THERESA BUSH: NEXT.

LUCAS COUNTY, OHIO HAS ONE OF THE HIGHEST INFANT MORTALITY RATES IN THE STATE, AND THERE S A CLEAR RACIAL DIVIDE.

LUCAS COUNTY S AFRICAN AMERICAN INFANTS ARE THREE TIMES MORE LIKELY TO DIE BEFORE THEIR FIRST BIRTHDAY THAN THEIR WHITE COUNTERPARTS.

IN THIS SPECIAL REPORT WE LL FOLLOW THE DEDICATED SOCIAL WORKERS AND PUBLIC HEALTH OFFICIALS ON THE FRONT LINE OF THE BATTLE TO MAKE SURE EVERY CHILD MAKES IT TO THEIR FIRST BIRTHDAY.

THE BATTLE FOR ONE IS NEXT.

NARRATOR: THE BATTLE FOR ONE WAS SUPPORTED BY THE PULITZER CENTER.

AND BY VIEWERS LIKE YOU.

THANK YOU.

LUCAS COUNTY, OHIO IS FACING A DEADLY PUBLIC HEALTH CRISIS.

DESPITE THE BEST EFFORTS OF MEDICAL PROFESSIONALS THE TOLL IS MOUNTING.

THE KILLER IS NOT NEW.

IT HAS BEEN WITH US FOR YEARS THE KILLER IS INFANT MORTALITY.

MY NAME IS THERESA BUSH.

THAT IS ME ON THE LEFT.

FOR THE NEXT HALF-HOUR I WILL BE YOUR GUIDE THROUGH THE CAUSES, EFFECTS AND POSSIBLE SOLUTIONS TO INFANT MORTALITY IN LUCAS COUNTY.

WE RE STARTING OUR JOURNEY HERE, AT MOM S HOUSE OF TOLEDO.

THEIR MISSION: TO SUPPORT SINGLE MOMS AS THEY COMPLETE THEIR EDUCATION, LEARN TO PROVIDE FOR THEIR FAMILIES AND BREAK THE GENERATIONAL CYCLE OF POVERTY.

JULIE HAAS IS THE PROGRAM DIRECTOR.

JULIE HAAS: MORNINGS ARE THE HIGHLIGHT OF THE DAY.

IT IS BY FAR THE MOST ACTIVE TIME OF THE DAY, IT'S OUR TIME TO CONNECT WITH THE MOMS AT DROP OFF.

IT IS OUR TIME TO REALLY SEE THE KIDS IN ACTION.

AMARION AND HIS MOM ARE JUST ARRIVING.

JULIE HAAS: AMARION CAME TO US WHEN HE WAS A BABY.

HE WAS BORN PREMATURE.

WHEN HE WAS BORN, THERE WERE SOME OF HIS INTERNAL ORGANS THAT WERE NOT FULLY DEVELOPED, HE WAS IN AND OUT OF THE HOSPITAL.

AND FOR ANYBODY, EVEN AS AN ADULT, BEING IN AND OUT OF A HOSPITAL IS STRESSFUL.

SO IMAGINE WHAT IT'S LIKE BEING NONVERBAL, A TINY LITTLE HUMAN ALREADY TRYING TO FIGURE OUT SO MANY THINGS IN THE WORLD.

WHAT CAUSED AMARION S MEDICAL ISSUES?

LET S LOOK AT THE NUMBERS.

INFANT MORTALITY IS DEFINED AS THE DEATH OF AN INFANT BEFORE HIS OR HER FIRST BIRTHDAY.

IT IS CALCULATED BY DIVIDING THE NUMBER OF INFANT DEATHS BY THE NUMBER OF LIVE BIRTHS AND MULTIPLYING BY 1000.

IT IS AN IMPORTANT INDICATOR OF AN AREA S HEALTH AND QUALITY OF LIFE.

IN THE UNITED STATES THE INFANT MORTALITY RATE IS 5.7 OUT OF EVERY THOUSAND BIRTHS.

IN THE STATE OF OHIO THE RATE RISES TO 6.9 OUT OF EVERY THOUSAND BIRTHS.

IN LUCAS COUNTY, THE RATE RISES AGAIN.

7.4 OUT OF EVERY THOUSAND BIRTHS.

THE TWO LARGEST CAUSES OF INFANT MORTALITY IN LUCAS COUNTY ARE LOW BIRTH WEIGHT AND PRETERM BABIES.

LUCAS COUNTY S INFANT MORTALITY RATE HAS BEEN TRENDING DOWNWARD OVER THE PAST FEW YEARS.

