cleveland. The group's mission is to create a unified strategy to reduce infant deaths and racial disparities in Cleveland.

Harris says her newborn came at a particularly tough time, but she was introduced to a support group that’s having a positive impact in neighborhoods like hers.

Christin Farmer is founder of Birthing Beautiful Communities.

Farmer is a doula, or birth coach, who with her team, supports women in all aspects of the birthing process, from nutrition and prenatal care, to providing a safe place to meet and socialize with other moms.

Women gather in ‘Sister Circles’ where Farmer says, they can unpack the undercurrent of stress that surrounds them.

“Women learn how to identify the symptoms of depression, and anxiety, and panic, and fear, " says Farmer, "and there’s so many women who come to the circle and they say that, ‘Wow, that’s what I’ve been experiencing. I have felt that way, but I didn’t know what to call it.’”

Farmer is working with Kent State University researcher Angela Neal-Barnettto develop a program that trains doulas not only to help with the physical care of birthing mothers, but also their emotional states including levels of stress hormones.

“When we look at the cortisol levels, the level of stress in black women, it tends to be at this toxic level.”

Researchers are not entirely clear how the stress hormone cortisol affects childbirth, or how structural racism in education, housing, employment, and incarceration rates contribute to that stress.

Looking deeper into those questions is part of First Year Cleveland's goals.

Owning the Issue
Neal-Barnett says Birthing Beautiful Communities is providing a model for how to turn around a decades’ old problem.

Credit JEFF ST.CLAIR / WKSU
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WKSU
Part of the team at Birthing Beautiful Communities includes, From left to right, Rod'Neyka Jones, Myranda Majid, founder Christin Farmer, Khalilah Williams, client Kendra Harris, and Verna Darby.

“If we are going to reduce the infant mortality rate among black women, it has to come from the black community itself.”

Birthing Beautiful Communities’ Christin Farmer says it took courage for First Year Cleveland to put race and racism at the forefront of its plan to combat infant mortality.

“It’s a very difficult conversation for people to have, and even for people to acknowledge because it’s a monster of an issue," says Farmer.

But she says that conversation has to begin somewhere, and everyone can agree that babies should not bear the brunt of a problem that America as a whole struggles to confront.

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Jeff St. Clair is the midday host for Ideastream Public Media.