Association for Public Policy Analysis & Management

Ohio ranks 45th in the nation for infant mortality, with an overall infant mortality rate (IMR) of 7.2 per 1,000 live births in 2015. More alarming is the racial disparity in terms of IMR. The rate among white and black babies was 5.5 and 15.1, respectively. The state has undertaken multiple initiatives, including support for research to understand the main drivers of high infant deaths and to find effective policies for reducing the rate. As one of the research task groups, we developed a system dynamics model of infant mortality in Ohio and used Medicaid claim data to calibrate the model. We ran simulation experiments to examine the impact of two interventions—progesterone therapy and long-acting reversible contraceptives—on infant mortality under multiple finance scenarios. Our results suggest that progesterone therapy and long-acting reversible contraceptives can reduce the IMR. However, neither of the medical interventions alone or together can reduce the rate below the targeted rate by 2025. In addition to medical intervention, other non‑medical programs may need to be considered to achieve the goal of reducing the infant mortality rate to below 6 per 1,000 populations.