BUT LUCAS COUNTY S INFANT MORTALITY RATE HIDES A STAGGERING DISPARITY WHEN YOU SEPERATE THE RATE BY RACE.

THE INFANT MORTALITY RATE FOR WHITE CHILDREN IN LUCAS COUNTY IS 4.7 PER THOUSAND BIRTHS.

FOR AFRICAN-AMERICAN INFANTS, IT S 13.7 PER THOUSAND BIRTHS.

THAT MEANS AFRICAN-AMERICAN INFANTS LIKE AMARION ARE THREE TIMES MORE LIKELY TO DIE BEFORE THEIR FIRST BIRTHDAY THAN THEIR WHITE COUNTERPARTS.

THE QUESTION IS: WHY?

AND IF INFANT MORTALITY IS A REFLECTION OF BOTH OUR HEALTH AND OUR QUALITY OF LIFE, IS IT A SOCIAL OR A MEDICAL ISSUE?

VO:TO FIND OUT, I DECIDED TO GIVE THE ISSUE A FACE -- -- MINE -- -- AND FOLLOW THE PROCESS OF A HYPOTHETICAL PREGNANCY.

MY FIRST CONVERSATION WAS WITH ANITA PATEL.

SHE S A FORMER NURSE WHO NOW WORKS IN MANAGEMENT.

THERESA BUSH: IF I WERE A NEW PATIENT, WHO JUST FOUND OUT THAT I WAS PREGNANT, AND SEEING YOU FOR THE FIRST TIME, THERESA BUSH: WHAT TYPE OF QUESTIONS WOULD YOU ASK ANITA PATEL: I WOULD ASK YOU WHAT NUMBER OF BABY THIS IS, HOW YOUR PREGNANCY IS GOING?

KIND OF HELP WALK YOU THROUGH WHAT TO EXPECT, WHEN TO REACH OUT TO THE DOCTOR.

AND THEN WE WILL ALSO TALK ABOUT WHAT ELSE IS GOING ON IN YOUR HOME?

WHAT ARE SOME OTHER NEEDS YOU HAVE?

ARE YOU ABLE TO PAY YOUR RENT YOUR UTILITIES, AND BEHAVIORAL HEALTH, THIS IS A STRESSFUL TIME, WOULD YOU BENEFIT FROM ANY OF THOSE RESOURCES?

THERESA BUSH: WOULD YOU DEFINE A LOW BIRTH WEIGHT BABY FOR ME?

ANITA PATEL: SO WHEN A BABY IS BORN, WEIGHING LESS THAN 2500 GRAMS, OR FIVE POUNDS, EIGHT OUNCES, THAT BABY IS CONSIDERED LOW BIRTH WEIGHT.

ANITA PATEL: AFRICAN-AMERICAN WOMEN HAVE THREE OR FOUR TIMES HIGHER INCIDENCE OF LOW BIRTH WEIGHT, PRETERM BIRTH, WHICH CAN LEAD TO THE INFANT MORTALITY.

THERESA BUSH: WHAT LEADS TO A PRETERM BABY?

ANITA PATEL: SUBSTANCE ABUSE AND TOBACCO USE DURING PREGNANCY CAN LEAD TO A BABY NOT BY WRITING DURING PREGNANCY WE ALSO FIND, INADEQUATE NUTRITION ANITA PATEL:, ALSO UNDER A LOT OF STRESS IN THEIR ENVIRONMENT.

THOSE FACTORS CAN ALSO LEAD TO A PRE TERM BIRTH.

THERESA BUSH: AND HOW WOULD YOU KNOW IF I'M AT RISK?

ANITA PATEL: IF THIS IS YOUR FIRST PREGNANCY, WE LOOK AT WHAT OTHER HEALTH CONDITIONS THAT YOU HAVE, ARE YOU DIABETIC?

DO YOU HAVE HYPERTENSION, THOSE COULD BE INDICATORS THAT YOU MAY HAVE SOME OF THOSE DIFFICULTIES DURING YOUR PREGNANCY, THAT WE SHOULD KEEP AN EYE ON SOME OF THOSE THINGS.

ANITA PATEL: AND NOT RECOGNIZING THAT AND KNOWING THAT WE NEED TO HAVE DIFFERENT APPROACHES WHEN WE'RE WORKING WITH OUR AFRICAN - AMERICAN -- THERESA BUSH: YOU JUST SAID, DIFFERENT APPROACHES LIKE WHAT WHAT DO YOU MEAN BY DIFFERENT APPROACHES?

ANITA PATEL: IN OTHER WORDS, WE NEED TO RECOGNIZE AND MAYBE, OR AND EARLY ON, ASSESS THE ENVIRONMENT OF STRESSORS.

