The Reduction of Infant Mortality in Illinois

The Family Case Management Program and Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

"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.

Illinois' ranking among the states has improved 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 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 also is 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).

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

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, there is cause for concern. The IDHS has made the reduction of racial disparities in health status a top priority, especially among society's most vulnerable members.

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.