fault lines travels to cleveland, ohio - to look at what is causing these deaths, and to try to find out why the united states has the worst rate of infant mortality in the industrialized world. >> it's monday morning in cleveland's metrohealth hospital. a newborn baby boy has just been rushed into neonatal intensive care unit known as the "nicu". >> weighing just over 2 pounds, he's 14 weeks premature it means he was only in the womb for less than six months. >> he's really retracting. you see his blood pressure? very low. >> they're right now trying to get urgent care to the baby that's just been born here, literally within the last couple of hours. and right now getting respiration assistance, and an intravenous drip inserted. this is the kind of scenario that happens all the time on this ward. >> medical advances have dramatically improved the odds of survival for premature babies, but they haven't changed one aspect of this crisis. almost all of the babies in this ward are black. >> just under 40 percent of the babies born are african american but they contribute to 70 percent of the babies who die in the first year of life. so there's this huge, huge disparity and that's kind of business as usual. it's been going on for decades. >> baby tyrione is just hours old, but he's on a life-support machine. the nurses are worried about his chances of survival - tyrione is so premature he can't breathe without a machine pumping oxygen through his tiny lungs. it's an extreme measure for such a small baby - it puts him at high risk for infection and internal bleeding. >> he's helpless. it seems like he's got a tube coming from everywhere. >> for tyrione's mother lashay welsh, it's an agonizing time. >> i really can't do anything, but just stand by and watch, and wait. and it's a long wait. >> but lashay can't stay with him. a single mother with three other children, her earnings keep the family just above the poverty line. >> my doctor's had put me on light duty, and my job didn't honor the light duty. our welfare is not enough to support me and my children, so i had to go back to work full duty. >> after working an overnight shift, finishing at 7 in the morning, lashay started having contractions. she was rushed to hospital and gave birth. but now she has to get back to work. >> i hate to say it this way, but i'm kinda glad that he did come now and that he's gonna be in the hospital for the next couple of months, so that i can work. >> so that's actually, oxygen being pushed in? >> even if a baby can be saved in a nicu, its an outcome and a cost doctors say could be prevented. >> you're talking about several thousand dollars per day. so if you have a baby that is in the hospital for 8 months, the math is pretty easy - you're closing in on a million dollars of care just to get that baby home. if you could prevent one of those preemies, you save the system hundreds of thousands of dollars. that's why access to care and pre-natal care is so vital. >> if you have to have a baby born prematurely, the united states is one of the best places in the world for that baby to be born. our neo-natal intensive care units are some of the best, if not the best in the world. that's not the point. >> dr. arthur james is one of the leading infant mortality experts in the united states. he says that the heart of the problem lies outside of the hospitals. >> unfortunately in this country, when we experience families who are in crisis, we generally throw everything and the kitchen sink at them to try and assist and help during that period of time, but we are not anywhere close to being that vigilant about trying to practice preventive medicine, about trying to keep families out of crisis. >> everywhere you look in cleveland, it seems those crises are playing out. in a corner of the city's public cemetery, 24-year-old laney smith is visiting the grave of her infant son, jayceon. he died two weeks ago. the burial sites are marked with nothing more than wooden sticks. but each one represents a story of personal loss. >> he's just a number. and it just don't feel like people right here. just a bunch of dirt. >> each year, 85 infants die within the first 12 months in cleveland, a death rate that's growing even while the city's population is diminishing. >> that's in the hospital? >> i just wish the funeral home part would go. 'cause once that leaves i think i might be better. >> that was the hardest part? >> yea, to like. >> laney had given birth to twins who were more than three months premature. jayceon's brother died within the first few hours. the surviving child spent time in intensive care before he was healthy enough to leave the hospital. >> laney says everything was normal, until one night - when jayceon was four months old - he stopped breathing in his sleep and died. >> i don't know what it was but something felf wrong and i woke up. and when i picked him up it was just like... nothing. >> the doctors told laney it was sudden infant death syndrome, or sids, the third leading cause of infant death. >> it's like losing a piece of your heart, missing a piece of your soul, 'cause my kids are my heart, my kids are my soul. >> now, laney is focused on raising her two-year-old daughter and six-year-old son. but she's finding it hard to overcome her