AND RECOGNIZE THAT IN CERTAIN NEIGHBORHOODS, WHERE WE HAVE AFRICAN-AMERICAN WOMEN, MAKE SURE WE UNDERSTAND WHAT RESOURCES DO THEY HAVE AVAILABLE FOR THEIR DAY TO DAY, BECAUSE IF THEY'RE STARTING OUT AT A DISADVANTAGE... ANITA PATEL: ...WE'RE NOT GOING TO GET VERY FAR ATTACKING THEIR HEALTH CARE.

IF I M STARTING OUT AT A DISADVANTAGE AND A DIFFERENT APPROACH IS NEEDED, DO I NEED SOMEONE SPECIFIC TO ADDRESS MY NEEDS AS AN AFRICAN-AMERICAN WOMAN?

I REACHED OUT TO MY CONTACTS, AND ONE NAME KEPT COMING UP.

D ANGELA PITTS IS IN HER FIRST YEAR OF PRACTICE AS A DOCTOR IN OBSTETRICS AND GYNECOLOGY IN THE DETROIT AREA.

THERESA BUSH: SO YOU ARE BROUGHT TO US SO WE ACTUALLY KIND OF FILTERED AROUND AND ASKED SEVERAL DIFFERENT PEOPLE AND AREA TOLEDO DOCTORS KNOW AND FRIENDS OF MINE TO TALK TO RECOMMENDED YOU.

THERESA BUSH: SO HOW DOES CULTURAL COMPETENCY AFFECT AND RELATE TO INFANT MORTALITY?

D ANGELA PITTS: SO WHEN WE LOOK AT INFANT MORTALITY IN THE UNITED STATES, D ANGLEA PITTS: DIFFERENT RACE GROUPS HAVE AN INCREASED RISK SO SUCH AS AFRICAN AMERICANS, D ANGELA PITTS: SO BEING ABLE TO KNOW YOUR PATIENT POPULATION KNOW WHAT AFFECTS THEM, YOU CAN BE ON HEIGHTENED ALERT.

THERESA BUSH: AND WHAT SPECIFIC ROLES DO YOU DO?

LIKE WHAT SPECIFIC STEPS DO YOU DO PERSONALLY TO PREVENT INFANT MORTALITY?

D ANGELA PITTS: THE GOAL IS HEALTHY MOM, HEALTHY BABY.

SO I DON'T ONLY TAKE CARE OF YOU AS A PREGNANT WOMAN, I ALSO TAKE CARE OF YOUR BABY.

AND AT THE END OF THIS, I WANT YOU TO GO HOME WITH YOUR BABY.

SO I LISTEN, I TELL YOU TO BE AN ADVOCATE FOR YOURSELF.

SO IF SOMETHING FEELS OFF, IF YOU'RE NOT FEELING YOUR BABY MOVE, IF YOUR BLOOD PRESSURE IS HIGH, I DON'T WANT YOU TO SIT AT HOME, THERESA BUSH: SO WHAT ABOUT WOMEN THAT CAN'T ADVOCATE FOR THEMSELVES?

OR DON'T KNOW HOW TO OR DON'T KNOW, THE RESOURCES?

OR WHERE TO GO?

D ANGELA PITTS: IF YOU FEEL THAT YOUR DOCTOR MIDWIFE IS NOT LISTENING, SAY IT AGAIN.

SO BEING AN ADVOCATE SAYING, GET IT AGAIN, INTO IF YOU NEED TO GO TO ANOTHER HOSPITAL, IF YOU NEED TO ASK FOR ANOTHER PHYSICIAN, YOU WANT TO BE AN ADVOCATE FOR YOURSELF.

THERESA BUSH: YEAH, WHAT ARE GENERAL THINGS THAT YOU MIGHT SAY TO A PERSON THAT IS HAVING A HORRIBLE PREGNANCY.

D ANGELA PITTS: WE LOOK, TALK.

AND THEN SOMETIMES THESE PREGNANCIES HAVE ADVERSE OUTCOMES, OR YOU GET A, YOU GET A PHONE CALL THAT YOU'RE NOT EXPECTING.

I WANT TO BE THAT PERSON THAT CAN WALK YOU THROUGH SOME OF THE TOUGHEST TIMES OF YOUR LIFE AND BE THERE FOR YOU TO HELP YOU COME OUT ON THE OTHER SIDE.

D ANGELA PITTS: AND SOMETIMES THOSE CONVERSATIONS HAVE TEARS, LOTS OF TEARS.

