How Much Do You Know About Infant Mortality?
Four questions. Two minutes. The answers may surprise you.
Black infants in Hamilton County were how many times more likely to die than white infants in 2025?
- About 2 times more likely — The gap is far wider. Black infants were more than 5 times as likely to die as white infants in 2025 — a disparity health leaders call extraordinary.
- About 3 times more likely — Still an underestimate. Black infants were more than 5 times as likely to die as white infants — a gap researchers say is unprecedented in Hamilton County.
- More than 5 times more likely — Correct — and the disparity in sleep-related deaths is even starker: the rate for Black infants was 18 times higher than for white infants.
- About the same as white infants — Unfortunately, the gap is enormous. Black infants were more than 5 times as likely to die, and the racial disparity in sleep-related deaths is 18 to 1.
What is the leading cause of infant death in Hamilton County?
- Sleep-related causes — Sleep-related deaths are the fastest-growing cause — now at their highest level since 2011 — but preterm birth still accounts for the most deaths overall at 46%.
- Preterm birth — Correct. Preterm birth is linked to 46% of infant deaths in Hamilton County. Sleep-related causes account for 24% but are rising sharply.
- Infection or illness — The leading causes are preterm birth (46%) and sleep-related deaths (24%), which are both preventable with the right support and resources.
- Birth defects — Preterm birth leads at 46%, followed by sleep-related causes at 24%. Both are areas where community intervention can save lives.
Of 22 sleep-related infant deaths in 2025, how many involved a Black infant?
- About half — roughly 11 — The disparity is far more severe. Of 22 sleep-related deaths, 19 — nearly all — involved a Black infant, revealing a profound racial inequity.
- Around 15 — Even higher. Of 22 sleep-related deaths in 2025, 19 were Black infants. The rate of sleep-related deaths among Black babies was 18 times higher than among white babies.
- 19 out of 22 — Correct. 19 of 22 sleep-related infant deaths involved a Black baby. Every single sleep-related death in 2025 occurred during co-sleeping, which experts consider unsafe.
- All 22 — 19 of 22 sleep-related deaths involved Black infants. All 22 occurred during co-sleeping — a practice experts warn is dangerous for newborns.
What do safe sleep guidelines say babies need?
- A soft surface with a blanket for warmth — This is actually unsafe. Babies should sleep on a firm, flat surface — no blankets, no stuffed animals. Soft surfaces increase the risk of suffocation.
- Alone, on their back, in a crib with a firm mattress — Correct. The ABCs of safe sleep: Alone, on their Back, in a Crib. No blankets, pillows, or stuffed animals. Every Hamilton County sleep-related death in 2025 violated these guidelines.
- Next to a parent for monitoring overnight — Co-sleeping is the most dangerous practice for newborns. In 2025, all 22 sleep-related infant deaths occurred during co-sleeping, and 73% involved sleeping next to another person.
- In a car seat for extra support — Car seats are for travel only. For sleep, babies need a firm, flat crib or bassinet — alone, on their back, with no loose items. This is what experts call the safe sleep environment.
These numbers are not just numbers. These are real families losing their babies. We refuse to allow even one baby to die.Meredith Smith, Executive Director, Cradle Cincinnati
In 2023, Hamilton County had something to celebrate. Infant mortality rates had dropped to match the national average — a rare milestone for a major urban county with persistent racial health disparities. Cradle Cincinnati, the local nonprofit leading the charge, called it a sign that targeted community intervention actually works.
That progress collapsed in 2025. A new Cradle Cincinnati report released this week shows 89 infants died in Hamilton County last year, pushing the overall infant mortality rate to 9.3 per 1,000 live births. The Black infant mortality rate hit 21 per 1,000 — nearly double the national average of 10.93 for Black infants.
Hamilton County vs. National Averages
| Hamilton Co. 2025 | National Avg. | Hamilton Co. 2023 | |
|---|---|---|---|
| Overall Infant Mortality Rate | 9.3 / 1,000 | ~5.6 / 1,000 | ~5.5 / 1,000 |
| Black Infant Mortality Rate | 21 / 1,000 | 10.93 / 1,000 | ~10.5 / 1,000 |
| Sleep-Related Infant Deaths | 22 | — | 15 |
| Black vs. White Sleep Death Rate | 18x higher | — | Near equal |
| % Deaths Linked to Preterm Birth | 46% | ~35% | ~40% |
| % Deaths Sleep-Related | 24% | ~20% | ~17% |
What's confounding researchers is the speed of the shift — particularly around sleep-related deaths. Cradle Cincinnati co-founder Dr. James Greenberg said that for the first five years of the organization's work, the Black-white disparity in sleep-related deaths was almost nonexistent. Now it's at its highest point since 2011, and the cause isn't fully understood.
All 22 sleep-related infant deaths in 2025 occurred during co-sleeping. In 73% of those cases, the infant was sleeping next to another person. In 55% of cases, the baby was in an adult bed.
