Public health experts consider the infant mortality rate an important indicator of a community's well-being. It is one of the factors that helped land Cuyahoga County in the bottom third of Ohio counties in overall health in a national study released last month by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
Cuyahoga, with its major health centers, performed well again on access to primary care in the annual study. But major health centers can't compensate for poverty and the other, often related stressors that contribute to the high infant mortality of Northeast Ohio.
Ohio's rate of infant mortality -- 7.7 deaths per 1,000 live births in the first year of life -- is 11th-worst in the nation, said a public radio report on the subject on WCPN's "Sound of Ideas."
The most recent rate reported for Cuyahoga County was a dismal 9.1 deaths, according to the Ohio Department of Health, and the average from 2006 to 2010 was 9.7.
Among the experts who discussed the subject on WCPN was Dr. Michele Walsh, division chief of neonatology at Rainbow Babies & Children’s Hospital.
"Within the three miles surrounding the University Circle area, infant mortality exceeds some Third World countries," she said, "and that is an embarrassment and cannot be allowed to continue."
PolitiFact Ohio agreed that the rate would be alarming. We wanted to know more.
We called Dr. Walsh, who said her statement about the city reflects data from a study conducted by researchers at Case Western Reserve University Mandel School of Applied Social Sciences.
Its extensive research database is called NEO CANDO, for Northeast Ohio Community and Neighborhood Data for Organizing. It draws from a wide variety of sources
that include the U.S. Census and the Ohio Department of Health, and it can break down information by neighborhood.
For worldwide rates of infant mortality, we checked the authoritative CIA "World Factbook."
The term "Third World," which once designated countries not aligned politically with the West or the Communist bloc East, generally refers to underdeveloped and developing countries of Asia, Africa and Latin America. Many poorer nations use the term to describe themselves. For our fact-check, we used the listings of Third World countries, as measured by poverty and low human development, from the Nations Online independent reference portal.
To stay within three miles of University Circle, we looked at data for neighborhoods on Cleveland's East Side.
We found that two neighborhoods, Hough and Mount Pleasant, had infant mortality rates above 27 per 1,000 -- worse than in North Korea, Uzbekistan, Vietnam, Samoa, Maldives or the Gaza Strip.
Two other neighborhoods -- Kinsman (with an infant mortality rate of 31 per 1,000) and South Collinwood (29) -- had infant mortality worse than was reported in Zimbabwe.
Infant mortality in the University Circle neighborhood, according to the NEO CANDO database, was slightly above 69 deaths per 1,000 live births. That exceeds the rate in countries that include, among others, Bangladesh, Haiti, Burma, Cameroon, Djibouti, Sudan, Kenya, Nepal, Pakistan, Rwanda and Uganda.
That number struck us as both anomalous and staggering. We looked for an explanation and got one from researcher Richard Stacklin of the Cuyahoga County Board of Health.
The rate for University Circle, he said, reflected the neighborhood’s small statistical base in 2009 of 43 births and 3 infant deaths. He said its most recent three-year average -- a preferable statistic for the neighborhood because it better accounts for fluctuations -- is 18.6 deaths, a figure he noted is still unacceptable and almost double the countywide rate.
The average rate worldwide, according to the "World Factbook," is 39.4 per 1,000.
The book estimates infant mortality in the United States in 2012 as 6 deaths per 1,000 births -- worse than the average for nations of the European Union and worse than countries including Australia, South Korea and Cuba.
Its figures show that some Third World nations have infant mortality rates that are exceeded by those for some neighborhoods within three miles of University Circle.
Walsh’s statement rates as True.