SO IF YOU HAD THAT CONVERSATION, NOTHING THAT YOU DID CAUSED YOUR LOW BIRTH WEIGHT, PRETERM DELIVERY, BUT OUR GOAL IS TO GET YOU ON THE OTHER END AND GET YOU TO A TERM DELIVERY OLLA DANIEL AVERY IS A LABOR AND DELIVERY NURSE AT TOLEDO HOSPITAL.

OLLA DANIELLE AVERY: LABOR AND DELIVERY IS SO DIFFERENT THAN ANY PART OF THE HOSPITAL BECAUSE IT'S TYPICALLY THE ONLY TIME YOU COME TO THE HOSPITAL FOR SOMETHING GOOD.

NINE TIMES OUT OF 10 IF YOU ASK A WOMAN TO TO RETELL THE STORY OF THE BIRTH OF HER CHILD, AND IT TENDS TO BE SOMETHING THAT WOMEN BOND OVER TELLING THIS STORY.

SO BEING ABLE TO BE A BRIDGE BETWEEN A WOMAN WHO IS LABORING DIFFERENTLY THAN OUR TYPICAL POPULATION.

AND WHAT OUR TYPICAL EXPECTATIONS ARE OR TYPICAL HOSPITAL NORMS ARE IS WHERE MY ROLE IS.

THERESA BUSH: FOR YOU BEING AN OB GYN NURSE, I'M TOUCHING ON THIS, BECAUSE YOU JUST TOUCHED ON SOMETHING.

HOW DO YOU COMFORT A MOTHER THAT'S IN THAT DISTRESS?

THAT IS NOT TRUSTING?

NOT TRUSTING WHAT THEIR DOCTOR SAYING IS FEELING LIKE SHE'S NOT BEING HEARD YOU KNOW, HOW DO YOU HOW DO YOU STEP IN AND, AND COMFORT THAT WOMAN?

OLLA DANIELLE AVERY: IF I'M ASSESSING MY PATIENT, AND SHE'S REPORTING THAT HER PAIN IS THIS, AND THAT'S THE PAIN THAT WE NEED TO TREAT.

OLLA DANIELLE AVERY: I THINK THAT WE NEED TO ACKNOWLEDGE THAT DIFFERENT CULTURES HAVE DIFFERENT APPROACHES TO PREGNANCY, AND MEDICATION AND MEDICINE.

THERESA BUSH: AND THAT CAN COME BACK TO PLAY WITH THE SOCIAL ECONOMIC AS WELL, IF YOU'RE NOT FINANCIALLY STABLE, AND YOU DON'T HAVE THE OUTSIDE HELP, YOU HAVE LITERALLY NO CLUE WHAT TO DO.

OLLA DANIELLE AVERY: WE DON'T SAY THAT IT TAKES A VILLAGE TO RAISE A CHILD FOR NO REASON, RIGHT.

AND WE HAVE GOTTEN AWAY FROM CIRCLING AROUND ANY MOTHER AND TEACHING HER THE THINGS THAT YOU NEED TO TEACH CULTURALLY.

OLLA DANIELLE AVERY: THE BLACK CULTURE, YOU WOULD HAVE A BABY, YOUR MOTHER, YOUR GRANDMOTHER, SOMEBODY HAD CHILDREN.

BREASTFED CHILDREN, KNEW WHAT THIS DIAPER RASH LOOKED LIKE, KNEW WHAT THIS, WHAT TO DO WITH THIS.

WHAT DO YOU DO WITH A COLICKY BABY, BUT IF YOU HAVE NO ONE TO SUPPORT YOU HOW, AND THE MEDICAL SYSTEM IS NOT SET UP TO ASSIST YOU IN NON IN THESE AREAS?

AND WHAT DO YOU DO?

IF THE MEDICAL SYSTEM IS NOT SET UP TO ASSIST ME WITH MY PRACTICAL NEEDS AS A NEW MOM, WHO IS?

PAULA HICKS-HUDSON: STATE OF THE CITY ADDRESS MAYOR PAULA HICKS HUDSON THURSDAY, FEBRUARY 9 2017.

THE CHALLENGES WE FACE IN TOLEDO ARE NOT UNIQUE.

HISTORY TELLS US THAT WE HAVE BEEN HERE BEFORE.

WE KNOW THAT WE KNOW WHAT WE MUST DO.

WE MUST CONTINUE TO FOSTER PROGRESS THROUGH PARTNERSHIP.

PAULA HICKS-HUDSON: WE MUST MANAGE OUR MOST PRESSING SOCIAL CHALLENGES AS WELL AS FISCAL CHALLENGES, INFANT MORTALITY, CHILDHOOD OBESITY, AND AGING POPULATION.

