When Cincinnati, Ohio’s healthcare providers, community leaders and residents, nonprofit organizations, and funders partnered to create a radical model of care and support, they were finally able to move the needle on the city’s (tragic and persistent) wicked problem: infant mortality.

In 2011, despite the area’s rich culture, Fortune 500 companies, and nationally ranked healthcare systems, Cincinnati and surrounding Hamilton County had one of the worst infant mortality rates in the country. Especially alarming was the fact that Black babies were dying at three times the rate of White babies. Now fast forward twelve years to 2023. Hamilton County recorded its lowest infant mortality rate on record—one that was on par with the national average, an aspirational goal set a decade earlier. The Black infant mortality rate had been cut in half and was now in the single digits for the first time in history. Today, over 220 children and counting are alive because of Hamilton County’s collective efforts to save babies.

In Infant Mortality and Other Wicked Problems, Jill Haubner Miller and Dr. Meredith C. Smith provide a practical framework for systems change that every community can use.