loss. >> and i go to school from 9-4 and i'm working 7 days a week. i have no off day. it's like my mind is just cluttered with everything - stress, everything. >> i just feel so horrible because i wasn't able to protect my kids and everybody says you're supposed to be able to protect your kids as a parent. but i feel like i failed. >> cases like laney's are all too common in cleveland. so what is it that's causing so many babies to die here in this city? why are those babies predominantly african american, and what is being done to try to stop it? >> catch more "faultlines" episodes on demand or at aljazeera.com/faultlines. >> we're here to fully get into the nuances of everything that's going on, not just in this country, but around the world. getting the news from the people who are affected. >> people need to demand reform... >> ali velshi on target weeknights 10:30p et >> the reasons for infant mortality are complex, but what everyone agrees is that poverty plays a part. the rates are worst in the cities of the south and the "rust belt" with their legacies of economic collapse and racial division. and one of the hardest hit cities is cleveland. >> here, the unemployment rate for whites is around 6%. for african americans, the number is almost three times higher. >> like many cities across america, the sight of boarded up businesses and devastated neighborhoods is something that's become increasingly common. but what's remarkable about cleveland is that it also happens to be the worst city in the entire united states for infant mortality. >> in cleveland, there are neighborhoods where the infant mortality rate is worse than that of countries such as guatemala, botswana. and even north korea. >> eric price is a lifelong cleveland resident. he says the scale of the problem is a product of living in a forgotten city. >> this used to be a great area. it was great for bringing up kids. it was great educationally. it was a middle-class, typical middle-class, mid-western neighborhood. >> eric remembers these neighborhoods as prosperous places when transport, oil and steel drove the city's economy. >> but now, there are no jobs, of course there's no money. they even started tearing down schools. they didn't care about our educational systems. they didn't care about our healthcare. i know parents who struggle to feed their kids on a daily basis. we literally have nothing. >> with the collapse of those communities, have come soaring rates of infant mortality. factors that social historians of the city say are inextricably entwined. >> sometimes we wanna deal with just the medical piece - which is really important, right? because people are dying, babies are dying. but we also then have to look at what is feeding that continuously. and if people don't have access to good housing they don't have access to healthy food, if they don't have access to money to buy food, right? all of those things. then we're gonna continue to see these kinds of statistics. >> 21-year-old areil smith is homeless, unemployed. and 8 months pregnant with her first child. the father of her unborn baby was sent to prison two months ago. she's been struggling to get by ever since. >> the situation that i'm in is not a situation for anybody pregnant to be in. to be homeless and then i have a child on the way is just the worst situation that i feel like i could possibly be in. >> areil has known hardship her entire life. she was raised in foster care, and she says her baby will be the only real family she has ever known. >> i feel like i don't have anybody. my son, that's gonna be my heart, like, you know, he gonna be everything to me. like, and that's somebody that i'm going to love unconditionally no matter what. >> areil's only support is charlesretta wynn, a community health worker. charlesretta works for a program called momsfrist that supports new and expecting mothers in cleveland's toughest neighborhoods. >> when i got hired, i was just supposed to provide the women with information and support. refer them to organizations that could help them to get some of the things that they need for their babies, because a lot of babies were dying in this neighborhood. >> but over the years, charlesretta has been doing a lot more than just offering health advice. she spends most of her time helping women navigate what she says is a broken welfare system. >> i'm a worker, i need people to work with me, you know, so we can help the situation. >> today, charlesretta is helping ariel get food assistance that has been slow to come. >> she says still hasn't gotten her benefits. she's eight months pregnant. now if she'd have had her benefits at six months like they were supposed to give it to her, she would have had her $75 to get her low-income housing. now they put her on the back of the burner. she still ain't got her benefits. >> your coupons won't start today, because you missed the month of april, so they're going to start the 24th through the 30th. >> you have to go to five different interviews before you get your cash assistance. so it takes a while to get them. i don't want to have to have cash benefits for 36 months. i don't want to have to have it for 12 months. but, like, i want to really depend on myself. but at this time i do need help. >> ariel wants to pursue her