Established in 2007, the Cleveland Office of Minority Health is committed to reducing health disparities among communities of color in Cleveland. As the infant mortality rates continued to rise in Cleveland, particularly among African American and Latino women, Frances Mills, Director of Community Health Initiatives for the Cleveland Department of Public Health and Director of the minority health office, knew that she had to get involved; not as an administrator but as a resident and health advocate.
Between 2014 and 2016, the infant mortality rate in the city was 12. 98 per 1,000 live births; more than double the Healthy People goal of 6.0. In some parts of the city the IM rate rose as high as 24 deaths for every 1,000 live births. The Lee Harvard neighborhood was one such community. As local health departments began to mobilize and First Year Cleveland was being formed, the local office began to partner with statewide and county coalitions poised to educate the community about infant mortality.
Mills joined the 44128 One Community group in 2017. It began as a group of interested men and women who lived, worked or worshipped in 44128. The group represents a wide range of interests, skills and gifts to lend to the effort. It includes representatives from public health, academia, faith based, leadership development and other non-profit organizations as well as community health workers representing infant and maternal child health home visitation programs. Efforts of the team were funded by the Ohio Department of Health’s Ohio Equity Institute in collaboration with City MatCH, a national group devoted to improving maternal and child health outcomes.
What Mills liked about the group was that everyone was committed to the values of “restoration and support”. Group members rallied around the idea of restoring the village and working to create a more supportive community for families in 44128. There has been as much learning as there has been working with this effort.
A great deal of care was taken to insure that group members got to know each other as we learned more about the community and the challenges that come with bringing healthy lives into the world. We discovered that it is more complicated as it seems. As we began to study the local data, we learned as much as we could about where the highest level of mortality was occurring. We discovered that most of the infant deaths in 44128 occurred in a few census tracts within the community. Lack of awareness about the issue was a huge challenge even among some group members. Prior to her appointment in the Office of Minority Health, Mills worked for a short period with the MomsFirst Program as a Community Engagement Specialist. During her tenure there, she learned that residents had little idea of the great disparities occurring right in their neighborhoods. Churches were of special concern. Due to their capacity to engage and involve, she knew they would be key to contributing to the success of any health awareness and education initiative. The One Community felt the same way. Facilitators of the group made a concerted effort to identify and engage churches in 44128 offering funding opportunities to create breastfeeding zones in their churches. Mills felt that infant mortality was so much more than access to care and poverty and that structural racism worked to create a level of stress in women, families and communities that had a negative impact on birth outcomes. She believed that a multisector, multi strategy approach would be necessary to begin to address infant mortality in Cleveland. That is exactly what she found with the One Life Community Group.
In addition to capacity building and agenda setting, the group reached out to local policy makers to raise awareness and seek assistance. They convened town hall meetings and conducted neighborhood canvasses. Support for those efforts extended well beyond the groups’ membership and included local fraternities and other volunteers. The group was also instrumental in advocating for job preparation and placement for 44128 residents in the Amazon fulfillment center. One of the big issues that remained for the group was the absence of labor and delivery services in the 44128 area and the need for labor and delivery support in local emergency rooms. The group received great news this past March that University Hospitals is planning an expansion of its Ahuja Center that will include labor and delivery services as well as a neonatal intensive care unit. Mission accomplished? Not likely. University Hospital will begin construction on the expansion project in the fall of 2019. Services will not be available to the community until 2022. In the meantime, One Life will continue, planning, serving, educating and advocating- one corner of the community at a time. And Mills will continue to leverage partnerships to strengthen the effort. Most of all, we know that she will be a consistent and visible force in the effort to reduce infant mortality in Cleveland.