FUTURE WORKFORCE NEEDS AGING INFRASTRUCTURE, COMMUNITY DEVELOPMENT AND JOB CREATION.

PAULA HICKS-HUDSON SERVED AS MAYOR OF TOLEDO FROM 2015 TO 2018 BEFORE REPRESENTING THE AREA IN THE OHIO HOUSE OF REPRESENTATIVES.

PAULA HICKS-HUDSON: I CALLED OUT THE ISSUE OF INFANT MORTALITY IN 2017.

BECAUSE IT IS SUCH A BLEMISH ON THE ABILITY OF GOVERNMENT TO DO WHAT GOVERNMENT IS DESIGNED TO DO, WHICH IS TO PROTECT ITS CITIZEN.

AND WHEN YOU LOOK AT THE MOST VULNERABLE OF ALL OF OUR CITIZENS, AN INFANT THAT CAN THAT DOESN'T MAKE IT TO THE AGE OF ONE OR EVEN BEYOND, THAT IS A MAJOR FAILING OF OUR CITY, OUR GOVERNMENT, OUR COMMUNITY, OUR SOCIETY.

WADE KAPSZUKIEWICZ: I THINK LENDING ONE'S VOICE THROUGH THE BULLY PULPIT OF THIS OFFICE IS VALUABLE.

I KNOW THAT'S WHAT MAYOR HICKS-HUDSON DID, ... WADE KAPSZUKIEWICZ: AND WHEN I FOLLOWED HER INTO THE MAYOR'S OFFICE, IT WOULD MAKE SENSE THAT I WOULD CONFRONT, YOU KNOW, MANY OF THE ISSUES THAT CONFRONTED HER WADE KAPSZUKIEWICZ IS THE MAYOR OF TOLEDO.

WADE KAPSZUKIEWICZ: THE ROLE OF THE CITY OF TOLEDO OR OF ANY CITY GOVERNMENT IS SUCH THAT WE WE NEVER PROVIDE DIRECT SERVICES ALONG AREAS OF HEALTH, WADE KAPSZUKIEWICZ: WE'RE NOT, YOU KNOW, WE DON'T, YOU KNOW, WE DON'T PROVIDE, WADE KAPSZUKIEWICZ: YOU KNOW, PRENATAL CARE.

WE'RE NOT GIVING SHOTS.

WE'RE YOU KNOW, WE'RE NOT PASSING OUT, YOU KNOW, NUTRITIONAL, YOU KNOW, SUPPLEMENT TABLETS OR YOU KNOW, ADVISING ON ANYTHING PERTAINING TO HEALTH CARE.

WADE KAPSZUKIEWICZ: HOWEVER, THAT IS NOT TO SAY WE'RE DISINTERESTED IN ADDRESSING PROBLEMS LIKE THIS, WADE KAPSZUKIEWICZ: A CITY DOES HAVE A ROLE IN SEEING TO IT THAT THE INVESTMENTS THAT WE ARE ALLOWED TO MAKE CAN BE DIRECTED IN WAYS THAT ARE HELPFUL.

WADE KAPSZUKIEWICZ: THE WORK THAT WE DO IN THE NORMAL COURSE, OF ATTEMPTING TO MAKE OUR CITY MORE LIVABLE, TO HELP MAKE OUR NEIGHBORHOODS MORE WALKABLE AND VIBRANT, DOUBLE AS THE WORK THAT WE CAN DO TO IMPROVE OUR OUTCOMES ON INFANT MORTALITY WADE KAPSZUKIEWICZ: I DO THINK IT'LL TAKE A WHILE FOR THE PUBLIC TO UNDERSTAND THIS.

BUT I ALSO THINK THE PUBLIC EVENTUALLY WILL, I THINK THE PUBLIC EVENTUALLY WILL COME TO UNDERSTAND WHAT'S AT ROOT HERE.

AND I THINK THEY WILL BE ALLIES AS WE TRY TO MAKE THE INVESTMENTS NECESSARY TO MOVE THE NEEDLE.

ERIC ZGODZINSKI IS THE HEALTH COMMISSIONER FOR THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT.

ERIC ZGODZINSKI: THE PUBLIC HEALTH ROLE IS I THINK, MULTIFACETED IN THE SENSE THAT WE CAN ADDRESS SOME OF THOSE THINGS THAT AFFECT INFANT MORTALITY, BUT IT JUST CAN'T BE US ALONE, YOU NEED TO MAKE SURE THAT SOCIETY ALSO TO ATTACKS THOSE PROBLEMS, AND SOLVE SOME OF THOSE PROBLEMS OF INFANT MORTALITY.