education, but was told that she wouldn't be eligible for welfare unless she took an unpaid job. even though she's pregnant. >> it's life. for me anyway. i have to deal with it. there's no other way around it. >> lot of times programs and stuff, all they care about is numbers. they don't care about people. >> charlesretta is convinced the system is failing to address the root causes of problems it was designed to solve. >> they need this assistance they get, stop cutting these programs that are helping people. and if it doesn't change, you're going to see more violence. you're going to see more babies dying, you're going to see more family tragedies, that's what you're going to see. >> cleveland hasn't always been the worst city in america for infant mortality. but while the problem at a national level has actually been improving, cleveland's numbers have been getting worse. >> cleveland's infant mortality figures are tracked by the city's department of health, so we've come here to city hall to speak to the person in charge and ask what they're doing to address what many here are saying is a crisis that's facing the city. >> as cleveland's public health director, karen butler is in charge of pregnancy programs like "moms first" that are designed to help pregnant mothers. despite the success of that program, some argue that it's only reaching a fraction of the population that needs help. >> through this mom's first program we have had tremendous success. in fact our most recent reports on our infant mortality rate demonstrate that there has been a steady decline in the infant mortality rate among our participant population. >> the city of cleveland, if you compare the rates, it's worse than any other us city. >> ok, so that. >> were you aware of that? >> not that we were the absolute worst. no. >> did you think you were in the bottom five? >> um, cleveland is one of the cities, one of the major large metropolitan cities that has a major issue with infant mortality as well as many of the other healthcare issues. >> but if you look at the picture of the city, the rates are worse than countries like albania and sri lanka. i mean that's surely not something you can be proud of. >> we're not, nor would we indicate that we're proud of our numbers. we're proud of the effort--we're proud of the effort that clevelanders are putting forth to begin to address those issues. >> that's good. >> thank you. >> can i just ask about the women who are falling outside the net? >> we've answered those. >> yeah, we did this. thank you. very much. >> after walking out of the interview, we were told that the official wasn't prepared for such specific questions. even though we'd been clear we wanted to speak about infant mortality throughout cleveland. >> well that was a surprising response to some pretty simple questions. and the interesting thing for me was, not only do the officials here in cleveland not seem to want to talk about the city wide rate of infant mortality, they also don't seem to know quite how bad those numbers are. >> back in the city's nicus, the sense of crisis is certainly being felt. every day, these doctors and nurses are battling to save lives. trying to control a situation they say is increasingly out of their hands. cleveland's economic struggles, its decayed neighborhoods with their rampant unemployment levels and uneven access to healthcare have combined to turn the city into america's infant mortality capital. but if this wasn't a perfect enough storm, now, politicians at the state level are now considering further cuts to healthcare. >> the politicians in columbus are playing games to be quite blunt. and we may not get literally billions of dollars that we have coming to us. that we're spending the money, but it may not be coming back to us, because politicians have decided they want to play politics. if that happens, that'll be disastrous for our state and it'll certainly be disastrous for our hospital for our nicu. >> catch more "faultlines" episodes on demand or at aljazeera.com/faultlines. >> bold... >> he took two m-16's, and he crawled... >> brave... >> ...do what you gotta do... >> then betrayed... >> why do you think you didn't get the medal of honor? >> a lifetime without the honor they deserved... >> some say that it was discrimination... >> revealing the long painful fight, to recognize some of america's bravest... >> he say.. be cool...be cool... >> ...proudest moment in my life.. >> honor delayed a soledad o'brien special report only on al jazeera america >> this summer, ohio's state capital columbus was the scene of heated debate over whether or not to expand healthcare coverage for the working poor. >> the question is: "shall the amendment be agreed upon?" >> ohio's republican-controlled legislature turned down $13 billion in extra funding from the federal government for what appeared to be ideological reasons. >> i urge the failure of this amendment. >> they even rejected a comparatively small emergency measure aimed at reducing the state's woeful infant mortality rates. >> we asked for $3.8 million to be targeted where the masses of racial and ethnic minorities live in the state of ohio . allowing infants to live until their first birthday. >> senator charleta tavares has been working for years to redress