Analyzing Decades of Disparities in Ohio’s Maternal and Infant Deaths

Why does Ohio have one of the highest Black infant mortality rates in the United States? To answer this question, this study analyzes the history of infant mortality rates as a measure of living conditions. Vital statistics, census data, historical narratives, published studies, and the ecosocial theory explain how social and structural racism has disadvantaged Ohio’s Black population. From the 1900s to the 21st century, causes of deaths have changed and rates have improved; nevertheless, 2 and 3 times more Black mothers and infants have died, and this disparity persists not only in Ohio but in other midwestern states. Racism manifested in stress, restricted home ownership, vulnerable neighborhoods, and poverty cause premature aging or weathering in the African American population. Before Ohio’s downturn in prosperity during the Rust Belt era beginning in 1970, Ohio had one of the best infant mortality rates in the nation. By the 21st century, Ohio’s governors, legislators, civic leaders, and health care systems vowed to correct the high African American maternal and infant mortality rates, calling it a public health crisis. In 2024, Ohio had a record low infant mortality rate of 6.5/1000 live births, and both Cradle Cincinnati in Hamilton County and CelebrateOne in Franklin County reported their Black infant mortality had reached a historic low.