ERIC ZGODZINSKI: IT IS THOSE BARRIERS THAT MOMS FACE, WHETHER IT'S TRANSPORTATION, WHETHER IT'S COMMUNICATION, WHETHER IT'S TAKING US UP ON RESOURCES, THOSE ARE ALL THINGS THAT, YOU KNOW, ARE BARRIERS, AND WE NEED TO TRY TO KNOCK THOSE DOWN.

ERIC ZGODZINSKI: AND I THINK IF YOU START REFLECTING ON THAT, YOU'LL START UNDERSTANDING THE ISSUES THAT WE HAVE.YOU KNOW, MANY THINGS THAT WE DEAL WITH, YOU CAN MAYBE THROW A THROW A DRUG AT AND MAYBE SOLVE SOLVE A, A HEALTH CONCERN, ERIC ZGODZINSKI: IT IS JUST NOT ONE THING THAT YOU CAN POINT TO TO SOLVE, IT REALLY IS A COMBINATION OF MANY DIFFERENT ISSUES IN THE COMMUNITY, MY CONTACTS SUGGESTED ONE MORE PERSON I SHOULD SPEAK TO.

ANIKA FIELDS.

SHE WORKS AS A CULTURAL COMPETENCE COUNSELOR.

BEFORE THAT, SHE WORKED IN PUBLIC HEALTH.

ANIKA FIELDS: I WORKED FOR BIRTH TO FIVE PROGRAMMING FOR LUCAS COUNTY FOR OVER TWO DECADES, I WORKED WITHIN A COUPLE DIFFERENT PROGRAMS THAT ALL FOCUSED ON MATERNAL FETAL HEALTH, COMBATING INFANT MORTALITY, THERESA BUSH: NOW, IS THIS A SOCIAL ISSUE OR A MEDICAL ISSUE?

ANIKA FIELDS: MY OPINION IS THAT THIS IS ACTUALLY BOTH A SOCIAL ISSUE AND A MEDICAL ISSUE.

REALLY TAKING THE TIME TO LOOK AT THE MOST IMPACTED BABIES, WHICH ARE BLACK BABIES ON THERE'S SEVERAL FACTORS THAT ARE COMMON, AND ONE IS SOCIO-ECONOMIC STRESS OR DEPRESSION, MENTAL HEALTH ISSUES, RANGE OF DIFFERENT DISPARITIES EXPERIENCED BY EXPECTANT MOTHERS OF BLACK BABIES.

AND THE REASON I SAY IT'S A MEDICAL ISSUE IS BECAUSE AT THE END OF THE DAY, IT THE MOTHER'S HEALTH, THE MATERNAL FETAL HEALTH IS WHAT HELPS TO PRODUCE A HEALTHY BABY.

THERESA BUSH: WHY DO YOU FEEL LIKE THERE IS A DISPARITY BETWEEN THE NUMBER OF AFRICAN-AMERICAN INFANTS AFFECTED INFANT MORTALITY, VERSUS THE NUMBER OF AFRICAN OF WHITE INFANTS THAT ARE AFFECTED BY INFANT MORTALITY?

ANIKA FIELDS: THERE'S A BIG ISSUE THAT REALLY NEEDS A LITTLE BIT MORE ATTENTION.

AND THAT IS THE ISSUE OF STRUCTURAL RACISM.

ANIKA FIELDS: WHAT WE SEE AND WHAT THE DATA TELLS US IS THAT PEOPLE WHO ARE SOCIO ECONOMICALLY DEPRESSED, EXPERIENCE FAR MORE CHALLENGES IN DAY TO DAY LIFE.

SO THAT MAY BE IN THE CRIMINAL JUSTICE SECTOR, THAT COULD BE IN LACK OF OPPORTUNITIES FOR EMPLOYMENT, IT COULD BE A HOST OF THINGS.

BUT THOSE THINGS ALL AFFECT AND PLAY INTO A PERSON'S HEALTH AND A POTENTIAL MOTHER'S HEALTH AND HOW SHE INTERNALIZES THAT, AND HOW IT AFFECTS THE DEVELOPMENT OF HER BABY HER UNBORN BABY THERESA BUSH: YOU TOUCHED ON SOMETHING WHAT IS SOCIAL, ECONOMIC DEPRESSION, ANIKA FIELDS: SOCIO ECONOMIC DEPRESSION, I WOULD DESCRIBE AS A CIRCUMSTANCE THAT PEOPLE OF COLOR AND OTHER ETHNIC MINORITIES EXPERIENCE WHERE THERE IS A, THERE ARE UNEQUAL OPPORTUNITIES, THERE'S UNEQUAL ACCESS.

