Why Does Infant Health Matter?

Infant Health: Why it matters and what California and [LOCAL] Maternal, Child, and Adolescent Health Programs are doing to prevent infant death and disease

ver 1.1, April 30, 2012

Why does Infant Health matter?

· Infant mortality is one of the most important indicators of the health of a nation because it is the result of maternal health, quality and access to medical care, socioeconomic conditions, and public health practices.1

· The infant death rate in the U.S. and in California has remained relatively stable in the past 10 years. Increases in preterm birth and preterm-related infant mortality account for much of the lack of decline. 1,2

How is California/COUNTY doing?

· In 2009, 2,593 infants died in California before age one.2

Infant Mortality Rates, Selected Countries and California, 2005 (per 1,000 live births)2

· The United States ranked 30th worldwide, with 6.9 deaths per 1,000 live births.

· When compared to other countries, California ranked 25th, with a rate of 5.3 deaths per 1,000 live births.

Infant mortality rate by race/ethnicity in California, 2009 (per 1,000 live births)2

· The infant mortality rate for African Americans is more than 2 times the California average, and almost 3 times the rate for Whites.

· Unlike women of other racial or ethnic groups, poor birth outcomes persist even when African American women have a pregnancy at an optimal age, have high income, or are well-educated.3

Leading causes of Infant Death in California, 20094

1. Congenital Malformations, Deformations, and Chromosomal Abnormalities – 25.8% of total deaths

2. Disorders of Short Gestation and Low Birth Weight – 13.5% of total deaths

3. Sudden Infant Death Syndrome – 7.2% of total deaths

4. Effect of Maternal Complications of Pregnancy – 6.5% of total deaths

What has California/COUNTY been doing to promote infant health and reduce death/disease? Examples of efforts to reduce infant morbidity and mortality include:

· The Black Infant Health (BIH) program serves pregnant and parenting African-American women through a group intervention as well as complementary case management to improve the health and social conditions for African-American women and their families.5

· The Fetal and Infant Mortality Review (FIMR) Program is a community-based program that reviews the contributing factors to fetal and infant deaths in 16 local health jurisdictions in California. These programs identify causes of mortality and implement the necessary actions to improve services to families and prevent these deaths.6

· The Regional Perinatal Programs of California (RPPC) promote access to risk appropriate perinatal care to pregnant women and their infants through regional quality improvement activities because many high-risk women and infants do not have access to specialized care and are more likely to die or suffer permanent disabilities if they do not receive appropriate care.7

· The Sudden Infant Death Syndrome (SIDS) Program provides education about SIDS and SIDS risk reduction, such as placing babies on their backs to sleep and grief counseling to families that experience a SIDS death. SIDS is a sudden unexplained death of an infant under one year of age.8

How can promoting infant health save money?

· In addition to the cost of the lives of infants, infant mortality also impacts parents, families, and communities.

· The cost of the loss of an infant’s life far outweighs the expense of preventive programs and health care expenses to prevent infant mortality.

o Programs aimed at preventing infant mortality, prematurity, and low birth weight such as early initiation of prenatal care, nutrition education, and preconception care are cost-effective approaches since they reduce the likelihood that an infant will be born needing costly and intensive medical treatment.9

What can be done to promote infant health?

· Continue to support programs that promote access to prenatal care and infant care, such as those that increase access to public transportation.

o Babies born to mothers who received no prenatal care are five times more likely to die, than those whose mothers received prenatal care.10

· Support programs that promote healthy behaviors, such as smoking cessation, drug/alcohol abuse cessation, optimal nutrition, fitness, and healthy sexual behaviors to improve maternal health. Healthy women have healthy babies.

· Encourage the use birth support services such as doulas, breastfeeding counselors and midwives.

The Bottom Line

· Most infant deaths are preventable.

· The infant mortality rate in California has remained relatively stable for the past 10 years, despite advances in medicine and technology, and African-American infants are more than twice as likely to die as White infants.

· Promoting infant health is cost-effective, thus we should continue support for prevention work.

References

1. MacDorman MF, Mathews TJ. Recent Trends in Infant Mortality in the United States. NCHS Data Brief, No 9. October 2008. Available at: http://www.cdc.gov/nchs/data/databriefs/db09.htm

2. CDPH,California State and Local Infant Morality Rate Data, 2009. http://www.cdph.ca.gov/data/statistics/Documents/MO-MCAH-StatewideInfantMortalityData.pdf

3. Black Infant Health Program Fact Sheet, http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Pages/BlackInfantHealth.aspx

4. CDPH, Birth and Death Records, 2009. Retrieved from: http://www.cdph.ca.gov/data/statistics/Documents/VSC-2009-0409.pdf

5. For more information, see: http://www.cdph.ca.gov/programs/bih/Pages/default.aspx

6. For more information, see: http://www.cdph.ca.gov/programs/FIMR/Pages/default.aspx

7. For more information, see: http://www.cdph.ca.gov/programs/rppc/Pages/default.aspx

8. For more information, see: http://www.cdph.ca.gov/programs/SIDS/Pages/default.aspx

9. Minnesota Dept of Public Health http://www.health.state.mn.us/divs/chs/infantmortality/infantmortality09.pdf

10. US Dept of Health and Human Services http://www.hhs.gov/news/factsheet/infant.html

ver 1.1, April 30, 2012