About Infant Mortality in the U.S.

The Centers for Disease Control is the government entity that tracks infant mortality in the U.S.  They note that the five leading causes of this problem are:

• Birth defects (20.4%)
• Pre-term or low birth weight (18%)
• Sudden Infant Death Syndrome or SIDS (6.7%)
• Pregnancy complications (diabetes/high blood pressure/obesity/infection/etc.-6%)
• Injuries (4.9%)

But this is a complex issue.  Infant mortality is significantly worse in

• rural v. urban areas

Click here for an NPR report on rural poverty.

• poor v. rich communities

Here is a CBS story about the link between poverty and infant mortality.  And this is Newsweeks’s take on it.  And this is a blogpost by the Robert Wood Johnson Foundation on the issue of poverty and health.  

• black v. white populations

 According to this academic study, you are more likely to survive to your first birthday if you are born to a white woman with an 8th grade education than to a black woman with a college degree!

Here is the Guardian’s report on the issue of race and infant and maternal mortality in San Francisco.

The New York Times Magazine did an in-depth report on this issue in 2018.  Click here for that report.

What We Can Do

So there are lots reasons for America’s high infant mortality rate.  And they all seem like enormous, unrelated problems.  With all the complexity inherent in infant mortality, what are some of the solutions?

We will never be able to get the infant mortality rate to zero, but there are MANY things we can do that we know will address the problem.

Infant death from birth defects can be reduced with:

• immunization programs for mothers against Rubella (measles) prevents birth defects in their children.  A link to information from the March of Dimes is here.
• prenatal screening for diseases that can be treated early
• promoting the use of prenatal vitamins like folic acid to prevent birth defects (click here for a link to March of Dimes on the importance of folic acid during pregnancy)

We can improve infant mortality linked to low birth weight and premature delivery by:

• funding and promoting smoking cessation programs like this one in Ohio.
• Changing pay incentives to doctors and hospitals for elective pre-term deliveries as promoted by the March of Dimes ‘Healthy Babies are Worth the Wait’ campaign.
• Encourage community support of breastfeeding by educating professionals, community members, and new mothers about the social benefits.  Provide incentives for employers and communities to offer clean, safe spaces for breastfreeding in the workplace, and other breastfeeding initiatives promoted by the CDC.

We can reduce the number of SIDS deaths by:

• promoting breastfeeding for new mothers, and providing community support of breastfeeding to ensure that mothers have access to clean, safe spaces while at work and in the community.
• funding ‘Safe Sleep’ programs like this one in Ohio. Safe Sleep programs like this also prevent fatal injuries (such as suffocation), which are the fifth leading cause of infant mortality in the U.S.

We can reduce infant deaths due to pregnancy complications by:

• supporting moms both before and after birth with home visits
• The Pew Charitable Trusts blog about doulas (community health workers doing pre- and post-natal home visits) here.
• Here is an article about how community health workers and home visits can lower the infant mortality rate of African Americans.
• Allowing midwives to attend to hospital births. 

And we even have some ideas about addressing discrimination in health care:

The Robert Wood Johnson Foundation blogged about a way forward here.  And discusses new narratives of hope here.

The Washington Post explored the topic in this article.

Here is an interesting plan for funding infant mortality programs that comes out of Ohio.

This is a great read about promising practices to prevent infant mortality.

The March of Dimes has listed their priorities for policies to improve infant morality in the states here.

 

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