Download & Other Tools
- Definition: Number of deaths of children under age 1 per 1,000 live births, by leading causes of infant death in California.
- Data Source: California Dept. of Public Health, Death Statistical Master Files; CDC, Mortality data on WONDER (Apr. 2015).
- Footnote: Figures are presented as rates over three-year periods. Leading causes of death were derived from the 2013 statewide mortality data using the categories listed in this report. It is important to note that leading cause of death in the U.S. differs from California. In the U.S., Accidents (0.3 per 1,000 live births in 2011-2013) surpasses Newborns Affected by Complications of Placenta, Cord, and Membranes as the fifth leading cause of death. LNE (Low Number Event) refers to data that have been suppressed because there were fewer than 20 infant deaths from a given cause. N/A means that data are not available.
- Measures of Infant Mortality on Kidsdata.org
Kidsdata.org provides the following measures of infant mortality for the state and California counties:
- Infant mortality rate, as three-year averages
- Infant mortality rate by leading cause of death, as three-year averages
- Infant mortality rate by race/ethnicity, as five-year average (due to low numbers)
To show comparable information at the local and state levels, kidsdata.org lists only the leading causes of death in children for the state of California. The leading causes of infant deaths in California are very similar to the leading causes locally and nationally. Kidsdata.org also provides data on deaths among older children.
- Infant Mortality
- Low Birthweight and Preterm Births
- Prenatal Care
- Why This Topic Is Important
Infant mortality is a key measure of a nation's health, as it reflects maternal health, quality of and access to medical care, socioeconomic conditions, and public health practices, among other factors (1, 2). Major causes of infant mortality include congenital malformations or abnormalities (birth defects); disorders relating to short gestation and low birthweight; maternal complications of pregnancy; and Sudden Infant Death Syndrome (3). Reducing infant mortality requires wide-ranging approaches, such as ensuring access to: high-quality primary care prior to pregnancy; high-quality and timely prenatal and well-baby preventive care; specialty care for preterm infants and those with health conditions; breastfeeding support; immunizations; and safe, healthy environments (1).
Although the U.S. infant mortality rate has declined in recent decades, it still is higher than those in most other developed countries (1, 2). The infant mortality rate among African Americans remains particularly high—more than double the rate for white, Latino, and Asian/Pacific Islander infants, nationally and in California (3, 4).Find more information and research about infant mortality in kidsdata.org's Research & Links section.
Sources for this narrative:
1. U.S. Dept. of Health and Human Services, Health Resources and Services Administration. (2013). Report of the Secretary’s Advisory Committee on Infant Mortality: Recommendations for Department of Health and Human Services action and framework for a national strategy. Retrieved from: http://www.hrsa.gov/advisorycommittees/mchbadvisory/InfantMortality/Correspondence/recommendationsjan2013.pdf
2. MacDorman, M. F., et al. (2014). International comparisons of infant mortality and related factors: United States and Europe (2010). Centers for Disease Control and Prevention, National Vital Statistics Reports. Retrieved from: http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_05.pdf
3. Mathews, T. J., et al. (2015). Infant mortality statistics from the 2013 period linked birth/infant death data set. Centers for Disease Control and Prevention, National Vital Statistics Reports. Retrieved from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_09.pdf
4. As cited on kidsdata.org, Infant Mortality Rate, by Race/Ethnicity, 1999-2013. (2015). California Dept. of Public Health (CDPH) and Centers for Disease Control and Prevention. Retrieved from: CDPH Death Statistical Master Files and http://wonder.cdc.gov/
- How Children Are Faring
California's infant mortality rate declined 33% between 1994 and 2013, from 7.0 per 1,000 live births to 4.7, echoing national trends. Local infant mortality rates range widely, from 2.6 to 7.5 per 1,000 live births, among counties with available data in 2011-13. Statewide, in 2011-13 and previous years, the leading causes of infant deaths were birth defects and disorders related to preterm birth and low birthweight. Disparities persist in infant mortality rates by race/ethnicity, with California's Asian/Pacific Islander and white infants having lower infant mortality rates than other racial/ethnic groups with available data.
