Our Health: Infant Mortality

Why is This Indicator Important?

Infant death is a measure of the health and well-being of children and the overall health of a community. It reflects the status of maternal health, the accessibility and quality of primary health care, and the availability of supportive services in the community. Infant mortality rates vary substantially among racial and ethnic groups; the rate continues to be higher for African American infants than for white infants.

Infants with low birthweight or preterm delivery have a higher risk of death. The use of alcohol, tobacco, and illegal substances during pregnancy is a major risk factor for low birthweight, infant mortality, and other poor outcomes.

Many of the risk factors for infant death can be prevented or reduced with good preconception and prenatal care. Advances in medical technology also have improved the survival of high-risk infants, such as those born before they reach full gestation. Other actions taken after birth can improve infants' health and chances of survival. Breastfeeding reduces rates of infection in infants, and putting infants to sleep on their back can help prevent Sudden Infant Death Syndrome (SIDS).

Measures

The rate of deaths among infants, under one year old, per 1,000 live births averaged over three years (the rate for a given year includes data from the prior two years; e.g., data for 2009 includes data from 2007-2009).

Infant death rate = (# of infant deaths in a calendar year ÷ # of live births in the same calendar year) × 1000

How Well is the Capital Area Community Doing?

The infant mortality rate in the Capital Area declined during the 1990s, but in recent years, there has been a slight increase in the three-year average. The rate for 2007-2009 was 5.1 deaths per 1,000 live births.

The infant mortality rate in the Capital Area continues to be lower than the state rate and is near Healthy People 2020 goal.

However, the difference in the infant death rate between African Americans and whites is significant. In Ingham County the death rate for black infants is more than three times the rate for white infants. We believe that African-American infants in Eaton and Clinton counties may be at higher risk for death than white infants; however, the data are not reportable due to small numbers.

Changing the Questions

Instead of only asking "why are rates of infant mortality consistently higher for African Americans than for whites?," perhaps we should also ask "how does unequal access to education, employment and housing impact birth outcomes for African Americans?" and "how does stress resulting from the daily experience of racism contribute to African American infant mortality?"

Resources

• Eliminating Disparities in Infant Mortality. This webpage is under the Centers for Disease Control and Prevention's Office of Minority Health and Health Disparities (OMHD) section. It offers a good introduction on infant mortality, the risk factors for SIDS, and promising strategies.
• Infant Mortality and African Americans. This webpage is maintained by the Office of Minority Health at the federal Department of Health and Human Services (DHHS) and has federal statistics demonstrating the disparity in infant mortality.
• Infant Mortality and Pregnancy Loss Knowledge Path. This page is a part of the Maternal and Child Health Library at Georgetown University. It offers a wealth of information about infant mortality for professionals and lay audiences alike.
• The March of Dimes. The March of Dimes is an advocacy group established by Franklin D. Roosevelt initially to stem the tide of polio among children. Once polio was eradicated, it shifted its focus first to birth defects and then to prematurity (the leading cause of infant mortality). This site provides a link to local and national funding and advocacy efforts. Peristat, a separate website administered by the March of Dimes, offers access to federal, state, and local perinatal statistics.
• Gaps in Infant Mortality Rates by Mother's Education: How Do States Compare?.This document, developed by the Robert Wood Johnson Foundation Commission to Build a Healthier America, shows, by state, the infant mortality rate among women of varying education levels. In almost every state the disparities in infant mortality was observed based on the amount of schooling the mother had.
• Unnatural Causes. This is the website of the documentary "Unnatural Causes." Episode 2 of the series "When the Bough Breaks" is specifically devoted to inequity in infant mortality. The site has video clips, advocacy toolkits, policy guides, and links to other resources.