Racial Disparities in Infant Mortality: The Persistent Challenge

The Reduction of Infant Mortality in Illinois
2012 Annual Report


Infant Mortality by Race - Illinois, 1980-2009

IL White Black
1980 14.7 12.1 26.3
1981 13.9 11.6 24.5
1982 13.6 11.4 24.6
1983 12.3 10.0 23.2
1984 12.0 9.7 22.1
1985 11.6 9.4 21.4
1986 12.0 9.6 22.3
1987 11.6 9.6 20.7
1988 11.2 9.1 20.9
1989 11.7 8.7 22.0
1990 10.7 7.4 22.1
1991 10.7 7.7 21.1
1992 10.0 7.4 19.5
1993 9.6 7.2 18.8
1994 9.0 6.7 17.9
1995 9.3 7.4 18.2
1996 8.4 6.3 17.5
1997 8.2 6.1 16.5
1998 8.2 6.3 16.8
1999 8.3 6.0 17.3
2000 8.3 6.2 16.3
2001 7.5 6.1 14.7
2002 7.2 5.4 15.6
2003 7.6 6.1 15.6
2004 7.3 5.8 15.1
2005 7.2 5.8 15.1
2006 7.4 5.9 14.3
2007 6.6 5.2 13.4
2008 7.2 5.8 13.9
2009 6.9 5.4 14

The graph presents the 2009 infant mortality rates of African American, Caucasian and Illinois' entire population. The rate among African Americans, while the third lowest on record, is at an unacceptably high level of 14 per 1,000 live births.

Illinois infant mortality rate has declined by more than 40 percent since 1986. Despite the steady progress, a significant disparity in infant mortality rates persists between African American and Caucasian infants (See Table 6). An African American infant born in Illinois during 2009 was 2.6 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. To that end, IDHS in partnership with other organizations committed to improving maternal and child health among all Illinoisans are creating interventions designed specifically to reduce racial disparities in health care and health outcome. These strategies include participation in a statewide Prematurity Prevention Task Force which was tasked with development of a set of recommendations that were presented to the Illinois legislative body in October 2012, increased focus on care of high-risk pregnant women in an Intensive Prenatal Care project, partnering with March of Dimes on a campaign to reduce elective late preterm deliveries, development of an Illinois Blueprint on Breastfeeding, partnership with Illinois Dept of Healthcare and Family Services on a number of CHIPRA workgroups aimed at improving perinatal health, joining the national COIN initiative to improve perinatal outcomes, and most recently, participation in the formation of a statewide Perinatal Collaborative.

Table 6 - Ratio of African American and Caucasian Infant Mortality

YEAR RATIO
1982 2.2 : 1
1983 2.3 : 1
1984 2.3 : 1
1985 2.3 : 1
1986 2.3 : 1
1987 2.2 : 1
1988 2.3 : 1
1989 2.5 : 1
1990 2.9 : 1
1991 2.7 : 1
1992 2.6 : 1
1993 2.7 : 1
1994 2.7 : 1
1995 2.5 : 1
1996 2.8 : 1
1997 2.7 : 1
1998 2.7 : 1
1999 2.8 : 1
2000 2.5 : 1
2001 2.5 : 1
2002 2.8 : 1
2003 2.6 : 1
2004 2.5 : 1
2005 2.7 : 1
2006 2.4 : 1
2007 2.6 : 1
2008 2.4 : 1
2009 2.6 : 1

In addition to the process of redesigning the Family Case Management program to focus on the needs of high-risk pregnant women at risk of a premature birth, other notable activities occurring in 2012 specific to improving birth outcomes include the development of an Action Learning Collaborative and enhanced breastfeeding programming. The state of Illinois through the Departments of Human Services, Public Health and Healthcare and Family Services applied for and received support for an Action Learning Collaborative sponsored by the Association of Maternal and Child Health Programs (AMCHP). The Action Learning Collaborative is specific to optimizing health reform to improve birth outcomes. Anticipated benefits of this collaboration effort are improved data sharing and a strengthened Maternal and Child Health Council that represents the priorities of the three agencies as well as other key partners and stakeholders.

Breastfeeding is a significant determinant of infant health. Illinois is in the forefront of promoting breastfeeding initiation and exclusivity. Effective January 2013, the Hospital Infant Feeding Act makes Illinois the first state in the nation to require that all birthing hospitals adopt a policy promoting breastfeeding. In the WIC program, Peer Counselors are used to help women initiate and continue breastfeeding. The Peer Counselors are mothers who have personal experience with breastfeeding and are trained to provide basic breastfeeding information and encouragement to new mothers. Peer Counselors are familiar with the resources available to WIC clients, have familiarity with the questions a new breastfeeding mother may ask, and recognize when to refer mothers to other resources during critical periods when mothers may experience difficulty. Peer Counselors are recruited and hired from WIC's target population of low-income women and undergo training to provide mother-to-mother support in group settings and one-to-one counseling through telephone calls or visits in the home, clinic, or hospital.