- Policy Implications
Some of the leading causes of infant mortality (e.g., birth defects, Sudden Infant Death Syndrome, and preterm births) are preventable, and can be addressed through public policy. California policy currently promotes newborn screenings for potentially fatal birth defects, as they can help avert long-term health consequences, and even death, through early identification and treatment (1). Public and institutional policy also can affect the risk and protective factors for Sudden Infant Death Syndrome (SIDS) and preterm births (2). Risk factors can be reduced through many different strategies, such as ensuring that women are in good health before conception, avoid smoking and substance use while pregnant, and forgo elective deliveries before 39 weeks gestation, as well as broader strategies that address social determinants of health (2, 3).
According to research and subject experts, policy options that could reduce infant mortality include:
For more policy ideas and research on this topic, see kidsdata.org's Research & Links section, or visit the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services Maternal and Child Health site. Also see policy implications on kidsdata.org for Low Birthweight and Preterm Births and Prenatal Care.
- Supporting evidence-based, culturally-appropriate communication and social marketing strategies to help educate families about ways to promote infant health, including family planning, breastfeeding, immunizations, smoking cessation, and safe sleep (2, 3)
- Ensuring that public education to prevent SIDS and Sudden Unexpected Infant Deaths (SUID), reaches a wide constellation of potential caregivers for infants; key recommendations include avoiding sleeping on the stomach, overly soft sleeping surfaces and loose bedding, co-sleeping, and smoking during pregnancy (2, 4)
- Sustaining funding for substance use screening among pregnant women, and for treatment specifically designed for pregnant women who use alcohol or illicit drugs (2)
- Supporting education and systems change to reduce the number of elective deliveries before 39 weeks (2, 3)
- Promoting research and strategies aimed at reducing the rates of preterm labor and delivery (5)
- Increasing public education about newborn screenings and ensuring funding for those screenings, as they can prevent infant death, brain damage, and serious illness (1)
- Continuing efforts to ensure that all women and infants, including those with special health care needs, receive quality medical care that is safe, timely, effective, efficient, equitable, and patient-centered (2)
- Supporting a comprehensive approach to women’s health, including integration of reproductive planning into women’s routine health care, as good health before conception can improve pregnancy outcomes; this should include addressing mental/behavioral health and social support needs, as well as increasing interpregnancy intervals (at least 12 months), as short intervals are associated with increased risk for preterm birth (2, 6)
- Continuing to address the underlying causes of infant mortality by focusing on social determinants of health, for example, investing in under-resourced communities and efforts to ameliorate the effects of poverty on families during childbearing years (2)
- Supporting ongoing efforts to improve data systems for measuring health care access, quality, and outcomes for women and infants, as timely and accurate data is critical for informing policy and program decisions (2)
- Promoting collaboration across agencies and sectors at the local, state, and national levels, to combine resources and expertise toward the common goal of reducing infant mortality (2)
Sources for this narrative:
1. California Dept. of Public Health. (2015). California Newborn Screening Program. Retrieved from: http://www.cdph.ca.gov/programs/NBS/pages/default.aspx
2. U.S. Dept. of Health and Human Services, Health Resources and Services Administration. (2013). Report of the Secretary’s Advisory Committee on Infant Mortality: Recommendations for Department of Health and Human Services action and framework for a national strategy. Retrieved from: http://www.hrsa.gov/advisorycommittees/mchbadvisory/InfantMortality/Correspondence/recommendationsjan2013.pdf
3. Richards, J., & DeFrancis Sun, B. (2013). Infant mortality toolkit. National Center for Education in Maternal and Child Health, Georgetown University. Retrieved from: http://ncemch.org/toolkits/infant-mortality.php
