James M Anderson Center for Health Systems Excellence
Infant Mortality

Preventing Infant Mortality

Infant mortality rates in Cincinnati and Hamilton County are almost double those of the rest of the nation. On average, one baby dies every three days.  Though the reasons  are unclear, at Cincinnati Children’s we believe that the key to improving these outcomes lies in the intersection of health services and the improvement of social conditions for high-risk pregnant women.    

We are working to improve birth outcomes in Hamilton County.The medical center has made the reduction of infant mortality a strategic priority, and together with our community partners, we are committed to improving birth outcomes across the county.     

Infant mortality, the death of an infant before his or her first birthday, is a fundamental marker of community health and well-being.  Poor birth outcomes, including premature birth, which is the leading cause of infant death, are costly.  Millions of public and private dollars fund preconception and prenatal care, mother and infant hospitalization and social services. Scores of agencies and providers participate in the care of women and infants in our community in a less than coordinated way. 

Infant mortality:

  • Is only one indicator of child health. There are about 4,000 high-risk births a year in Hamilton County; more than 200 children have lifelong handicaps and 1,000 have prolonged, high-cost hospitalizations. 
  • Is a health system indicator because it reflects on the health of women and men of child-bearing age (preconception care) and the health of pregnant women (prenatal health) and children (newborn and infant care). 
  • Shows marked racial, demographic and geographic disparities. In particular, African Americans are disproportionately affected by high infant mortality, and in Ohio, a black infant is 2.5 times more likely to die in the first year of life compared to a white infant. 

The medical center’s goal for 2015 is to reduce infant mortality by 30 percent, focusing initially on births in one high-risk geographic population within Hamilton County. Price Hill is a community with an elevated rate of prematurity − the leading cause of infant mortality in Hamilton County. We will begin to develop effective interventions that can be replicated throughout the county. Strategies for reaching our goal will include improving access to early prenatal care and implementation of a bundle of care that addresses the social determinants of preterm birth (smoking cessation, nutrition, stress reduction). 

Community Leadership and Partners

Social and health factors impact healthy birth outcomes and infant vitality. Though doctors and hospitals have an important role, social agencies that provide insurance, food and formula, shelter, in-home nursing care, smoking programs and early childhood development information have an equally significant and continuous impact on the survival of infants in their first year of life. 

Our Leadership

  • James Greenberg, MD, codirector of the Perinatal Institute, Cincinnati Children’s
  • Elizabeth Kelly, MD, director of Maternal and Infant Health, Cincinnati Health Department
  • Neera Goyal, MD, Perinatal Institute, Cincinnati Children’s
  • Heather Grooms, Anderson Center for Health Systems Excellence, Cincinnati Children’s 

Key Partners

The Office of  Maternal and Infant Health and Infant Mortality Reduction  (OMIHIMR)
Housed at the Hamilton County Public Health Office, OMIHIMR was created to integrate the work of multiple organizations and put focus on the sizable public and private financial investments being made despite poor birth outcomes (infant mortality and preterm birth rates among the highest in Ohio and the United States).  OMIHIMR does business as Women & Infant Vitality Network (WIVN).

Fetal Infant Mortality Review (FIMR)
OMIHIMR has led to the creation of FIMR, housed in the Cincinnati Health Department.  FIMR was convened to provide insight and make recommendations based on how social, health, environmental and safety issues affect fetal and infant deaths.  FIMR has made tangible contributions to infant-mortality reduction through its mortality review activities, home interviews, annual report and connection with the Perinatal Community Action Team (PCAT).  

Perinatal Community Action Team (PCAT)
PCAT is a coalition of 20 healthcare, social service, faith-based and education organizations.  Recommendations from FIMR and a Hamilton County Public Health monthly real-time data surveillance report guide PCAT actions.  

PCAT develops and participates in the implementation of evidence-based infant mortality / prematurity reduction initiatives such as: 

  • CenteringPregnancy group prenatal care, University Hospital, Christ Hospital Prenatal Clinic, Healthy Beginnings
  • Early Access (Enhanced Care) Project, Cincinnati Health Department Health Centers 
  • Oyler Neighborhood School Preconception Pathway Project
  • Preconception Peer Education Program with local colleges and universities
  • Head Start “Experience of Care” qualitative research project
  • Safe Sleep Awareness promotion campaign
  • Public awareness and community engagement presentations and discussion groups
  • Messaging campaigns including an infant mortality awareness video
  • Targeted neighborhood improvement initiatives (under development)

Infant Mortality Rates

Numbers are for Hamilton County, Ohio, in 2010.


   Infant deaths per 1,000 live births to black mothers


   Infant deaths per 1,000 live births to white mothers