ANIKA FIELDS: WE SEE THE DISPARITIES OF BLACK MOTHERS OF BLACK PEOPLE IN GENERAL.

AND UNTIL WE'RE ABLE TO TAKE A SERIOUS LOOK AT THE STRUCTURAL RACISM AND THE IMPLICATIONS ON HOW IT AFFECTS LIFE IN GENERAL, AND THE TOTAL, OVERALL WELL BEING OF PEOPLE OF COLOR AND OTHER ETHNIC MINORITIES, I DON'T THINK WE'RE REALLY, REALLY GOING TO ANIKA FIELDS: ELIMINATE THE PROBLEM.

PAULA HICKS-HUDSON: THE PER CAPITA NUMBERS SHOULD NOT BE THEY SHOULD NOT EXIST IN AN A IN A PLACE WHERE WE HAVE SAFE DRINKING WATER., WE HAVE A COMPLETE HEALTH CARE SYSTEM, AND I THINK WHETHER IT'S SHEER NUMBERS OR IT'S ONE NUMBER, THE FAMILY THAT WE HAVE RESOURCES IN THIS COMMUNITY.

AND THOSE RESOURCES ARE NOT MEETING THE NEED OF EVERY MOM.

PAULA HICKS-HUDSON: SO WHEN I MAKE THAT STATEMENT IN 2017, AND I MAKE THAT STATEMENT IN 2018 2019 AND 2020... PAULA HICKS-HUDSON: IT'S STILL THE SAME THING THAT WE NEED TO PUT OUR RESOURCES AVAILABLE AND MAKE THEM AVAILABLE TO HELP MY BE HEALTHY TO HELP BABIES BE BORN HEALTHY HOW AVAILABLE RESOURCES SUPPORT THE HEALTH OF A COMMUNITY IS THE FOCUS OF AN AREA OF RESEARCH CALLED SOCIAL DETERMINANTS OF HEALTH.

KATE SOMMERFELD LEADS THE TEAM PUTTING SOCIAL DETERMINANTS OF HEALTH INTO ACTION IN LUCAS COUNTY.

KATE SOMMERFELD: SO THE SOCIAL DETERMINANTS OF HEALTH ARE NON CLINICAL FACTORS SUCH AS HOUSING, TRANSPORTATION, EDUCATION THAT REALLY IMPACT THE HEALTH OF AN INDIVIDUAL AND HEALTH OF COMMUNITIES.

KATE SOMMERFELD: SO STRUCTURAL RACISM, WE KNOW ABSOLUTELY IS A DIRECT CORRELATION AND THE CAUSE OF INFANT MORTALITY, THE TOXIC STRESS THAT, IN PARTICULAR, MINORITY, BLACK AND LATINA MOM'S EXPERIENCE IS REAL.

AND SO FROM A STRUCTURAL PERSPECTIVE, EVERYTHING FROM ENSURING THAT PROVIDERS ARE PROVIDING THE RIGHT CARE, BUT ALSO WHEN YOU LOOK AT THINGS LIKE JOB WAGE, AND EDUCATION, KATE SOMMERFELD: WE KNOW THAT THINGS LIKE INSTITUTIONAL AND SYSTEMIC RACISM ARE DIRECTLY IMPACTING OUR BIRTH WEIGHT AND OUR INFANT MORTALITY RATES ACROSS COMMUNITIES.

KATE SOMMERFELD: IF YOU'RE A BLACK MOM, YOU'RE MORE LIKELY TO HAVE A BABY DIE BEFORE THE FIRST BIRTHDAY THEN A WHITE MOM REGARDLESS OF EDUCATION, LEVEL OR GARDEN, REGARDLESS OF INCOME, SO IT'S ABSOLUTELY AN EDUCATION ISSUE, HAVING ACCESS TO EVERYTHING STARTING FROM HIGH QUALITY PRESCHOOL, ALL THE WAY UP TO JOB ACCESS, AND THE ABILITY TO PROVIDE FOR YOUR FAMILY AS WELL.

IS THAT THE ANSWER?

IS THE STRESS CAUSED BY STRUCTURAL RACISM IS DRIVING THE HIGH INFANT MORTALITY RATE AMONG AFRICAN-AMERICANS IN LUCAS COUNTY?

THE STRESS OF NAVIGATING THE MEDICAL SYSTEM.

THE STRESS OF FIGHTING TO BE HEARD.

THE STRESS OF HAVING TO SEEK HELP ONCE YOUR CHILD IS BORN.

HOW DO YOU SOLVE THAT?

