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Why Is This Important?
In addition to providing key information about maternal and infant health, the infant mortality rate is an important marker of the overall health of a society. In 2020, the infant mortality rate in the United States was 5.4 deaths per 1,000 live births. The five leading causes of infant death in 2020 were: 1) birth defects; 2) preterm birth and low birth weight; 3) sudden infant death syndrome; 4) injuries; and 5) maternal pregnancy complications (CDC Reproductive Health, 2022). Many environmental contaminants are likely toxic in utero; many cross the placenta and make their way into the circulatory system of the developing fetus. Although several environmental exposures have been implicated as possible risk factors for infant, perinatal, neonatal, and post-neonatal mortality, the magnitude of the contribution to these increased rates remains relatively uncertain. Evidence linking environmental exposures and perinatal mortality is mixed: associations have been found with environmental tobacco smoke, solid fuels, water disinfection by-products, and arsenic in groundwater. Several studies have found links between particulate matter, heat waves, and arsenic exposure with excess infant mortality. Mixed evidence has been found for the association between arsenic, dioxins, and neonatal mortality; meanwhile, various air exposures such as particulate matter, nitrogen dioxide, and carbon monoxide have been linked with neonatal mortality. Research on post-neonatal mortality specifically is sparse, but associations have been found with particulate matter. Neighborhood-level characteristics have proven to be useful predictors of mortality. Neighborhoods are the geographic units where interventions can be targeted, and those interventions can be an effective way to improve reproductive outcomes. Neighborhood-level characteristics contributing to mortality include social, economic, and environmental risk factors (CDC NEPHT Program, 2022). In 2019, infant mortality rates by race and ethnicity across the United States were highest for non-Hispanic Black (10.6 per 1,000 live births), followed by non-Hispanic Native Hawaiian or other Pacific Islander (8.2), non-Hispanic American Indian/Alaska Native (7.9), Hispanic (5.0), non-Hispanic White (4.5), and non-Hispanic Asian (3.4) (CDC Reproductive Health, 2022).
Infant mortality: Number of deaths among infants younger than 1 year of age in a given year divided by the number of live births in the same year. Neonatal mortality: Number of deaths among infants younger than 28 days of age in a given year divided by the number of live births in the same year. Post-neonatal mortality: Number of deaths among infants 28 days of age or older and younger than 1 year of age in a given year divided by the number of live births in the same year. Perinatal mortality: Number of fetal deaths at more than 28 weeks of gestation plus deaths of infants younger than 7 days old in a given year divided by the number of live births plus fetal deaths of infants at more than 28 weeks gestation in the same year.
Data NotesData for combined years 2017-2021.
- Birth Certificate Data, Bureau of Vital Records and Health Statistics (BVRHS), Epidemiology and Response Division, New Mexico Department of Health.
- New Mexico Death Data: Bureau of Vital Records and Health Statistics (BVRHS), Epidemiology and Response Division, New Mexico Department of Health.
How the Measure is Calculated
Numerator:Infant mortality: Number of deaths among infants younger than 1 year of age in a given year.
Denominator:Infant mortality: Number of live births in the same year.
Birth Certificate Data
Birth certificate information is submitted electronically by hospital medical records staff who use standard mother and facility worksheets and medical charts to collect the needed information. Training of hospital staff is provided by the Bureau of Vital Records and Health Statistics (BVRHS). The birth certificate information is reviewed by BVRHS for completeness and consistency with state law and NMDOH and national guidelines. BVRHS will contact hospital staff for clarification of missing, inconsistent or incorrect entries. CDC's National Center for Health Statistics provides feedback to BVRHS on data quality and the NMDOH provides feedback to the hospitals to improve data quality and training.
Death Certificate Data
Death certificate information is submitted electronically by funeral directors, who obtain demographic information from an informant, a close family member of the decedent. The NMDOH Bureau of Vital Records and Health Statistics (BVRHS) does annual trainings for funeral directors and local registrars and the death certificate information goes through extensive scrutiny for completeness and consistency. The cause of death is certified by the decedent's physician or the physician that attended the death. Accidental and suspicious deaths are certified by the Office of the Medical Investigator. When death certificates are received the cause of death literals are keyed into software locally by the BVRHS, then shipped to the National Center for Health Statistics (NCHS) where they are machine coded into ICD-10 cause-of-death codes. NCHS returns the ICD-10 codes to BVRHS where the death records are updated.