HAMILTON COUNTY, Ohio — After celebrating record-low infant mortality just two years ago, Hamilton County is now facing an alarming reversal.
On Tuesday, local health leaders revealed that the county’s Black infant mortality rate more than doubled in 2025.
The new data, released by nonprofit organization Cradle Cincinnati, paints a troubling picture: 89 infants died in Hamilton County last year. The infant mortality rate climbed to 9.3 deaths per 1,000 live births in 2025, up from the 2023 milestone when rates matched the national average.
The data shows 46% of infant deaths were linked to preterm births and 24% to sleep-related causes. While preterm birth remains the leading cause, preliminary findings show a sharp increase in sleep-related deaths — now the highest since 2011 — and a widening racial gap that health officials call “extraordinary” and “unacceptable.”
WATCH: New report reveals black mortality rate in Hamilton County more than doubles
Black infants were more than five times as likely to die as white infants in 2025, according to the report. Out of 22 sleep-related infant deaths, 19 were Black infants, and the rate of sleep-related deaths among Black babies was 18 times higher than that of white babies.
Overall, the Black infant mortality rate climbed to 21 deaths per 1,000 live births — far above the national average of 10.93 — while white infants saw far lower rates.
“These numbers are not just numbers. These are real families losing their babies,” Meredith Smith, executive director of Cradle Cincinnati, said. “We refuse to allow even one baby to die, and we will keep working until every child celebrates their first birthday.”
Dr. James Greenberg, co-founder of Cradle Cincinnati, said the scale of the racial shift is unprecedented.
“For the first five years of our work, there was almost no Black-white disparity in sleep-related deaths. Now it’s spiking, and we don’t yet know why," Greenberg said.
India Brown, a panelist at Tuesday’s press event, knows the crisis from both a professional and personal angle. She works with Poem Perinatal Outreach, connecting pregnant and postpartum mothers — many of them Black — with mental health resources. She also serves on the board of Mama Certified, an initiative born from Cradle Cincinnati to combat Black maternal and infant mortality.
Brown also carries her own loss: a miscarriage of twins at 17 weeks.
“I was in the hospital, alone, giving birth, and then walking away without my babies,” Brown said. “Afterward, no one really follows up with you. It’s lonely. And it’s a loss that often goes unacknowledged. ... One in four women will experience a miscarriage, but it’s the club no one wants to belong to.”
Brown said seeing the latest numbers was “sobering” and “heartbreaking" and emphasized the need to keep mothers visible in the care process beyond the standard postpartum checkup.
"First, we have to raise awareness, because if people don’t know it’s happening, they can’t help change it," Brown said. “Everything becomes about the baby. That makes it hard to really serve baby, because mom and her ecosystem is just as important to baby surviving."
Cradle Cincinnati and community partners are trying to reverse the trend. Initiatives include:
- Queens Village Corner, where community advocates are embedded in maternity care settings at the University of Cincinnati Medical Center, with expansion planned for Good Samaritan Hospital. Those two facilities account for about 80% of births to Black women in the county.
- Cribs for Kids, which distributes safe sleep surfaces at no cost to families in need.
- Deployment of postpartum doulas, mental health support and community health workers in high‑risk neighborhoods.
Officials say all of the county’s sleep-related infant deaths in 2025 occurred during co-sleeping — a practice experts warn is unsafe for newborns.
Unsafe sleep conditions caused 15 deaths in 2023 but jumped to 22 deaths in 2025. Of those, 73% involved the baby sleeping next to another person, and 55% involved the infant sleeping in an adult bed.
Greenberg said parents should follow safe sleep guidelines: babies should sleep alone, on their backs, in a crib or bassinet with a firm mattress and no blankets or stuffed animals.
"In 2023, we were actually below the national rate, and that was something to celebrate. Now we are well above it. Are we the worst? I don't know. It doesn't matter. It's high," Greenberg said. "Any infant death is one too many, and we've got a problem that we need to address, so we're acting now."
