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State trends in infant mortality, 1968-83.

J C Kleinman

    American Journal of Public Health
    |June 1, 1986
    PubMed
    Summary

    This study analyzed infant mortality rate (IMR) trends from 1968-1983. Nine states showed unfavorable IMR trends and higher rates than the national average.

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    Area of Science:

    • Public Health
    • Biostatistics
    • Epidemiology

    Background:

    • Infant mortality rates (IMRs) are critical public health indicators.
    • State-level IMR data often contain significant random error, complicating trend analysis.
    • Understanding regional variations in IMR trends is crucial for targeted interventions.

    Purpose of the Study:

    • To analyze state-specific infant mortality rate trends from 1968 to 1983.
    • To identify states with unfavorable IMR trends compared to national averages.
    • To assess the statistical methods for analyzing noisy IMR data.

    Main Methods:

    • Employed weighted least squares estimates to fit log-linear models for state IMR trends.
    • Utilized simulated data to validate the accuracy and unbiasedness of the estimation methods.
    • Conducted separate analyses for White IMRs across 49 states and non-White IMRs across 30 states.

    Main Results:

    • Weighted least squares provided nearly unbiased estimates and valid significance tests for IMR trends.
    • The power to detect trend changes was limited, particularly in states with smaller populations.
    • Identified nine states with IMR trends less favorable than the national experience.
    • These nine states also exhibited 1981-83 IMRs exceeding the national average by over 5%.

    Conclusions:

    • Log-linear models with weighted least squares are effective for analyzing state IMR trends despite data variability.
    • Certain states require focused attention due to persistently high or worsening infant mortality.
    • Further research may be needed to enhance the power of trend detection in smaller state datasets.

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