Infant mortality is the number of infants who die during their first year of life. Infant mortality is measured by the Infant Mortality Rate, which is the number of infant deaths per 1,000 live births. The Infant Mortality Rate is commonly accepted as a measure of the general health and well-being of a population.
In 2010 there were 98 infant deaths in the City of Milwaukee. A substantial portion of these deaths were preventable. The overall city rate for infant mortality in 2010 was 9.5 infant deaths per 1,000 births. For Milwaukee’s non-Hispanic families, the White infant mortality rate was 4.7 deaths, and the Black rate was more than triple this rate at 14.8 per 1000. The Hispanic rate was 5.7. Preliminary unverified data for 2011 shows that Milwaukee’s infant mortality rate increased to 9.7.
According to the 2007 Big Cities Health Inventory, the City of Milwaukee ranks 7th worst for infant mortality among the 53 largest cities in the US, and the difference, or disparity between Milwaukee’s infant mortality rates for African Americans and whites is one of the worst in the nation. The reduction of infant mortality, and specifically the reduction of racial disparities in infant mortality, is a goal of the City of Milwaukee Health Department.
What are the leading direct causes of infant mortality?
Around half of Milwaukee’s infant deaths are due mainly to prematurity (when a baby is born more than three weeks early). Infants born prematurely have a greater risk of medical complications, long-term disabilities and death. Click here to learn more about infants born prematurely.
Around 20% of Milwaukee’s infant deaths are due to congenital abnormalities (“birth defects”) and their associated complications
About 20% of Milwaukee’s infant deaths are attributable to a combination of Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Death in Infancy (SUDI) and unsafe sleep. Of these deaths, the majority died in an unsafe sleep environment. Click here to read about how to create a safe sleep environment for your baby.
What other factors affect the infant mortality rate?
Infant mortality is a complex problem with no single solution. Rather than just being an issue of health care access or health care quality, there are numerous social, economic and racial/ethnic issues that play a role.
Racial disparities in infant mortality rates persist even after taking education and income into account. According to the documentary “Unnatural Causes” (www.unnaturalcauses.org), produced by California Newsreel, “Infant mortality among white American women with a college degree or higher is about 4 deaths per thousand births. But among African American women with the same level of education, infant mortality is about 10 per thousand births – almost three times higher. In fact, African American mothers with a college degree have worse birth outcomes than white mothers without a high school education.”
Recent research also shows that stress over a lifetime can make it more likely that a woman will lose her baby. Chronic stress can cause the release of hormones that make premature labor more likely, and can also cause inflammation in the placenta, leading to less blood flow and less oxygen to the baby during pregnancy. Some people believe that this chronic stress is one explanation of how factors like poverty and racism make infant deaths more likely.
What is the Fetal Infant Mortality Review (FIMR)?
The Fetal Infant Mortality Review (FIMR) is designed to learn what can be done to prevent fetal and infant deaths occurring in the City of Milwaukee. The FIMR team is concerned with both infant deaths (babies who are born alive but die within the first year of life) and fetal deaths (babies who die before they are born, but after the 20th week of pregnancy).
The FIMR model brings together a case review team of health care professionals, public health experts, agency representatives, community advocates, and consumers to analyze all fetal and infant deaths. FIMR data collectors gather information from local hospitals, physician offices, social service agencies, the Medical Examiner, and also carefully review both the mother’s and baby’s medical records.
When possible, FIMR interviews the mother and gets her perspective on her prenatal care, her life circumstances, her healthcare provider and, most importantly, her relationship to her baby. A narrative, a ‘life story,’ is then brought before the Case Review Team for review. These stories, combined with the record reviews, allow the Case Review Team to identify a wide range of factors associated with each life and death.
The purpose of these reviews is to identify the factors associated with these deaths, and develop recommendations for change. To date, the FIMR project has produced four reports summarizing the FIMR findings and recommendations. These reports have been distributed to local leaders, to hospitals, to healthcare providers and to the community.
Where can I find more information about infant mortality?
City of Milwaukee Health Department Materials