To Make Better Decisions on Infant Mortality, Follow Black Women by Ryan Adcock

Several months ago, the Ohio Department of Medicaid asked Cradle Cincinnati to help coordinate how our community would spend $2.9 Million to help combat Hamilton County’s high infant mortality rate. A wide range of partners eventually submitted proposals that totaled nearly twice that price tag. So, hard decisions had to be made. Because of a longstanding and substantial racial disparity in birth outcomes, Cradle Cincinnati has seen the need to include the voice of Black women at decision making tables. But this time we went a step further – rather than simply including these voices, we decided to fully trust Black women to make these decisions and set our community’s priorities. A group of 10 Black women who have been engaged in our work carefully ranked each proposal and effectively set the agenda for how our community will use these resources.

There are a lot of good reasons that nonprofit efforts should be striving for more radical versions of inclusion. But to me, there is no reason better than this: the best decisions are made by the people closest to the problems. At the end of this process, I was struck by the thoughtful and nuanced decisions this panel of women had made. Were the decisions different from those I would have made on my own? Yes – and that’s exactly the point. Were they made with the same care and deliberativeness I would have used myself? Of course – and the fact that I was at all surprised by that fact only reveals my own biases. Black women live the issues of preterm birth and infant death with a closeness I will never know. Of course, of course, of course they held this responsibility with care.   

More equitable decision making is complex and we at Cradle Cincinnati are still figuring out the path forward. But, we’ve learned a few things that I think are worth sharing:

• Equityoften requires white men to cede power. By the nature of my race, mygender, my job title, and my education – I find myself with more professionalpower than I often realize. Actively identifying places where I can give away powermeans that my control of the work will shrink but my impact will grow.
• Equitymeans identifying and equipping new leaders. We did not randomly select 10Black women to make these decisions. For more than a year, we had been workingwith and equipping leaders in our community so that they would be fully readyfor this kind of work. For too long, nonprofits have asked people to jump inand out of work for a focus group or a quick insight – but long term investmentin developing leaders will create bigger change.
• Toidentify equity opportunities, look at your processes. The bad guy inequity work is often not an overtly racist person, but a bad process that isleading to inequitable results. How does your company hire? How does yourapartment complex choose its residents? How do funds get distributed? It’s not sexy,but a better process can lead to better results.

So, thank you to Danielle Gentry, Monica Williams, Tanyqua Oliver, Jori An Cotton, Desirae Hosley, Lavenia Jones, Angel Evans, Jamaica Gilliam, Danyelle Bush and Dameta Wright for leading our community to a better future.   

Read about the funded community initiatives here.

Ryan Adcock is the Executive Director of Cradle Cincinnati.