Despite slow gains, Cradle Cincinnati continues to drill down on ways to decrease infant mortality
UPDATE: Cradle Cincinnati, Hamilton County Public Health and the Cincinnati Health Department announced at a news conference May 12, “After hitting an all-time low, the infant mortality rate for Black infants has more than doubled over the past two years. Data shows the rate went from 9 deaths per 1,000 live births in 2023 to 21 in 2025. The majority are caused by pre-term birth and unsafe sleep conditions. Seventy-three percent involved the baby sleeping next to another person and 55 percent involved the infant sleeping in an adult bed. Hamilton County’s overall infant mortality rate (all races) jumped from 5.5 deaths per 1,000 live births in 2023 to 9.3 in 2025. Read the report here. Doctors and community leaders will drill down on the data to discuss next steps.
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The infant mortality rate, or the death of an infant before its first birthday, continues to remain high among Black families. Efforts in Cincinnati and beyond have made some progress to lower it, including recognizing the importance of doulas and educating both healthcare providers and moms. How effective is this strategy and can more be done?
Stats and causes
Preliminary 2024 data from the National Vital Statistics System finds the infant mortality rate is 5.52 out of every 1,000 live births. Among White women the rate is 4.41 and among Black women it’s 10.98.
National statistics show the infant mortality rate did not significantly change from 2023. It increased 3 percent from 2021 to 2022 and was unchanged from 2022 to 2023.
Ohio ranks 45th in the nation for infant mortality. The 843 babies who died in preliminary 2024 data, were down slightly from 909 in 2023.
In 2023 Montgomery County was 9.8 deaths per 1,000 live births. That’s higher than both the state and national average.
In Hamilton County from October 2024 to September 2025, the infant mortality rate was 8.9. (3.35 for Whites and 20.67 for Blacks)
Sleep-related infant deaths are on the rise in Hamilton County. Twelve involved an infant sleeping in an adult bed instead of in a crib or bassinet. Eight occurred while an infant and adult shared a bed or other sleeping surface like a sofa. And four involved a nursing pillow.
The National Institutes of Health says the most common causes of infant mortality are in this order:
- Congenital anomalies
- Preterm birth
- Sudden Infant Death Syndrome (SIDS)-unexpected death, often related to unsafe sleep environments.
- Pregnancy complications
- Accidents
There are ways to reduce the infant mortality rate including better prenatal care and education on safe infant sleep practices. The ABC’s of safe sleep include:
- Alone
- on their Back
- in a Crib
While solutions and support at home are part of the needed response, Cradle’s research and collaboration with hospital systems and staff throughout the region are also part of the strategy to help move the needle on infant mortality. As Brick by Brick’s Hernz Laguerre Jr. reports in this podcast, part of the effort includes just listening to mothers more.
Stories
A 2023 KFF survey found about one in five Black women say they have been treated unfairly by a healthcare provider or staff because of their racial or ethnic background.
Cincinnati teacher Jamira Holt says her first and only pregnancy was one to remember. While in labor with twins, she says she was poked and it was painful because possibly she didn’t have enough anesthesia. She communicated that, wasn’t acknowledged and then rushed into making a series of decisions.
“Maybe just listening more instead of thinking that they know what the anesthesia is going to do, and always trust that things could be different when it comes to the human body,” says Holt.
She talked about that lack of listening in a survey with Corinn Taylor, PhD, a nurse, researcher and founder of The Empowerment Foundation. Taylor noticed early on that pregnant women, especially Black women, weren’t being listened to.
“I feel like it’s very disturbing because it ultimately affects the care the patient receives. And when someone is telling you about the situation, their story, whatever that may be, I think it’s super important for that person to be heard, because that’s how care is going to be effective, if we understand the things that patients are going through.
Taylor partnered with the United Way and other nonprofits for the study. Her report gives recommendations to health systems, helping them better understand pregnant women and their prenatal and post-partum needs. Agol Aloak was another of the three dozen women participating in the study. She had a high-paying job and felt belittled by a healthcare worker who wanted her to qualify for WIC.
According to Agol, “She goes ok, this is your money range for income and I was looking at it and asked, ‘What if you make more?’ And she gave me this really disgusted face like you don’t make more and I’m like, ‘I do. I make this much amount,’ and she’s like, ‘well you don’t even qualify,’ and then moved the paper out of my face and made me feel like you put me in this box already and you don’t know who I am.”
Agol wants to tell other mothers you don’t have to lower yourself and put yourself in a box. There are other ways to get help. In the survey she also explained she was forced to have a C-section when she didn’t think it was necessary. One study found Black women are more likely to receive a C-section compared to White women.
Women’s health is strongly tied to the infant mortality problem.
Cradle Cincinnati
With Hamilton County facing the second highest infant mortality rate in the country among counties in 2011, UC Obstetrician Gynecologist Dr. Elizabeth Kelly and others started asking, “How can we deliver social support and get those together with medical drivers and have a holistic approach to healthcare?”
