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Understanding State-Level Variations in the US Infant Mortality: 2000 to 2015
Alireza Ebrahimvandi1, Niyousha Hosseinichimeh1, Jay Iams2
1Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia.
American Journal of Perinatology
|December 25, 2018
Summary
Reducing preterm-related mortality (PMR) significantly lowered infant mortality rates (IMR) in successful states. State variations highlight the need for targeted interventions to further decrease infant deaths.
Area of Science:
- Public Health
- Epidemiology
- Biostatistics
Background:
- Infant mortality rate (IMR) and preterm-related mortality rate (PMR) exhibit significant state-level variations.
- Understanding the drivers of IMR reduction is crucial for public health interventions.
Purpose of the Study:
- To identify diagnoses contributing to IMR reduction.
- To analyze factors associated with state-level PMR.
- To exploit state variations in infant mortality trends.
Main Methods:
- Analysis of linked birth-infant death files to examine IMR patterns.
- Cross-sectional time series analysis of state-level PMR and explanatory variables.
- Fixed-effect regression modeling to identify factors associated with PMR.
Main Results:
- Substantial state-level variations observed in IMR and PMR changes.
- In 'successful' states, PMR reduction was the primary driver of IMR decline.
- Changes in other leading causes of mortality did not significantly differ between successful and unsuccessful states.
Conclusions:
- Mortality trends and causes are heterogeneous across states.
- Reducing inadequate prenatal care is a contributing factor to decreased PMR.
- Targeted state-level strategies are necessary to address variations in infant mortality.
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