Columbus, Ohio, has one of the highest rates of babies dying before their first birthdays in the country. But many folks don’t know that this infant mortality crisis exists; with its growing workforce of younger, well-educated residents, the Midwest city has a reputation for livability, and it tends to do well on national rankings of best places to live.
“For the longest time, we were on our own,” Twinkle Schottke, the executive director of Moms2B, a nonprofit that runs support meetings for pregnant women in underserved neighborhoods where infant deaths are concentrated, told me in October. Now, there’s a new, small, glimmer of hope that help may be on the way: City officials will further develop a pilot for a specialized transportation service that would help connect expectant moms to healthcare. This news comes weeks after an extensive CityLab report spotlighted a waning commitment to address the city's infant mortality rate using a high-profile grant.
It’s a small step to address an enormous problem, and arguably, it’s overdue. Columbus leaders had made infant mortality a focus of its winning pitch for the Smart City Challenge, a $50 million grant sponsored by the U.S. Department of Transportation in 2016. As one of its citywide goals, Columbus proposed to reduce infant mortality by improving mobility to medical care in one of the hotspot neighborhoods. Research shows that environmental stressors—including unstable housing, high rates of crime, and a lack of transportation—are strongly linked to premature births, the primary cause of infant death.
Yet the focus on vulnerable moms seemed to be fading into the background when I visited Columbus in October 2017 to report on the grant’s progress. The city had spent much of the past year leveraging the grant money to accelerate additional “smart city” investments around the region, to the tune of $450 million. In summer 2016, Sidewalk Labs, the urban technology subsidiary of Alphabet, worked pro bono to develop a proposal for a text-message-based Uber-esque service that would ferry moms on Medicaid to medical appointments. But as of October, the city had no plans to pilot that proposal.
Other investments, such as a bus rapid transit line connecting downtown to suburban shopping centers, and sensor-embedded streetlights, would instead “trickle down” to help vulnerable moms, city officials explained to me. Neighborhood advocates and health researchers were skeptical. “We need to be hyper-focused on the needs [of this population],” said Jason Reece, a professor of urban planning at the Ohio State University, whose research helped shape the grant proposal. Schottke seemed crushed when I told her the Sidewalk Labs proposal seemed unlikely to move forward. “I don’t mean to seem ungrateful,” she said. “But my moms need help now.”
The article that resulted from my reporting stirred local and national conversation about the “smart city” movement. Readers questioned whether Columbus’s social goals were merely lip service for what would be flashier tech and real estate investments. Urban planning and transportation professors around the country emailed to tell me they’d use the story in their classes. On a bustling Facebook thread, a leader of the Columbus business development group partnering with the city to implement the grant first called the piece “editorialized,” but later agreed that it “did a good job of outlining our collective case for change.” And Erika Clarke Jones, the executive director of CelebrateOne, the city-appointed task force on infant mortality, circulated the article among board members, “to help keep you informed.”
Meanwhile, premature birth rates in the city increased.
Then, in mid-November, news came out that the city had requested to alter its portfolio of “smart city” projects, which the DOT had approved. Funding a service especially for pregnant moms, like the one developed by Sidewalk Labs, had never been explicitly promised in Columbus’ original grant proposal, but the city is now planning to eventually pilot such a project, Brandi Braun, the city’s deputy innovation director, told me on Thursday.
“We are committed to developing a project focused on the non-emergency medical transport for mothers,” she said. In the near term, this means spending a still-unspecified amount of the $50 million grant money on working with city, county, state, and private partners to “develop a framework” for piloting the Uber-like ride-hailing service.
There is no schedule in place yet, Braun said, for getting the pilot off the ground. But she said that this, and other changes to the grant, resulted from a review by a citywide committee that took place over the fall, and ongoing solicitation with “stakeholders and end-users.”
The Smart City grant is not the only work happening to address Columbus’ infant mortality crisis. The city’s Department of Neighborhoods is developing master redevelopment plans for some of the communities where the most babies are dying. CelebrateOne, the special task force, is seeking grant funding for a supportive housing pilot for pregnant moms. And Moms2B continues its work, helping hundreds of women move through pregnancies with a little more ease, with health education, cooking classes, free diapers, and complimentary bus passes.
Most of those women deliver healthy babies. But Schottke has forwarded me email after email about one participant in particular, a woman five months into her pregnancy and experiencing a lot of stress. She kept getting stranded at Moms2B because the Medicaid-provided shuttles she relied on routinely failed to show up; on one occasion, Schottke told me, the woman was brought to tears when she learned there was no one coming for her.
This week, Schottke emailed to inform me that this woman had given birth at just 19 weeks, and that the baby had died. No on-demand ride could have saved this life. But it couldn’t have hurt.