Infant Mortality in Birth Outcomes: Measures and Data
What is the public health burden of infant mortality?Washington’s infant mortality rate has declined since 1980, as has the national rate. The majority of this decrease occurred during 1980-1995, when the rate dropped from 11.8 to 5.8 deaths per 1,000 live births. Washington state had the lowest infant mortality rates in the United States (4.7 per 1000 live births) in 2006.
Among African Americans in Washington, the infant mortality rate has declined but is still much higher than rates for Non Hispanic Whites. The rate has been increasing for Non Hispanic Native Americans/American Indians in Washington since 1994. The Perinatal Indicators Report for Washington Residents and the Maternal and Child Health Data Report provides additional data and a discussion issues related to infant mortality. The Health of Washington State Infant Mortality chapter explores the relationship between infant mortality rates, income, education and other socioeconomic factors.
The leading causes of infant mortality listed on death certificates from 2006-2008 were birth defects (22%), SIDS (14%), and preterm births (11%). Risk factors for infant mortality are discussed briefly under Basic Facts and in the Health of Washington State. Some environmental exposures may influence risk for certain birth defects, which in turn may raise the risk for infant death. An inadequate level of folic acid at conception and during early pregnancy is a major risk factor for neural tube defects like spina bifida.
Scientific reviews of the literature have shown a consistent relationship between particulate air pollution and respiratory death among postneonatal infants (age 28 – 364 days). In general, more research is needed to understand the possible effects of environmental exposures on infant mortality.
How is infant mortality defined and tracked?Infant mortality is the number of deaths among children under 1 year per 1,000 live births. This indicator can be broken down into neonatal deaths (< 28 days) and postneonatal deaths (28-364 days). The perinatal death rate refers to fetal deaths of 20 weeks gestation or more as well as deaths among infants less than 7 days old.
In Washington, the Department of Health (DOH) Center for Health Statistics tracks birth and death certificates through the Vital Registration System. The State Registrar reports linked birth and infant death files to CDC National Center for Health Statistics, which maintains data on all births and deaths in the United States and its territories. Data are standardized among all jurisdictions and are generally available one year later than state data.
What is being done to reduce infant mortality? Despite success in past decades to reduce infant mortality rate in the U.S., there is some concern that the rate of decline has slowed or leveled off in recent years. The Kids Count Indicator Brief: Reducing Infant Mortality outlines strategies for improving prevention and further reducing the infant mortality rate in the U.S., especially where rates are highest.
In Washington, programs at the Department of Health (DOH) and Department of Social and Health Services (DSHS) work with a variety of partners in the state to carry out programs promoting a healthy infancy, including:
These services address issues that promote healthy birth outcomes such as healthy birth spacing, unintended pregnancy reduction, prenatal medical care access, smoking cessation, alcohol and drug use prevention, healthy weight gain, breastfeeding promotion, and addressing family violence.
- State Title X Family Planning Program: family planning and women’s health services
- Special Supplemental Nutrition Program for Women, Infants and Children (WIC): breastfeeding support, nutritious foods, education and referrals to preventive services
- First Steps Program: prenatal medical care, Maternity Support Services, Infant Case Management
- Take Charge Program: family planning services for low income men and women
Other DOH activities include data surveillance, perinatal quality improvement projects, and development and dissemination of preconception healthy living messages.
More Information on Specific Birth Outcomes