April 30, 2015
MDH releases plan to cut infant mortality rates, tackle disparities
The Minnesota Department of Health (MDH) has released an infant mortality reduction plan that calls for improving the state’s infant mortality rate with a stronger focus on reducing disparities across racial and ethnic groups. The plan is available on the MDH website at Infant Mortality Reduction Initiative.
The plan notes that Minnesota has made significant strides in reducing infant mortality for all races and has one of the lowest overall infant mortality rates in the U.S. Minnesota’s most recently documented mortality rate was 4.9 infant deaths per 1,000 live births during the period from 2008 to 2012. Infant mortality is defined as the death of an infant before age 1.
However, Minnesota’s rate is still about twice as high as some other industrialized countries such as Japan’s rate of 2.3 per 1,000 and Sweden’s rate of 2.5 per 1,000. In addition, a persistent disparity, particularly between whites (4.3/1,000) and African Americans (9.2/1,000) and American Indians (9.1/1,000), requires the state to think differently about the problem and to focus on health equity.
The plan notes that health and birth outcomes are strongly influenced by social and economic factors including income, education, and housing, and Minnesota’s inequities in these and other areas prevent some babies from having the opportunities for a healthy start.
“Minnesota has some of the lowest infant mortality rates in the country, but it is not acceptable that American Indian and African American infants are dying at twice the rate of white infants,” said Health Commissioner Dr. Ed Ehlinger. “This plan underscores that, if we are to improve overall infant survival, we must do more to address the social and economic factors impacting infant mortality in Minnesota.”
Data from 2008 to 2012 also show significant disparities among Black babies. While the composite African-American infant mortality rate is 9.2 deaths per 1,000 live births, the U.S. born Black rate is 12.4 per 1,000 compared to the foreign-born African American rate of 5.9 per 1,000.
The top causes of deaths also differ by race. Congenital anomalies are the leading cause of infant deaths in Minnesota overall, and the leading cause of infant deaths among Asians, Hispanics and Whites. Prematurity is the leading cause of infant deaths among African Americans, while Sudden Unexpected Infant Deaths (SUIDs), which includes sleep-related deaths, are the leading causes of deaths among American Indian infants.
MDH developed the plan in partnership with stakeholders representing a wide range of Minnesotans. Participants helped identify sources of disparities, as well as potential remedies including potential changes to systems, policies, and practices.
The plan contains seven broad recommendations.
- Improving health equity and addressing the social determinants of health that most significantly impact disparities in birth outcomes.
- Reducing the rate of Sudden Unexpected Infant Deaths (SUID).
- Ensuring a comprehensive statewide system that monitors infant mortality.
- Providing comprehensive, culturally appropriate, coordinated health care to all women during the preconception, pregnancy and post-partum periods.
- Reducing the rate of preterm births in Minnesota.
- Improving the rate of pregnancies that are planned, and reducing the rate of teen pregnancies.
- Creating a stakeholder task force to guide implementation of recommendations and action steps.
Later this year, MDH will release the second phase of the plan that will include more targeted tactics.