racial health disparities in ohio. she proposed an amendment to ohio's budget to fund health programs to specifically reduce infant mortality in minority communities. >> every public official will hold up a baby, will talk about how children are our greatest assets, but it seems to some communities and the community that i represent, that some babies matter more than others. >> those opposed say "nay" >> the proposal went nowhere. the majority voting to move ahead without the amendment. >> i'm for doing well for the poor, but you don't do it by making it easy for them to stay in poverty, you have to drive them out and make them uncomfortable in their poverty and they will do for themselves. they will earn for themselves and they will be much better off at the end of the day when they have earned it on their own, versus when they have gotten handouts. >> but why would politicians in a state clearly in the midst of a crisis, with such high numbers of babies dying before their first birthday, turn down money that could make a real difference? >> i'm sebastian walker with al jazeera. i just wanted to see if senator obhof is available to speak about the medicaid expansion. >> you can leave your information and i can ask him about it. >> okay, thank you very much. >> no problem. >> it's a simple question that many, it seems, didn't want to answer. >> i mean we wanted a short conversation with anybody on the republican side to talk about the health dispairites. is there anyone else that's willing to speak to us on the republican side? >> not that i know of. >> thank you. >> we'd love to talk to him, even just for five minutes. >> sure, i know that he is chalked up for the day, but i'll make sure he gets it. >> okay, thanks very much. it's just about infant mortality and the healthcare provisions. >> alright. >> okay. >> thank you. >> eventually, we did catch up with one of them. republican state senator kris jordan. >> oh, hi, i'm sebastian walker from al jazeera. >> just on infant mortality in ohio, are you aware that this is one of the worst states in the country for... >> i've got a meeting that i'm running late to. >> could we just, very briefly, get your comment on that? >> i've got a meeting that i'm running late to! >> really briefly, this is one of the worst places in the entire country for.. >> kris jordan: i've got a meeting that i'm running late to, that i told you five times. >> could we just get your position really quickly senator? just a couple of minutes of your time? >> well, we've been trying to get answers from politicians on the other side of the health care debate here in columbus. the one person we found didn't want to answer any of our questions. and with nothing currently on the table to do anything about healthcare disparities here in ohio, it looks like the state's infant mortality crisis is just going to keep getting worse. >> we live in a system where racism is still prevalent and there's stereotypes and caricatures that follow certain groups of people like low income, single black mothers that "you're not doing your best. you're living off the system. you're driving cadillac's"- all this stuff that has no basis in reality. >> racism and poverty are intertwined and i think each makes the other worse. but i think racism is the venom in the bite of poverty. >> i would say to the politicians: stop thinking about yourselves, ok? start thinking about the people who put you in there. have some empathy for them, have some sympathy for them. >> before leaving ohio, we went to see one of the mothers we'd met earlier in our time here. ariel has just given birth - not to the boy she was expecting- but to a daughter who she's named samari. samari was full-term but substantially underweight. she has several birth defects, including a cleft lip and palette. >> once i saw her, it made me like sad, kinda depressed, but it's something that i eventually got over it, because i mean she's gonna be here regardless whether her lip gets fixed or not. i mean she's my daughter and she has to be taken care of. >> areil was still homeless and waiting for her public housing to come through. but now with a newborn baby to take care of. >> so what kind of future are you hoping for for samari? >> i definitely want her to have a better education, a better group of people to be around, a better society to live in. i mean for the time being we're here, so we make the best of it. but when i definitely get a chance we definitely moving, somewhere away from here. >> these people have decided that today they will be arrested. >> i know that i'm being surveilled. >> people are not getting the care that they need. >> this is a crime against humanity. >> hands up... >> don't shoot. >> hands up... >> don't shoot. >> what do we want? >> justice. >> when do we want it? >> now. yo >> i'm ali velshi."on target" tl divide. the battle to bring high speed internet to people that want i.t. and the laws that get in the way leaving you the customer in the middle. the battle for economic prosperity in the 21st century has convinced many americans cities that they will be left in the dust if they don't offer businesses and entrepreneurs superhigh speed internet service. that's why the holy grail has become

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