THE ANSWER BRINGS US BACK TO AMARION AND MOM S HOUSE OF TOLEDO.

IF INFANT MORTALITY IS A BATTLE, AMARION IS A SURVIVOR.

JULIE HAAS: AMARION IS A SUCCESS STORY JULIE HAAS: WE INTENTIONALLY WORKED WITH HIS MOTHER, ON MAKING SURE THAT ALL AROUND, WE WERE DOING WHAT THE DOCTORS HAD INSTRUCTED US TO DO.

AND AFTER A COUPLE OF MONTHS, WE ARE HAPPY TO SAY THAT THIS YOUNG MAN RECENTLY TURNED ONE, HE IS THRIVING IN HIS ENVIRONMENT, HIS MEDICAL ISSUES ARE UNDER CONTROL.

AND MOST IMPORTANTLY, HE IS MEETING ALL OF HIS DEVELOPMENTAL MILESTONES, CHRISTINA RODRIGUEZ: I BELIEVE WHAT WE SEE HERE AT MOM'S HOUSE, IS DEFINITELY THE SOCIAL SIDE WE SEE THE LACK OF WHICH CAUSES THE HEIGHTENED POSSIBILITY OF INFANT MORTALITY, CHRISTINA RODRIGUEZ IS THE EXECUTIVE DIRECTOR OF MOM S HOUSE OF TOLEDO.

CHRISTINA RODRIGUEZ: THE CLIENTELE WE SERVE ARE AT THE TOP OF THOSE STATISTICS, YOU'RE TALKING YOUNG, BLACK, AND A LACK OF EDUCATED YOUNG PEOPLE.

CHRISTINA RODRIGUEZ: ONE OF THE THINGS THAT WE HERE AT MOM'S HOUSE HAVE REALLY STARTED TO UTILIZE THE TERM ACES, ADVERSE CHILDHOOD EXPERIENCES, CHRISTINA RODRIGUEZ: NOW, WHEN WE TALK ABOUT ACES, THERE'S THE MEDICAL SIDE OF IT.

BUT THERE'S ALSO THE SOCIAL SIDE OF IT, WHETHER IT'S SEEING THEIR MOTHER, BE ABUSED BY THEIR FATHER, OR LIVING IN EXTREME POVERTY OR MOVING ALL THE TIME, AND THEY'RE CONSTANTLY BEING TRAUMATIZED, THROUGH THOSE EXPERIENCES IN THEIR LIFE, WHICH START TO SHAPE THEM AND WHO THEY ARE.

AND THEN THEY COME TO US.

CHRISTINA RODRIGUEZ: AND THE DIRECT CORRELATION TO INFANT MORTALITY REALLY IS A SOCIAL CORRELATION.

WHEN A CHILD HAS TRAUMA IN THEIR LIFE, AND THEY'RE IN AN AT RISK ENVIRONMENT AT ALL TIMES.

CHRISTINA RODRIGUEZ: AND THAT CAN CAUSE STRESS, THAT COULD CAUSE THEM TO START BEHAVING IN MANNERS THAT ARE UNHEALTHY FOR THEM.

BUT IT COULD ALSO CAUSE THE PARENT TO HAVE ANXIETY AND STRESS AND POTENTIALLY EVEN LEAD TO SOME TYPE OF CHILD ABUSE OR NEGLECT.

CHRISTINA RODRIGUEZ: AND THAT'S HOW YOU CHANGE A COMMUNITY BY CHANGING THE MINDSETS OF THESE YOUNG LADIES WHO ARE PARENTING, THESE LITTLE PEOPLE WHO WILL BE OUR LEADERS CHRISTINA RODRIGUEZ: AND WE HOPE THAT WHAT WE'RE DOING EVERY DAY HERE CONTRIBUTES TO THAT RATE OF INFANT MORTALITY GOING DOWN HERE IN LUCAS COUNTY.

AND THAT BRINGS US TO THE END OF OUR JOURNEY -- IF I LEARNED ONE THING, IT S THIS: INFANT MORTALITY CAN BE ATTACKED BY LARGE MEDICAL AND SOCIAL INSTITUTIONS, BUT THE TRUTH MAY BE IF THERE IS GOING TO BE ANY PROGRESS IN THE BATTLE AGAINST INFANT MORTALITY IN LUCAS COUNTY IT MAY HAPPEN IN ROOMS LIKE THIS, ONE CHILD AT A TIME.

I M THERESA BUSH.

THANKS FOR WATCHING.

NARRATOR: THE BATTLE FOR ONE WAS SUPPORTED BY THE PULITZER CENTER.

AND BY VIEWERS LIKE YOU.

THANK YOU.

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