By Tim Bonfield
The Cincinnati Enquirer

A new program hopes to make a difference in the continuing high numbers of African-American babies dying from complications of premature birth in Hamilton County.

Meanwhile, officials are working on ways to raise public awareness of the potentially fatal risks of infants and adults sleeping in the same bed.

These are early reactions to an annual report to be released today that analyzes childhood deaths that occurred last year in Hamilton County. Findings from the report by the Child Fatality Review Team of the Hamilton County Family and Children First Council include:

• Of the 138 Hamilton County children who died in 2002, 55.8 percent were black children despite African-Americans accounting for about 23.4 percent of the county population.

• Of the 138 deaths, 55 were attributed to prematurity - by far the No.1 cause of childhood death in Hamilton County. Of those, 38 infants, or 69 percent, were African-American.

• Three deaths were traced to homicide, seven died in traffic accidents, one drowned.

• Last year, seven of 17 deaths from unintended injury were directly traced to "co-bedding," when infants are allowed to sleep with adults, where they can be suffocated by pillows and blankets or by adults rolling over on them. Co-bedding may have been a contributing factor in up to 20 deaths - up sharply from five deaths with direct or suspected links to co-bedding last year.

"That's a lot of deaths and it's something that's completely preventable," said Patricia Eber, executive director of the Family and Children First Council.

The child fatality report is distributed to more than 2,000 people in local public health departments, social service agencies, and other governmental and civic organizations, and is available upon request (call 946-4990).

Addressing racial disparity

Racial disparity in childhood deaths has been an issue here and nationwide for years. Locally, the child fatality report indicates the disparity has been getting worse for the past three years.

So now, the Family and Children First Council is using a two-year $300,000 grant from the Ohio Department of Health to try to reduce the gap. The program, coordinated by the Healthy Moms and Babes agency, plans to provide a variety of increased support services to high-risk African-American mothers.

Exactly how the program will work has yet to be decided. One of the first steps has been to launch several focus groups to ask African-American women a series of pregnancy, parenting, lifestyle and health questions.

"I still feel we don't totally understand these issues. This county is rich in resources, so it always puzzles me that we don't do better," Eber said.

Rethinking infant mortality

One thing the data already indicate is that infant mortality in Hamilton County is not closely connected to teen pregnancy. While many parents, teachers, preachers and politicians lecture children on the moral, economic and social pitfalls of teen pregnancy, infants born to teen mothers are not dying from their circumstances.

Of the 55 infants (of all races) that died last year from complications of premature birth, two infants (or 4 percent) involved mothers aged 17 or less - the lowest rate of all age groups. The highest number of deaths - 7, or 13 percent - actually involved mothers aged 22 to 25.

So why are deaths occurring among babies of older mothers? There is no easy answer, said Dr. Judith Daniels, who has worked for years as medical director of the Cincinnati Health Department.

The infant deaths could be a result of naturally declining health as women age, including the risks posed by diabetes and high blood pressure. Years of smoking, alcohol abuse or drug abuse affect some women and their babies. The growing popularity of fertility treatments - which can cause premature births from multiple-baby pregnancies - also may play a role.

"I don't know that anybody understands all the variables," Dr. Daniels said. "But any time you try to deal with something this long and nothing happens, it seems logical to go back to the drawing board."

E-mail tbonfield@enquirer.com