Source: www.citymatch.org

Public Health Community Advisory – September is Infant Mortality Awareness month, and CityMatCH is looking to draw attention to the inequities that still linger. Overall, the United States is making progress in reducing infant mortality rates (IMR). In 2013, the IMR was 5.96/1,000 live births. From 2005 through 2011, the infant mortality rate declined 12 percent. The decline was highest in states with the highest burden, which is encouraging news.[1] However, the disparity between white and black infant mortality continues to persist. If projections hold true, the infant mortality rate for blacks will still be 2.3 times higher for whites in 2020, as shown through CDC Wonder Data.[2] Although white mothers with more than a high school education are predicted to reach the Healthy People 2020 goal of 6.0, white mothers with lower education and ALL black mothers will not.[3]

Based on this information, CityMatCH epidemiology staff completed some additional future projections on national infant mortality rates, using the same CDC Wonder Data. Using the same type of projection methodology as Loggins and Andronde, CityMatCH projections indicated:

• the black infant mortality would remain in the double digits until 2023;
• the black infant mortality rate would not reach the Healthy People 2020 goal of 6.0 until 2045—another 30 years; and,
• parity in rates using these projections would not be achieved until 2070 – almost 50 years from now.

This is not just a black and white issue. We also see disparities when looking at American Indian/Alaska Native (AI/AN) infant mortality rates as well. AI/AN rates are 7.61 nationally, which is significantly worse than the non-Hispanic white rate of 5.96.[4] In addition, some states have AI/AN IMR rates over 10. We are making progress, but it simply isn’t good enough. We cannot accept this enduring inequity for the whole of our lifetimes.

CityMatCH, the national membership organization of urban maternal and child health (MCH) leaders, has a 25-year history of working to reduce infant mortality rates across the country. CityMatCH is part of the UNMC Department of Pediatrics, section of Child Health Policy. Our mission is to strengthen public health leaders to promote equity and improve the health of urban women, children, families, and communities. Throughout our history, CityMatCH has worked with urban communities across the country to strengthen partnerships, create peer exchange opportunities, provide epidemiology training, and disseminate guidelines and recommendations to a large national audience.

CItyMatCH has been instrumental in national-level infant mortality reduction efforts, including creating and facilitating the broad uptake of the Perinatal Periods of Risk (PPOR) approach, where local communities analyze their data to strategically implement infant mortality prevention programs. CityMatCH has also coordinated a number of action learning collaboratives specifically addressing the persistent racial disparities in IMR. Our most recent effort is the Institute for Equity in Birth Outcomes, a national initiative of 23 teams working to improve birth outcomes in populations that experience the largest disparities. Please visit our website to learn more about us and our initiatives: www.citymatch.org.

_{[1] MacDorman, M., Hoyert, D., Mathews, T. (2013). Recent declines in infant mortality in the United States, 2005-2011.  NCHS Data Brief, 120.
[2] United States Department of Health and Human Services (US DHHS), Centers of Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics (DVS). Linked Birth / Infant Death Records 2007-2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program, on CDC WONDER On-line Database. Accessed at http://wonder.cdc.gov/lbd-current.html on Jul 25, 2016 12:27:50 PM
[3] S. Loggins & F.C.D. Andrande. Despite an Overall Decline in U.S. Infant Mortality Rates, the Black/White Disparity Persists: Recent Trends and Future Projections. Journal of Community Health, August 2013
[4] Mathews TJ, MacDorman MF, Thoma ME. Infant mortality statistics from the 2013 period linked birth/infant death data set. National vital statistics reports; vol 64 no 9. Hyattsville, MD: National Center for Health Statistics. 2015. http://www.cdc.gov/nchs/fastats/american-indian-health.htm}

This article was written by Joe Sibilia, Public Health Communication Specialist, CityMatCH, University of Nebraska Medical Center, Department of Pediatrics  joe.sibilia@unmc.edu