Amid Ohio’s high infant-mortality rate, a report released the Health Policy Institute of Ohio urges leaders to look beyond medical care for preventative approaches.

The report issued last week suggests the focus should be on improving social and economic conditions such as employment opportunities, housing, transportation, and education.

Researchers explain by improving these areas Ohio could see a jump in progress as it relates to trying to reduce the number of infants dying before their first birthday.

127 policy recommendations are included in the 233-page study that is broken down into 11 categories.

The area of background and purpose highlights Senate Bill 332, where many recommendations proposed in a report published by the Ohio Commission on Infant Mortality. The components of SB 332 included a study that does the following:

• Reviews state policies and programs that impact the social determinants of health for infants and women of child-bearing age.
• Identifies opportunities to improve programs and policies.
• Studies the impact of using a state-funded rental assistance program targeted at infant mortality reduction.
• Evaluates the best practices other states have implemented to improve the social determinants of health for infants and women of child-bearing age.

This area also highlights the social determinants of health where researchers looked beyond medical care to explore factors in the social, economic and physical environment that affect infant mortality. They estimated that of the modifiable factors that impact overall health, only 20 percent are attributed to clinical actors (i.e. access to high-quality medical care). The remaining 80 percent is attributed to non-clinical factors, including an individual’s social and economic environment (40 percent), health-related behaviors (30 percent) and physical environment (10 percent).

The study goes on to examine infant mortality, which is the death of a live-born baby before his or her first birthday, overall. The study focuses on the scope of the problem in Ohio including disparities and trends, ethnicity and the leading/direct causes of informant mortality which include:

• Prematurity-related (e.g., related to birth before 37 weeks, low birth weight, respiratory distress, and neonatal hemorrhage).
• Congenital anomalies/birth defects.
• Sudden Infant Death Syndrome (SIDS).
• Maternal conditions (e.g. premature rupture of membranes, placental separation).
• Lack of oxygen to the fetus/infant during delivery.
• Maternal/infant infections.
• Other infections.
• Accident/injury
• Other causes.

Researchers go on to consider social determinants of health through the health equity overview that discusses the following key concepts:

• Social-ecological framework.
• Life-course perspective.
• Health inequities, disparities, and equity.
• Toxic and persistent stress, trauma and violence.

In an area of the study, researchers consider housing as a possible cause noting affordability, residential segregation, stability, neighborhood conditions, and quality.

Transportation is also a considered factor contributing to infant mortality where researchers focused on access and connectivity, active transportation and traffic safety and air quality.

Education was also looked at closely as a possible contributing factor where areas were dissected including income and employment, literacy and health literacy, and social capital and social support.

As for employment, researchers considered this area as a contributor by analyzing income; working conditions; work-related conditions such as work-related stress, and physical demands of work; and workplace policies and employment benefits.

The study then goes on to compare conditions and elements in Ohio as they compare to other states as well as the variety of infant mortality-related policy across the country.

Overall the researchers concluded the state should focus more on improving community conditions such as:

• Providing families with acceptable, stable housing and salaries.
• Work on connecting low-income families to jobs, post-secondary education, social capital, and transportation.
• Prevent violence, support marriage and consider the expansion of early childhood programs that will work to decrease education disparities.
• Address racism, discrimination, violence and stress.
• Pursue fundamental changes to housing, education, employment, and transportation while also focusing on immediate needs such as homelessness.

The full report can be found here.