Infant mortality rate in Alabama increases in 2023

FOR IMMEDIATE RELEASE

CONTACT: Carolyn Miller, (334) 206-2959

The Alabama Department of Public Health (ADPH) announces that the infant mortality rate of 7.8 deaths per 1,000 live births in 2023 increased over the 2022 rate in Alabama. This represents the deaths of 449 infants of the 57,835 live births in 2023 who did not reach 1 year of age. Alabama's infant mortality rate remains higher than the United States provisional rate of 5.6.

Among racial groups, the infant mortality rate for white infants rose to 5.7 (229 infant deaths) from 4.3 in 2022, and the infant mortality rate for Black infants increased to 13.0 (204 infant deaths) from 12.4 in 2022. Alabama recorded its lowest overall infant mortality rate ever, 6.7, in 2022.

The three leading causes of infant deaths in 2023 were:

• Congenital malformations, deformations and abnormalities (20.7%)
• Disorders related to short gestation and low birth weight, not elsewhere classified (14.3%)
• Sudden infant death syndrome (6.5%)

State Health Officer Dr. Scott Harris said, "Many factors contribute to infant mortality, including race, poverty, educational levels, and access. It is discouraging that racial disparities remain in birth outcomes, and the Black infant mortality rate is twice the rate for white infants. A possible reason is limited access to prenatal care and the proximity of hospitals to where these mothers live. Challenges to improve the health of all mothers and babies continue. There is no easy solution; we must follow evidence-based practices to save lives."

Selected pregnancy and birth statistics include the following:

• The three-year infant mortality rate for the years 2021-2023, 7.4, equaled the three-year rate for the years 2019-2021. The 2023 rate of 7.8 is the highest single-year rate since 2016 when the infant mortality rate was 9.1.
• Medicaid was the method of payment for 45 percent of all births in 2023; 52 percent of infant deaths were to mothers whose deliveries were paid by Medicaid. Private insurance paid for 50 percent of all births, and 39 percent of infant deaths were to mothers with deliveries paid by private insurance.
• The percent of births with no prenatal care (2.6) in 2023 was tied with the year 2020 as the highest in the past decade.
• The percent of births with maternal smoking has steadily declined and fell to its lowest level in a decade, 3.9 percent. However, according to the Alabama Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, in 2022, 16.1 percent of mothers reported using e-cigarettes or other electronic nicotine products in the past two years; 52.7 percent of those mothers used them more than once a day during the three months before they became pregnant.
• The number of births to teenagers has been decreasing and fell to the lowest number ever (3,467). The percent of births to teenagers remained at a historic low of 6.0 for the second year.

ADPH programs focus on the reduction of infant deaths, including the following initiatives:

• In response to a lack of access to prenatal care in rural counties, ADPH is partnering with medical providers to provide prenatal care to low-risk women in up to nine county health departments through in-person or telehealth visits, up to 36 weeks of pregnancy.
• To help prevent sleep-related infant deaths, the Cribs for Kids program provides cribs for families without a safe place for their babies to sleep. In the past three years, the program has provided 2,500 cribs at no charge to the families.
• The Clear the Crib Challenge was implemented in 2023 to reduce the risk of sudden infant deaths and suffocation. This promotion challenges participants to clear a crib of all items except a firm mattress, fitted sheet, and the baby. This social media promotion encourages sharing the ABCs of safe sleep--alone, back, crib.
• The Well Woman Program promotes healthy living, prevention, and early detection of disease for women ages 15 to 55, resulting in healthier pregnancies. The program will expand from nine counties in the past fiscal year to 12 counties in fiscal year 2025, providing preconception, interconception, and postconception care.
• ALL Babies has expanded to statewide coverage for pregnant women without other insurance who fall within the income guidelines of the program.
• Nurses from the Fetal Infant Mortality Review Program, based in five major delivering hospitals, review most fetal and all infant deaths. Case summaries are presented to a regional multi-disciplinary committee to determine the cause of death and ways to prevent future deaths.

Additional programs include the Count the Kicks phone application to count fetal kicks, increased education on the impact of sexually transmitted diseases on pregnancies and newborns, promotion of car seat safety, and WIC participation to improve nutrition for infants and young children. WIC serves women who are pregnant, recently had a baby, or are breastfeeding; infants; and children up to 5 years of age.

Graphs and detailed charts are available at the ADPH website.

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11/14/24

County health departments throughout Alabama provide a wide range of confidential and professional services. Contact your local county health department for additional information.

Mission: To promote, protect, and improve Alabama's health

Vision: Healthy People. Healthy Communities. Healthy Alabama.

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