Infant mortality in West Virginia. Identifying risk factors for public health intervention

Because infant death rates vary within populations, it is important for program managers and planners to identify high-risk subgroups for whom effective interventions can be targeted. Matching infant death certificates with birth records permits us to describe infant mortality and calculate risks by a variety of maternal and infant characteristics recorded at birth. In this paper, we illustrate how several variables are associated with infant death, and show how analysis of a recent birth cohort in West Virginia can assist health officials in determining appropriate strategies for risk reduction. While efforts need to focus on reducing social and economic barriers to maternal and infant health, different strategies are required to address separately the neonatal and postneonatal components of infant mortality. Matched records can be used in a variety of ways to develop support for, and highlight the needs of, West Virginia's Maternal and Child Health programs, to monitor trends over time, to evaluate program achievements, and to modify program goals.