Infant Mortality Rose in 2024 — But Progress is Possible and It’s Happening

In 2023, we celebrated a major milestone: Hamilton County had achieved its lowest infant mortality rate on record of 5.5 deaths per 1,000 live births and our first-ever single digit Black infant mortality rate of 9.0. But in 2024, Hamilton County’s infant mortality rate rose to 6.8. Today, we released a new report detailing 2024 maternal and infant health outcomes across Hamilton County.

“Any increase in infant mortality is deeply devastating to families and our community. These numbers represent real lives: babies who will never have the opportunity to live, grow and thrive,” said Dr. Meredith Smith, Cradle Cincinnati Executive Director. “But this year’s data does not take away from the steady improvements that have been made. Progress is possible, and it’s happening.”

Black Infant Mortality Rate Increased to Its Highest Rate in the Past Five Years

Hamilton County’s Black infant mortality rate rose to 13.7 in 2024, following a historic low of 9.0 in 2023. The increase was primarily driven by deaths due to extreme preterm birth. As a result, Black families were 3.5 times more likely to experience an infant loss than white families. This local pattern reflects a national trend, where Black infant mortality continues to outpace other racial and ethnic groups 

While Black infant mortality increased last year, for the past 11 years overall, infant mortality has decreased among the Black community.

“Partners and community members in Hamilton County have made a commitment to reducing Black infant mortality by centering Black women’s experiences and voices. And in the past five years, the disparity in Black and white infant deaths has narrowed twice,” said Dominique Walker, Cradle Cincinnati Data Manager. “When Hamilton County comes together, we’ve seen what can happen — and we can do it again.”

Rates for other races and ethnicities can be found in the full report.

Deaths Due to Preterm Birth Continue to Be a Leading Cause of Infant Death

Extreme preterm birth, defined as a baby born before 28 weeks gestation, is the leading cause of preterm birth-related infant death. Deaths due to preterm birth increased from 22 in 2023 to 34 in 2024. 

“The vast majority of infants who die in Hamilton County do so before their mother reaches her third trimester. What this tells us is that delivering interventions in the 3rd trimester is too late,” said Dr. James Greenberg, Cradle Cincinnati Co-Founder. “To have the best possible outcome, support needs to reach women early in pregnancy — in the first trimester — including access to prenatal care, smoking cessation services and social support.”

Deaths Due to Birth Defects Consistent with National Average

Deaths due to birth defects in Hamilton County remain consistent with national averages and show no racial disparities. Congenital heart defects are the leading cause of birth defect-related deaths over the past year.

Sleep-Related Infant Deaths Remain a Major Concern and Stubborn Problem

In 2024, Hamilton County lost 15 infants to sleep-related infant deaths before their first birthdays. The leading contributor was adults sharing a bed with infants and rolling onto them during sleep.

Of additional concern: four sleep-related infant deaths last year involved the improper use of a nursing pillow during sleep. For comparison, ten deaths involving nursing pillows were reported in the previous ten years in Hamilton County combined.

Babies are safest when they sleep alone, on their backs and in their own safety-approved sleep space, such as cribs, portable cribs or bassinets. Unsafe sleep environments, including sharing a bed, sleeping on a couch, using blankets or pillows in a crib, or placing an infant on their stomach or side, increase the risk of sleep-related infant death.

“Educating families on safe sleep recommendations is the first step in preventing sleep-related infant deaths. But families have also told us that they need real, tangible support to help combat the exhaustion and stress that comes with parenting,” said Dr. Elizabeth Kelly, Cradle Cincinnati Co-Founder. “Our community should continue to invest in community health workers, doulas and mental health therapy services if we seek to eliminate all sleep-related infant deaths.”

2024 Hamilton County maternal and infant health data is available to view at www.cradlecincinnati.org/the-issues.

State of Hamilton County Maternal and Infant Health Webinar

On Thursday, July 31 at 10am, Cradle Cincinnati will host a community webinar, diving into the data shared in the report. Learn more about local trends in preterm birth, safe sleep and factors impacting maternal and infant health outcomes — and have your questions answered by members of the Cradle Cincinnati team. Register to join us at https://bit.ly/cincymih24.