200178 When infant mortality is a "rare" event: A closer look at infant mortality at the county level using epidemiologic methods

Tuesday, November 10, 2009

Abigail N. Becker, MPH, CHES , Public Health Department, Placer County, CA Health and Human Services, Auburn, CA
The U.S. infant mortality rate has remained fairly constant over the last six years (6.86 infant deaths per 1,000 live births in 2005) while the Placer County, CA infant mortality rate has fluctuated considerably from 7.22 infant deaths per 1,000 live births in 2000 compared to 4.97 in 2005.1

Infant deaths are a rare event in Placer County. When using data to support prevention efforts, small numbers and unstable rates can inhibit strategic planning efforts aimed at reducing infant deaths in rural areas. I hypothesize that looking closer at additional variables in the linked birth and death files along with GIS mapping will provide Placer County greater insight into factors associated with infant mortality. This expanded variable analysis will assist in efforts to plan meaningful prevention strategies that target reducing infant deaths.

From 2000-2005, 65% of infant deaths in Placer County were neonatal deaths. The leading cause of infant death was extreme immaturity. Of all deaths with known gestational age, 48% were very preterm infants (less than 32 weeks gestation). Among very preterm infant deaths, the median age of the mother was 30 years; 58% of these women were delivering their first child. GIS maps illustrated areas in the county with higher neonatal death rates.

There is value in small number data analysis at the local level. Delving deeper into these datasets may help to guide prevention planning efforts for infant mortality.

1. MacDorman MF, Mathews TJ. Recent Trends in Infant Mortality in the United States. NCHS Data Brief. 2008;9:1-8.

Learning Objectives:
Explain the value of annual small number infant death data analysis at the local level. Identify four variables to use in a linked birth and death dataset for increased analysis of infant mortality at the local level.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I graduated with my MPH in epidemiology from The University of Iowa in 2006. I served as a Cal-EIS fellow from July 2006-June 2007. In July, 2007 I accepted a position as the public health epidemiologist for Placer County, CA where I provide a variety of analyses from public health preparedness to maternal, child, and adolescent health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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