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OVERVIEW OF INFANT MORTALITY IN ALABAMA

Infant mortality (IM) is a measure of the health of a population in a community, state or nation. Many factors can influence infant mortality, including medical complications, personal and social behavior, environmental conditions, and genetics. In the United States (U.S.) in 2015, the IMR was 5.9 infant deaths per 1,000 live births. Nevertheless, the U.S. ranked 24th in infant mortality compared to other industrialized nations of the world at 6.15 infant deaths per 1,000 live births, according to 2010 figures, compared with an average of 5.0 for other industrialized countries.

Despite progress in many states, the Alabama IMR continues to remain above the national IMR, ranking among the top three highest in the U.S. over the last decade, with a rate in 2016 of 9.1 infant deaths per 1,000 live births. This rate corresponds to 537 infants who did not live to celebrate their first birthdays. To put this into perspective, a kindergarten classroom with 20 students would equate to almost 27 empty kindergarten classrooms in Alabama in 2016 because of these infants’ deaths. The impact of infant deaths on families, communities, society, and the state is profound.

The leading causes of infant death in Alabama are chromosomal malformations (birth defects), disorders related to short gestation (preterm birth) and/or low birth weight, and Sudden Infant Death Syndrome (SIDS). Furthermore, black infants die at a rate that is twice that seen among white infants. In addition to this racial disparity, inequity is seen also across economic, social and geographic divisions. Our priority areas for improving birth outcomes in Alabama include the following: ensuring access to systems of care, implementation of evidence-based population care, and reducing risk factors by addressing the social determinants of health. Health equity underlines infant deaths and efforts to move toward achieving healthy equity must be included in strategies to improve maternal health and birth outcomes.

ALABAMA IM DATA

In Alabama in 2016, approximately 20 percent of women of child bearing age (ages 18 – 44 years) were uninsured, and these women are likely to have health conditions that are not identified, diagnosed, or managed. Many women who are eligible for Medicaid during their pregnancies will no longer have access to insurance after the period of sixty days post- delivery. Additionally, thirty-two percent of women in Alabama have not had well woman visits, which focus on preventive care and assist women in becoming and staying healthy. According to the American College of Obstetricians and Gynecologists (ACOG), the well woman visit is a fundamental part of medical care and is valuable in promoting prevention practices, recognizing risk factors for disease, and identifying medical problems. In 2016, Alabama recorded 59,090 live births. These births were comprised of 39,241 births to white mothers and 19,849 births to black mothers or mothers of other races. There were 7,074 births classified as preterm (before 37 weeks gestation), accounting for approximately 12 percent of total births but almost 65 percent of total infant deaths. The percent of preterm births for whites was approximately 10 percent and the percent of preterm births for blacks was 15 percent. The best predictor of a preterm birth is a previous preterm birth, and of the 7,074 preterm births, there were 1,059 (15 percent) of these mother who had