She teamed with Dr. James Greenberg of Cincinnati Children’s Hospital Medical Center to form Cradle Cincinnati in 2013. Dr. Kelly continued to ask questions about pregnant moms like, “What are her stressors? What does she need to have a healthy pregnancy? What does she need to have a healthy life.”
Cradle Cincinnati then connected mothers with a care manager, a community health worker, a doula and others for housing support, transportation needs, talk of domestic violence and other stressors of everyday life. The care manager also worked with the medical team for an ultrasound or medication that the mother couldn’t access.
According to Dr. Greenberg, “There’s good evidence that if you get a mom in a setting where she feels safer, that will support a better pregnancy outcome. If you get a mom in a setting where she has more secure housing, that will lead to a better pregnancy outcome.”
Cradle Cincinnati has expanded since its inception. The organization runs a group called Queens Village which helps create community with birthing parents through meetings, gatherings and workshops, creating a network of support and even advocacy.
Executive Director Meredith Smith says, “It’s a space for Black women to gather together to do two things. One, heal from the reality of living in a Black body in the United States and so that is a live gathering and celebration and whatever they’re asking for. So, at times it’s yoga and sometimes it’s painting and sometimes it’s just, celebrating infant mortality when it’s going down and other times it’s co-creating interventions when it’s going up.”
Effectiveness
Ohio is doubling down on Cradle Cincinnati’s approach, and last year Governor Mike DeWine toured counties that would see the most immediate impact upon its rollout, including Montgomery County.
Dayton Children’s serves as the lead coordinator for the region, bringing together hospitals, families, community care providers and other stakeholders. The program is called Roots to Rise Dayton.
Dayton is doing something else, through UD it’s recruiting women for doula training, as Brick by Brick’s Emiko Moore reports in this podcast.
Cradle Cincinnati’s Dr. Greenberg says, “We’re at the point where we think we can start to spread it now,” but recognizes there is still a lot of work to be done. “If we look at the Black infant mortality rate in Hamilton County, it’s really high. And it’s as high as it was when we started. So, what’s changed actually is that the White infant mortality rate has gotten a lot better. The Black infant mortality rate, not so much.”
Other national programs
Family Connects started in Durham, North Carolina in 2008 and has been tried in communities across 20 states. NPR reported on the program in New Orleans where new moms get three visits, covered by the city’s health department. Nurses bring diaper bags filled with needed supplies. They weigh and measure the baby and check in with the mothers about their health and well-being.
Louisiana lawmakers passed a law in 2025 requiring private insurance plans to cover it.
Two years in, Tulane University research shows families who got the visits were more likely to stick with the recommended schedule of pediatric and postpartum checkups and moms and babies were also less likely to need hospitalization and overall healthcare spending was down among families insured by Medicaid.
NPR reports research in other parts of the country was similar and in North Carolina one study found it reduced E-R visits by 50 percent in the year before the baby turned one. In addition, for every $1 invested in the program, it saved $3.17 in healthcare billing before the child turned two.
Looking ahead
Cradle Cincinnati continues to look for ways to decrease the infant mortality rate among Blacks.
One pilot program showing success is a separate health navigator within Queens Village. The program is called Queens Village Corner. According to Dr. Greenberg, “In real time they (the navigator) can work with the healthcare provider to address concerns as they come up.” This is on top of help a community health worker is providing to the mother as well as a doula. Greenberg says, “The thing we found is if a provider, let’s say, was able to make a referral to a community health worker that might fall through the cracks. This is a way of making that much more seamless without any gaps that could fail.”
What do you think the best way is decrease the infant mortality rate? Cradle Cincinnati and other efforts have shown some success. But the rate among African Americans remains high. We want to build community around context and solutions in our cities. Your feedback is very important to the effort, as we continue to dig deeper into the responses to some of our most pressing social issues, including health, the environment and the housing crisis. Click on the green button below to take a short survey to help reinforce and refine our work. Thank you.
Ann Thompson – Host, Producer
Over the last thirty years in Cincinnati, Ann Thompson has brought a wealth of knowledge and expertise to her reporting. She has reported and anchored for WVXU, WKRC, WCKY, WHIO-TV and Metro Networks and freelanced for NPR, CBS and ABC Radio. Her work has been recognized by the Associated Press and she has won awards from the Association of Women in Communications and the Alliance for Women in Media. She is a former News Director and Operations Manager. Ann has reported from India, Japan, South Korea, Germany and Belgium as part of fellowships. Ann thinks of the Brick by Brick project as “journalism for good.” She serves as host and producer. Ann lives in Anderson Township with her husband Scott. They have two boys. Jake graduated from the Air Force Academy in 2022 and Kurt attends West Point.
