Infant Mortality

What does this indicator measure?

Infant Mortality measures the rate at which babies die before their first birthday per 1,000 live births in the City of St. Louis. According to the Missouri Department of Health, the most common causes of infant mortality include birth defects, preterm birth and low birth weight, maternal complications of pregnancy, Sudden Infant Death Syndrome (SIDS), and infant injuries. Over a 5-year period (2011-2015), 232 of 23,617 babies born alive died before their first birthday in St. Louis City. That means that 10 babies die before their first birthday for every 1,000 live births in St. Louis. 

Infant Mortality analysis

Babies born alive who die before their first birthday in St. Louis City.

Data Source: Missouri Department of Health and Social Services, MOPHIMS 2011-2015. Data compiled by Generate Health.

What does this analysis mean?

Black babies are three times as likely to die before their first birthday as white babies. The infant mortality rate for black families is 13.5 deaths per 1,000 live births compared to 4.4 deaths 
per 1,000 live births for white families. Over the course of a 5-year period (2011-2015) in St. Louis, 232 babies died before their first birthday. 174 of those babies were black. 

Compared to white infants, black infants experience higher rates of nearly every risk factor that contributes to infant mortality, including preterm birth, low birth weight, and birth defects. If infant mortality rates were equitable, 23 fewer black babies would die before their first birthday every year. 

Why does Infant Mortality matter?

According to the nonprofit Generate Health’s calculations, the babies who die before their first birthday in the St. Louis region could have filled 15 Kindergarten classes every year [generatehealthstl.org]. Infant Mortality was chosen as an indicator because it highlights the disadvantages black residents have from the second they are born. For babies to be born healthier, their mothers need to be provided sufficient care before, during, and after pregnancy. Birth outcomes are influenced by the mother’s health over the course of her lifetime.  

Which Calls to Action from the Ferguson Commission report are linked with this indicator?

While the Ferguson Commission report did not explicitly call out infant mortality, its calls to action related to child and maternal health include:

• Increase Health Insurance Coverage and Access [forwardthroughferguson.org]
• Expand Medicaid Eligibility [forwardthroughferguson.org]
• Provide Gap Coverage [forwardthroughferguson.org]
• Increase ACA Marketplace Enrollment [forwardthroughferguson.org]

How can I learn more about this issue?

Infant mortality was addressed in the "Seeing Inequity: Visualizing Racial Disparities in St. Louis [www.facebook.com]" infographic series presented by Forward Through Ferguson. 

Flourish St. Louis [www.flourishstlouis.org] is an infant mortality reduction initiative funded and supported by the Missouri Foundation for Health. In May 2017, Generate Health [generatehealthstl.org], the backbone organization behind Flourish St. Louis, issued a 10-year report on the state of infant health called the "St. Louis Fetal-Infant Mortality Review [generatehealthstl.org]." In addition, they produced a needs assessment of preconception health in St. Louis called "Women’s Health Before and Between Pregnancy [generatehealthstl.org]."

1. Why are there racial disparities in infant mortality in St. Louis?

Infant mortality is a complex issue that is affected by more than just healthcare. Infant mortality is seen as the canary in the coal mine indicating that something is not right in our society. We live in a region with world class medicine, but black babies are three times more likely to die than white babies. After hearing from several community members, FLOURISH prioritized these contributing factors: Infant Health, Behavioral Health, Prenatal Care, Transportation, Housing and Health Communications & Navigation. There are many more contributing factors to infant mortality. 

2. What can St. Louis do to reduce racial disparities in infant mortality?

FLOURISH St. Louis encourages people to learn about the disparities that exist in our community and raise awareness. Individuals can keep current about what is happening by following FLOURISH on social media or signing up for the newsletter. Individuals are also invited to join one of the Action Teams. Each of the action teams have developed a variety of strategies to address racial disparities in infant mortality. 
 
As a region, FLOURISH has been named responsible for the infant mortality component of the Community Health Improvement Plan. Strategies, such as asking all maternity and children’s hospitals in the region to become safe sleep certified through Cribs 4 Kids, have been identified as regional goals. 

3. What initiatives are currently underway to reduce racial disparities in infant mortality in St. Louis?

FLOURISH St. Louis is a collective impact effort made up of several organizations throughout the region. Everyone has a piece to the puzzle and we must work together to solve it. Current action team efforts include: 

• Behavioral Health – Expanding the Perinatal Behavioral Health Initiative and the adoption of universal screening protocols for perinatal and postpartum women; Training the behavioral health workforce in motivational interviewing, trauma-informed leadership, perinatal mood and anxiety disorders, bereavement, and other topics. 
• Infant Health – Coordinating alignment around the Portable Crib network; Assisting hospitals to become Safe Sleep Certified by Cribs 4 Kids. 
• FLOURISH More – Developing a Tenants’ Bill of Rights
• Health Communications & Navigation – Working with the HEAL partnership to bring the maternal and child health lens to community health workers; researching and developing improvements to central resource management systems such as 2-1-1.