Strategies for improving birth outcomes among high risk women in Mississippi: Data support for implementation and financing of interconception care

Objective: To describe the pattern of Mississippi infant mortality and describe methods for supporting implementation and financing of interconception care through data analysis.

Background: In 2005, Mississippi ranked the highest in the nation on infant mortality rate. In 2007, the rate was 10.1 infant deaths per 1,000 live births, more than twice the Healthy People 2010 recommendation of 4.5 per 1,000 live births.

Methods: Using Mississippi Vital Records, the neonatal, post-neonatal, infant mortality rates, and average mortality rates for years 1996 to 2007 were calculated. The mortality rate ratios were also calculated between nonwhite and white to indicate degree of racial disparity. The 95% confidence intervals for average mortality rates were constructed using Poisson distribution. Chi-square test for trend was applied to indicate trends in neonatal, post-neonatal, and infant mortality rates.

Results: From 1996 to 2007, a total of 5,404 of Mississippi infants died on or before their first birthdays. Among those, 3,299 (61%) infant deaths occurred during the neonatal period. Over the study period, the neonatal, post-neonatal, and infant mortality rates for nonwhites were consistently higher than whites. On average, the mortality rate ratios between nonwhites and whites were 2.38, 1.89, and 2.17, respectively and were significant different. No significant linear trends were observed for neonatal-, post-neonatal, and infant mortality rate.

Public Health Implications: Assisting women to set and achieve personal goals for reproductive health should be a priority consideration for public health professionals as we work together to improve health outcomes for infants and their families.