The Reduction of Infant Mortality in Illinois 2006 - 2007

Helping Families. Supporting Communities. Empowering Individuals.

State of Illinois
Rod R. Blagojevich, Governor

Department of Human Services
Carol L. Adams, Ph.D., Secretary

The Reduction of Infant Mortality in Illinois (pdf)
Annual Report for Fiscal Years 2006 and 2007
January 2008

The wisdom of a grandmother starts with the right information...

  • Babies sleep safest on their back, alone, in a crib
  • Never smoke around any baby

For more information please call SIDS of Illinois at 800-432-SIDS (7437)


TABLE OF CONTENTS

Introduction Letter from DHS's Secretary

Executive Summary

Introduction

Success Story

Program Descriptions

  • Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
  • Family Case Management
  • The Chicago Healthy Start Initiative
  • Targeted Intensive Prenatal Case Management
  • Closing the Gap

Service Delivery System

Caseload

Performance

Outcomes

Racial and Ethnic Disparities in Infant Mortality: The Persistent Challenge

Financing

History


EXECUTIVE SUMMARY

This annual report is presented in compliance with the provisions of the Illinois Family Case Management Act, found at 410 ILCS 212, the purpose of which is to "provide for the establishment and recognition of a program of family case management to ensure and provide statewide wrap-around services targeted toward reducing the incidence of infant mortality, very low birth weight infants, and low birth weight infants within the state."

Illinois' infant mortality rate for 2005 (the latest year available) was 7.2 deaths for every 1,000 live births, a rate that is tied with 2002 for the lowest rate in the state's history. However, the 1,294 deaths in 2005 represented the lowest number in the state's history and were 10 fewer than in 2002.

The Illinois Department of Human Services (IDHS) is helping to reduce the state's infant mortality rate through the integrated delivery of two programs - the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and Family Case Management (FCM). These programs serve more than 44 percent of all infants and nearly 85 percent of the Medicaid-eligible infants born in Illinois. The Department supplements these statewide programs with targeted initiatives for women whose chances of giving birth prematurely are greater than average and for infants who have a greater-than-average chance of dying before their first birthday.

Program Success - The Department monitors the performance of the WIC and FCM programs on several short-term health status indicators. At the end of Fiscal Year 2007, performance on each indicator was --

  • The proportion of WIC-eligible children with health insurance was 94.1 percent;
  • The proportion of fully-immunized one-year-olds in WIC was 85.3 percent;
  • The proportion of fully-immunized two-year-olds in WIC was 79.9 percent;
  • The proportion of WIC infants who are breastfed was up to 65.1 percent;
  • The proportion of infants in WIC who were breastfed through six months was 25.7 percent;
  • The proportion of children in FCM who received at least 3 well-child health care visits during the first year of life was up to 81.3 percent.

Improved Health Status - For nine consecutive years, infants born to Medicaid-eligible pregnant women who participated in WIC and FCM have been found to be in better health than those born to Medicaid-eligible women who did not participate in either program. The rate of very low birth weight was 60 to 70 percent lower than that among non-participants, and the rate of infant mortality was 50 to 70 percent lower.

Fiscal Savings - In addition to the significant health benefits afforded by the WIC and FCM programs, Illinois' investment in these programs saves the State an average of $200 million each year in Medicaid expenditures. Those expenses for health care in the first year of life were 30 to 50 percent lower among dual-program participants than among non-participants in 2007.

INTRODUCTION

"The infant mortality rate is the most sensitive index of the status of economic and social development of any country." -- Helen M. Wallace, M.D., M.P.H. 1

This report describes the accomplishments of the Illinois Department of Human Services' (IDHS) maternal and child health program in reducing infant mortality and improving maternal and infant health in Illinois.

Illinois' infant mortality rate reached the lowest rate on record with 7.2 deaths for every 1,000 live births in 2005. This rate was also achieved in 2002.

Illinois' ranking among the states has improved dramatically over the past two decades, with most of the progress occurring since 1990. In 1980, Illinois' infant mortality rate ranked 47th among the states and the District of Columbia. By 1990 the state's ranking was 44th and by 2005 Illinois had moved up to 31st .

There are many factors that contribute to an improvement in the state's infant mortality rate, just as there are many factors that contribute to the problem of infant mortality itself. There have been dramatic improvements in medical and pharmacological treatments for the conditions that used to take the lives of infants who were born prematurely. Illinois has maintained one of the best systems of hospital-based perinatal care services in the nation. Illinois' success in maternal and child health services is also due to the Department of Human Services' ongoing collaborative efforts with both the Illinois Department of Public Health (IDPH) and the Illinois Department of Healthcare and Family Services (IDHFS).

Nine consecutive annual evaluations have shown that participation in WIC and FCM during pregnancy substantially improves infant health. This improvement contributes an estimated annual savings of at least $200 million in Medicaid expenditures for care required during the first year of life. Additional savings from avoided special education, disability and rehabilitation costs potentially accrue over a lifetime. A recent in-depth analysis of Medicaid-eligible WIC and FCM participants showed that these programs reduce very low birth weight among program participants by 24 percent - a statistically significant reduction -- after controlling for differences in demographic and behavioral characteristics.

While Illinois has made steady progress in the reduction of infant mortality, a significant disparity in infant mortality rates persists between African American and Caucasian infants. An African American infant born in Illinois during 2005 was 2.7 times more likely than a Caucasian infant to die before reaching its first birthday. This disparity has persisted for many years and must no longer be accepted. In addition, in the years since 1996 there appears to be an emerging disparity between the infant mortality rates for Puerto Ricans and all non-Hispanic Whites. Although this is due in part to the small number of births and deaths involved, the Department is nonetheless concerned. The IDHS has made the reduction of racial disparities in health status, especially among society's most vulnerable members, a top priority.

Illinois' infant mortality rate has declined by 40 percent since 1986, in part due to investments in the WIC and Family Case Management programs.

1 Wallace, Helen. Infant Mortality. In Wallace, H.M., Ryan, G.M., and Ogelsby, A.C. (eds.) (1988) Maternal and Child Health Practices: Third Edition. Oakland, CA: Third Party Publishing. p. 411.

A Success Story

Two years ago, I was pregnant. My relationship with my baby's father was not stable. I also had just been let go on my job due to missing many days when I was sick. I was feeling very down and hopeless, and not sure where to turn. I was receiving some help from family but they were unable to help much. My friend referred me to WIC services at the local health department. The first time I went to my WIC appointment, I felt so embarrassed and was so full of questions and concerns that I did not know if I would have the courage to ask [for assistance].

The caseworker that was assigned to me for WIC was helpful and made me feel so at ease. She referred me to Family Case Management and a caseworker met me at my WIC appointment. She also was very helpful and I was able to relate all my concerns about the baby, the loss of my job and other issues. She helped me sign up for KidCare and was able to help me in other ways with referrals.

My baby is now a year old and we are doing wonderful. I no longer need WIC services as I am married to the baby's father and I have a good job. I don't know what I would have done without the temporary support and assistance given to me during this trying time. These programs are awesome and I want to thank all of you.