4. Centers for Disease Control and Prevention, Division of Reproductive Health. (2015). Sudden unexpected infant death and sudden infant death syndrome. Retrieved from: http://www.cdc.gov/SIDS/index.htm
5. Centers for Disease Control and Prevention, Division of Reproductive Health. (2014). Preterm birth. Retrieved from: http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm
6. Johnson, K. A., et al. (2012-2014). Action plan for the national initiative on preconception health and health care (PCHHC). PCHHC Steering Committee. Retrieved from: http://www.cdc.gov/preconception/documents/actionplannationalinitiativepchhc2012-2014.pdf
- Websites with Related Information
- Association of Maternal & Child Health Programs (AMCHP)
- California Maternal Quality Care Collaborative
- California Perinatal Quality Care Collaborative
- CityMatCH, National Organization of Urban Maternal Child Health Leaders
- Health Resources and Services Administration: Maternal and Child Health Bureau, U.S. Dept. of Health and Human Services
- Infant Mortality and Pregnancy Loss Knowledge Path, National Center for Education in Maternal and Child Health
- National Institute for Children's Health Quality (NICHQ)
- Sudden Unexpected Infant Death and Sudden Infant Death Syndrome, Centers for Disease Control and Prevention, Division of Reproductive Health
- Key Reports
- Effect of Home Visiting by Nurses on Maternal and Child Mortality: Results of a 2-Decade Follow-up of a Randomized Clinical Trial, 2014, JAMA Pediatrics, Olds, D. L., et al.
- Fetal and Perinatal Mortality: United States (2013), 2015, Centers for Disease Control and Prevention, National Vital Statistics Reports, MacDorman, M. F., & Gregory, E.
- Infant Mortality Statistics from the 2013 Period Linked Birth/Infant Death Data Set, 2015, Centers for Disease Control and Prevention, National Vital Statistics Reports, Mathews, T. J., et al.
- Infant Mortality Toolkit, 2013, National Center for Education in Maternal and Child Health, Richards, J., & DeFrancis Sun, B.
- International Comparisons of Infant Mortality and Related Factors: United States and Europe (2010), 2014, Centers for Disease Control and Prevention, National Vital Statistics Reports, MacDorman, M. F., et al.
- NHPCO's Facts and Figures: Pediatric Palliative & Hospice Care in America, 2015, National Hospice and Palliative Care Organization, Friebert, S., & Williams, C.
- Opportunities and Strategies for Improving Preconception Health through Health Reform: Advancing Collective Impact for Improved Health Outcomes, 2015, Association of Maternal & Child Health Programs
- Report of the Secretary’s Advisory Committee on Infant Mortality: Recommendations for Department of Health and Human Services Action and Framework for a National Strategy, 2013, U.S. Department of Health and Human Services, Health Resources and Services Administration
- Trends in Infant Mortality in the United States, 2005–2014, 2017, National Center for Health Statistics, Mathews, T. J., & Driscoll, A. K.
- County/Regional Reports
- 2014 Solano Children's Report Card, Children's Network of Solano County
- 2016 Kern County Report Card, Kern County Network for Children
- Community Health Assessment 2015, Los Angeles County Dept. of Public Health
- Fresno Community Scorecard
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- Santa Clara County Public Health Department: Data and Statistics
- The 22nd Annual Report on the Conditions of Children in Orange County, 2016, Orange County Children's Partnership
- More Data Sources For Infant Mortality
- Child Trends Databank: Infant, Child, and Teen Mortality
- Childstats.gov, Federal Interagency Forum on Child and Family Statistics
- Diversitydatakids.org, Brandeis University, Institute for Child, Youth and Family Policy
- FastStats: Infant Health, Centers for Disease Control and Prevention
- Health Indicators Warehouse, National Center for Health Statistics
- KIDS COUNT Data Center, Annie E. Casey Foundation
- National Survey Publications and Chartbooks, U.S. Dept. of Health and Human Services, Health Resources and Services Administration
- National Vital Statistics Reports, Centers for Disease Control and Prevention, National Center for Health Statistics
- PeriStats, March of Dimes
- Pregnancy Risk Assessment Monitoring System (PRAMS), Centers for Disease Control and Prevention
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