Improving the Odds
More Information
Infant mortality rate is 13.9 deaths per 1,000 live births for Hamilton County versus 8.3 for Ohio and 6.8 for the nation.
Neonatologist Edward Donovan has been addressing issues surrounding the community’s high infant mortality rates for more than 30 years. His latest endeavor is to lead a community-wide effort to cut the rate in half by 2013.
Cincinnati Children’s is leading a community-wide effort to reduce infant mortality.
For nearly three decades, Edward Donovan, MD, has cared for our community’s most vulnerable citizens—infants born too early, often to moms not ready for motherhood.
There are far too many such babies in our community, and they don’t fare well. The infant mortality rate in Hamilton County is nearly twice that of the rest of the country.
And despite community-wide efforts to improve the numbers, Donovan says, “It’s getting worse because premature births are on the rise, and most of the infant deaths are premature babies.”
Fixing What's Broken
A neonatologist and medical director of the Child Policy Research Center at Cincinnati Children’s, Donovan is part of a Cincinnati Children’s team working on a structured, community-wide effort to change this sad reality.
The effort began several years ago when local health care and community leaders decided they’d had enough. In 2007, they held an Infant Mortality Summit where they came together to work on fixing the problem.
At the time of the Summit, infant mortality in Hamilton County and Greater Cincinnati was nearly 14 percent—strikingly higher than in comparable metropolitan areas and the US overall.
Summit leaders set the ambitious goal of reducing the county death rate to below the national average by 2013. They developed an action plan that included creating an infant mortality board, with members appointed by Hamilton County commissioners and Cincinnati City Council. Cincinnati Children’s is represented on the board by Donovan and Arnold Strauss, MD, director of the Cincinnati Children’s Research Foundation and Chairman of the Department of Pediatrics.
One of the board’s first tasks was an inventory of all providers in the community who were working on the infant mortality problem; they found 52. Next is determining how the public funding allocated to the problem, which Donovan says is substantial, can be used most effectively.
He believes Cincinnati Children’s can help in this process by applying quality improvement methods that have worked well within the hospital. “The community needs to be getting more for its investment,” Donovan says. “How do we improve services with the money we have?”
One large scale improvement, he believes, would be getting services to the socially isolated young mothers who don’t ask for help. “When it comes to infant mortality,” he says, “those affected are those who are disconnected from the system.”
Donovan sees evidence of this in his role with Fetal Infant Mortality Review (FIMR), a Health Department effort that grew out of the 2007 Summit. Each month, FIMR reviews every infant death in the city. Too often, Donovan says, they find that the deaths could have been prevented. “These are problems that could be prevented by giving poor and socially isolated young mothers access to services.”
Despite the enormous hurdles, Donovan says he is encouraged by the community-wide effort being applied to the problem and pleased that Cincinnati Children’s plays a key role. He also believes the 2013 goal is achievable.
“I am a believer in setting ambitious goals, and I truly believe we can make it because the problems we’re finding with FIMR are fixable.”
