- Infant Mortality
- Low Birthweight and Preterm Births
- Prenatal Care
- Teen Births
- Why This Topic Is Important
Infant mortality is a key measure of a nation's health, as it reflects socioeconomic conditions, public health practices, maternal health, and access to high-quality medical care, 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 that improve primary care prior to pregnancy, prenatal and well-baby preventive care, specialty care for preterm infants and those with health conditions, breastfeeding support, and immunizations, along with empowered communities creating safe, healthy environments for all families (1).
Although the U.S. infant mortality rate has declined in recent decades, it remains higher than rates in most other developed countries (1, 2). The infant mortality rate among African American/black mothers is particularly high—more than double the rate for white, Latino, and Asian/Pacific Islander groups, both nationally and in California (3, 4).Find more information and research on infant mortality in kidsdata.org's Research & Links section.
Sources for this narrative:
1. U.S. Department of Health and Human Services. (2013). Report of the Secretary's Advisory Committee on Infant Mortality: Recommendations for HHS action and framework for a national strategy. Retrieved from: https://www.hrsa.gov/advisorycommittees/mchbadvisory/InfantMortality/About/natlstrategyrecommendations.pdf
2. MacDorman, M. F., et al. (2014). International comparisons of infant mortality and related factors: United States and Europe, 2010. National Vital Statistics Reports, 63(5). 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. National Vital Statistics Reports, 64(9). 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. (2017). California Department of Public Health & National Center for Health Statistics.
- How Children Are Faring
California's infant mortality rate declined by 37% between 1994 and 2015, from 7 infant deaths per 1,000 live births to 4.4 per 1,000, echoing national trends. At the county level, infant mortality rates range widely, from 2.8 (San Mateo) to 8.1 (Mendocino) among counties with data in 2013-15. Statewide, in 2013-15 and in previous years, the leading causes of infant death were birth defects and disorders related to preterm birth and low birthweight.
Disparities persist in infant mortality rates by race/ethnicity. Statewide, among groups with data in 2011-15, infants born to African American/black and multiracial mothers died at rates of at least 9 per 1,000, whereas Asian/Pacific Islander and white mothers had infant mortality rates below 4 per 1,000.
- Policy Implications
Some of the leading causes of infant mortality (e.g., birth defects, preterm births, and Sudden Infant Death Syndrome (SIDS)) are preventable, and can be addressed through public policy. California 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 address the risk and protective factors for 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).
Policy and program 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 Bureau. 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 practices (2, 3)
- Ensuring that public education to prevent SIDS and other sleep-related infant deaths 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 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 and ensuring funding for prenatal and newborn screening services, as early identification can reduce the risk for 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, 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 the interval between pregnancies to at least 12 months (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. (2017). Genetic Disease Screening Program. Retrieved from: https://www.cdph.ca.gov/Programs/CFH/DGDS
2. U.S. Department of Health and Human Services. (2013). Report of the Secretary's Advisory Committee on Infant Mortality: Recommendations for HHS action and framework for a national strategy. Retrieved from: https://www.hrsa.gov/advisorycommittees/mchbadvisory/InfantMortality/About/natlstrategyrecommendations.pdf
3. Richards, J., & DeFrancis Sun, B. (2013). Infant mortality toolkit. National Center for Education in Maternal and Child Health. Retrieved from: http://ncemch.org/toolkits/infant-mortality.php
4. Centers for Disease Control and Prevention. (2017). 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 (2017). Preterm birth. Retrieved from: http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm
6. Johnson, K. A., et al. (n.d.). Action plan for the National Initiative on Preconception Health and Health Care, 2012-2014. Retrieved from: http://www.cdc.gov/preconception/documents/actionplannationalinitiativepchhc2012-2014.pdf
- Websites with Related Information
- Association of Maternal and Child Health Programs (AMCHP)
- California Dept. of Public Health: Maternal, Child and Adolescent Health Division
- California Maternal Quality Care Collaborative
- California Perinatal Quality Care Collaborative
- CityMatCH, National Organization of Urban Maternal Child Health Leaders
- Infant Mortality and Pregnancy Loss, National Center for Education in Maternal and Child Health, Georgetown University
- National Institute for Children's Health Quality
- Sudden Unexpected Infant Death and Sudden Infant Death Syndrome, Centers for Disease Control and Prevention
- U.S. Dept. of Health and Human Services: Maternal and Child Health Bureau
- Key Reports and Research
- 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, National Vital Statistics Reports, MacDorman, M. F., & Gregory, E. C. W.
- Health Equity and Birth Outcomes, 2017, March of Dimes
- Infant Mortality Statistics from the 2013 Period Linked Birth/Infant Death Data Set, 2015, 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, National Vital Statistics Reports, MacDorman, M. F., et al.
- NHPCO's Facts and Figures: Pediatric Palliative and 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 and Child Health Programs
- Report of the Secretary’s Advisory Committee on Infant Mortality: Recommendations for HHS Action and Framework for a National Strategy, 2013, U.S. Department of Health and Human Services
- 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
- 2017 Kern County Report Card, Kern County Network for Children
- Community Health Assessment and Community Health Improvement Plan, Los Angeles County Dept. of Public Health
- Live Well San Diego Report Card on Children, Families, and Community, 2017, The Children's Initiative & Live Well San Diego
- Santa Clara County Public Health Department: Health Data and Statistics
- The 24th Annual Report on the Conditions of Children in Orange County, 2018, Orange County Children's Partnership
- More Data Sources For Infant Mortality
- CDC WONDER, Centers for Disease Control and Prevention
- Child Trends Databank: Infant, Child, and Teen Mortality
- KIDS COUNT Data Center, Annie E. Casey Foundation
- Maternal and Child Health Bureau: National Survey Publications and Chartbooks, U.S. Dept. of Health and Human Services
- National Vital Statistics Reports, Centers for Disease Control and Prevention, National Center for Health Statistics
- PeriStats, March of Dimes Perinatal Data Center
- Pregnancy Risk Assessment Monitoring System (PRAMS), Centers for Disease Control and Prevention
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