Sleep-Related Deaths: What the Data Shows
- 22 — Total Sleep Deaths in 2025
- 19 — Were Black Infants
- 73% — Co-sleeping Next to a Person
- 55% — In an Adult Bed
I was in the hospital, alone, giving birth, and then walking away without my babies. Afterward, no one really follows up with you. It's lonely. And it's a loss that often goes unacknowledged.India Brown, Poem Perinatal Outreach & Mama Certified board member
India Brown knows this crisis from multiple angles. She works with Poem Perinatal Outreach, connecting pregnant and postpartum mothers — many of them Black — with mental health resources. She also sits on the board of Mama Certified, an initiative that grew out of Cradle Cincinnati to address Black maternal and infant mortality.
Brown also carries her own grief: a miscarriage of twins at 17 weeks. She described giving birth alone in a hospital, then leaving without her babies — and receiving almost no follow-up care. She said that invisible loss is something many women experience but few talk about openly.
'Everything becomes about the baby,' Brown said. 'That makes it hard to really serve the baby — because mom and her ecosystem is just as important to baby surviving.'
What's True, What's Misunderstood
Hamilton County had one of the best infant mortality rates in Ohio just two years ago.
Verdict: true
In 2023, Hamilton County's infant mortality rate matched the national average — a milestone health officials celebrated as proof that targeted community programs work. That progress has since reversed sharply.
The Black-white gap in sleep-related infant deaths has always been this wide.
Verdict: false
Dr. James Greenberg of Cradle Cincinnati says for the first five years of their work, there was almost no racial disparity in sleep-related deaths. The current gap — 18 times higher for Black infants — is unprecedented and unexplained.
Safe sleep guidelines recommend that babies sleep in their parents' bed for monitoring.
Verdict: false
Every sleep-related infant death in Hamilton County in 2025 occurred during co-sleeping. Experts recommend babies sleep alone, on their backs, in a crib or bassinet with a firm mattress — no blankets, pillows, or stuffed animals.
Most Black births in Hamilton County happen at just two hospitals.
Verdict: true
UC Medical Center and Good Samaritan Hospital together account for about 80% of births to Black women in Hamilton County. Cradle Cincinnati is targeting both facilities with embedded community health advocates.
Hamilton County: Then vs. Now
2023 — A Milestone
- ~5.5 Deaths per 1,000 Matched national average
- 15 Sleep-Related Deaths Lowest in recent years
- Near-zero Black-white gap in sleep deaths
- Celebrated as a public health success
2025 — A Crisis
- 9.3 Deaths per 1,000 Well above national average
- 22 Sleep-Related Deaths Highest since 2011
- 18x higher sleep death rate for Black infants
- Officials call it 'extraordinary and unacceptable'
Safe Sleep: What Every Parent and Caregiver Should Know
- Alone — Always — Babies should sleep in their own space — not in an adult bed, not on a couch. Co-sleeping next to an adult or child was a factor in 73% of Hamilton County's sleep-related infant deaths in 2025.
- Back — Every Time — Always place a baby on their back for sleep. This reduces the risk of suffocation and sudden infant death syndrome (SIDS). Side or stomach sleeping is not safe for newborns.
- Crib — Firm and Flat — Use a crib, bassinet, or portable play yard with a firm, flat mattress. No pillows, no blankets, no bumper pads, no stuffed animals. Soft surfaces and loose items are dangerous.
- If You Need a Safe Sleep Surface, Ask — Cradle Cincinnati's Cribs for Kids program distributes free, safe sleep surfaces to families who need them. No one should have to co-sleep because they can't afford a crib.
- Support Mom, Too — Maternal mental health directly affects infant outcomes. If you know a new or pregnant mother — especially a Black mother — check in beyond the standard 6-week appointment. Loneliness and unaddressed trauma are part of this crisis.
What Cradle Cincinnati Is Doing to Reverse the Trend
Cradle Cincinnati and its community partners have launched several targeted initiatives to address the surge in infant mortality — particularly among Black families.
Queens Village Corner embeds community health advocates directly inside maternity care settings at UC Medical Center. The program is expanding to Good Samaritan Hospital — the two facilities where approximately 80% of Black women in Hamilton County give birth.
The Cribs for Kids program distributes safe sleep surfaces at no cost to families who need them. Officials believe lack of access to safe cribs or bassinets may be contributing to co-sleeping deaths.
Postpartum doulas, mental health workers, and community health workers are being deployed in high-risk neighborhoods to support mothers after birth — a gap that advocates like India Brown say is often left unfilled by traditional health care.
Mama Certified, an initiative born from Cradle Cincinnati, works specifically to combat Black maternal and infant mortality by increasing visibility of mothers' needs in the care process — not just the infant's.
Resources for Hamilton County Families
- Get a Free Safe Sleep Surface: Cribs for Kids provides free cribs and bassinets to families in need across Hamilton County. No family should have to choose between co-sleeping and nothing.
- Perinatal Mental Health Support: Poem Perinatal Outreach connects pregnant and postpartum mothers — especially Black moms — with mental health resources and community support.
- Safe Sleep Guidelines: Alone. On their back. In a crib with a firm mattress. No blankets, pillows, or stuffed animals. Every time, every nap, every night.
- Queens Village Corner: Community advocates are embedded at UC Medical Center and expanding to Good Samaritan Hospital — serving the 80% of Hamilton County's Black births that happen at those two facilities.