CLEVELAND, Ohio — During their years serving on committees examining infant mortality in Cuyahoga County, Healthcare workers Da’na Langford and Tenisha Gaines came to believe it takes boots on the ground in under-resourced neighborhoods, not large institutions, to make change.
After repeated meetings focusing on data instead of action, the women talked about quitting their jobs at University Hospitals and creating their own health clinic for women — a colorful space, filled with Black caregivers, supporting the mental and physical health of Black women and families.
The clinic remained a dream. Then Langford traveled to Africa.
There, in the slave dungeons in Ghana, Langford heard the voices of her Black ancestors echoing down the centuries.
“They had shed blood, they had been murdered, they had been raped,” Langford, 40, said. “(They said) it was my responsibility to speak up and to act. When I returned, I wanted to know, what are we actually doing to combat racism in health care?”
Langford and Gaines left their jobs at UH to launch Village of Healing, a nonprofit that opened its first health clinic in February in Euclid. Patients are surrounded by brightly colored furnishings, and care is delivered by Black practitioners.
The nonprofit’s leadership — mindful of a 2020 study suggesting that negative health outcomes are cut in half when Black newborns are cared for by Black physicians — believe it’s important to provide Black healthcare providers for patients who want a physician who looks like them.
“With healthy, powerful black women come healthy, powerful black families,” Langford said. “Black women are the CEOs of our families. When the black woman is powerful and healthy, it trickles down into a powerful healthy black family.”
The clinic, located in Euclid, treated about a dozen patients in its first three weeks. Langford is co-founder, CEO and medical director, while Gaines, 45, is co-founder, COO and executive director.
At UH, Langford was a nurse midwife and Gaines was a program director and patient access manager in the ob/gyn department.
Village of Healing strives to reverse statistics showing that here and across the country, Black babies are dying at a higher rate than white babies.
In Cuyahoga County, Black babies are almost three times more likely to die before their first birthday than white babies. In 2021, the infant mortality rate per 1,000 births was 11.6 for Blacks, compared to 5.2 for whites, according to preliminary data.
Ohio has had among the worst infant mortality rates in the United States for the past few years. But the state has shown improvement, dropping from 7.43 deaths per 1,000 in 2016 to 6.53 in 2020, according to the latest federal data.
Ohio’s infant mortality rate dropped from 7.43 in 2016, to 6.53 in 2020, the last year for which federal data is available.
Gov. Mike DeWine recently addressed the problem by starting a $2.25 million state program to help improve birth outcomes and reduce infant mortality by providing stable housing for low-income families.
A 2020 study published in the peer-reviewed journal PNAS outlined these sobering national findings about infant health:
* Black newborns in the United States are more than twice as likely to die in their first year as white newborns.
* Black infants cared for by white physicians die in hospitals at triple the rate of white infants cared for by white physicians.
Babies are the most sensitive indicator of community health, said Marie Jones, director of community health initiatives at Neighborhood Leadership Institute.
Village of Healing is taking the right approach to tackling infant mortality, Jones said.
“We need a special touch; we need the acknowledgement of who we are,” said Jones. “And we need that to be seen in the face of our providers. Absolutely.”
Grassroots efforts combat infant mortality
Village of Healing joins other community groups focused on infant health.
The efforts of the community group “44128: One Community” helped to drop infant deaths in that area to zero in 2017. It was the first time that no infant deaths had occurred in that ZIP in at least 10 years. The ZIP code covers portions of southeast Cleveland and suburbs such as Warrensville Heights.
However, “44128: One Community” was not able to continue its efforts in that area due to loss of funding, said Jones, who was on the “44128: One Community” organizing team.
The group, a program of the Neighborhood Leadership Institute, is still active in other parts of Cuyahoga County, Jones said. Neighborhood Leadership Institute works to improve greater Cleveland communities through grassroots leadership development and engagement.
Birthing Beautiful Communities and the Pregnant with Possibilities Resource Center are among the grassroots nonprofits also addressing social determinants of health affecting infant mortality. Birthing Beautiful Communities provides doulas for expectant moms, and Pregnant with Possibilities offers free, culturally sensitive programs for Black women and teens.
Saint Luke’s Foundation, which focuses on health equity, has been paying attention to the grassroots movement centered on infant mortality, President and CEO Tim Tramble said. It granted $75,000 to Village of Healing, as well as funding other local nonprofits doing similar work.
Village of Healing has $1.2 million annual budget.
The idea is to funnel monetary support to the people closest to the problem, which hasn’t always been the case in the philanthropic world, Tramble said.
“If you are doing anything from an equitable approach, the individuals who are closest to the problems should be the individuals that you support to address the problems,” he said. “They are more aware of the issues, they have more of a cultural relevance. They have the lived experience.”
Infant mortality by the numbers
In Cuyahoga County, infant mortality hit highs of 10.5 per 1,000 births overall, and 18.5 for Black infants, in 2015. Since then, numbers have dropped for all infants.
Infant mortality for all babies even ticked downward during the pandemic, from 16.3 to 11.6 for Black babies from 2019-2021, and 8.6 to 7.4 for all babies during that same time, according to preliminary county health data.
Langford credited the effort of grassroots organizations working to end racial disparities in health care with more babies surviving.
Another factor may have been that more pregnant Black women worked from home during the COVID-19 pandemic, and were spared the aggravation of stressful workplaces, Langford said.
Feeling seen and heard
Langford and Gaines still laugh about the early days of Village of Healing, when they used personal funds to get up and running, and swapped ideas in 2 a.m. texts. Langford’s ideas meshed well with Gaines’ MBA background.
Together, they turned an empty storefront into a brightly decorated, welcoming clinic where artwork donated by African-American artists greets patients when they arrive. Quotes by James Baldwin, Angela Davis, and Biden inaugural poet Amanda Gorman speak from the walls.
In a nod to Black history, exam rooms are named after enslaved women who were subjected to multiple experimental surgeries by J. Marion Sims, the controversial “father of modern gynecology.”
A collaborating physician and two nurses are part of the staff.
Patient Carmela Alexander of Lyndhurst recommended the health clinic to several friends and her mother.
“It was just amazing,” said Alexander, who followed Langford from UH to Village of Healing. “Everyone had a smile on their face. Everyone spoke to you. It was just an overwhelming feeling like, if I want to go anywhere (for medical care), this is the place to be.”
Alexander appreciated how Langford encouraged her to talk about the stress of caring for her children and grandfather. When Alexander described her monthly mood swings, Langford offered a prescription to balance her hormones.
“My mood swings are 1,000% better,” Alexander said.
Other women find support through Village of Healing’s mental programs, which began in 2019.
Mother to Mother is a maternal mental health program offered to women with mental health issues. Expectant moms are paired with volunteer mentors who connect with them at least once a week for support and education.
In a partnership with Birthing Beautiful Communities, every mom who is assigned a doula through BBC also gets a Mother to Mother mentor, Langford said.
The Professional Black Women’s Group gives women over age 30 who have college degrees a safe space to discuss toxic stress with a mental health therapist.
When the COVID-19 pandemic shutdowns hit, the groups switched to virtual meetings.
“We knew that Black moms were going to be suffering,” Langford said.
Over the next five years, the nonprofit plans to open more locations throughout the county, and expand its medical offerings to include pediatrics, dentistry and primary care.
Patients know that Village of Healing caregivers will advocate for them, because caregivers and patients share life experiences, Langford said.
“The lived experiences of being Black women are always going to trump everything else,” Langford said. “It’s why people are excited about Village of Healing.”