September 2009

From the President

Infant Mortality: What is Keeping Us “Stuck”

By Phyllis Sloyer, President, AMCHP 

I began my career wanting to be a neonatal intensive care center nurse. The intrigue soon wore off as I realized what we as a society may not be doing to prevent low birth weight and other contributing factors to infant mortality. Our infant mortality rate is worse than the rates in countries my grandparents migrated from to come to this land of success and opportunity. In this issue you will read once again of the alarming statistics and the contributing factors to infant mortality in the United States. Whether it is pre-term births, poor perinatal care, or ethnic and racial disparities, we just seem to be stuck in moving the needle forward.  [read more]  

From the CEO

Infant Mortality: A Call to Action for MCH Programs

By Mike R. Fraser, PhD

As an indicator of our overall maternal and child health status the United States’ infant mortality rate is a reminder of just how much work we’ve done to improve the health of women and children and just how far we have to go to truly realize our vision of healthy children, healthy families, living in healthy communities. Our nation’s infant mortality rate is high among developed countries – we rank 28th in the world according to the Centers for Disease Control and Prevention (CDC) – and this is something about which we all should be very concerned. State and territorial Maternal and Child Health (MCH) programs are the natural home for infant mortality reduction programs, and many play a leading role in infant mortality reduction in states and territories. But what does this really mean for women and children? [read more


Being Born at the Right Place: Neonatal Levels of Care

By Capt. Wanda Barfield, MD, MPH*
Team Leader Maternal, Child Health Epidemiology Team
Centers for Disease Control and Prevention, Atlanta, GA

Increases in preterm birth and preterm-related infant mortality account for much of the lack of decline in the United States infant mortality rate from 2000 to 2005, therefore providing appropriate care for these vulnerable infants is vital. Perinatal regionalized systems, including obstetrical transport and appropriate referral to neonatal intensive care, have been an important mechanism for improving outcomes for preterm and medically complex infants. However, regionalized systems do not exist in all states and regulatory language defining levels of neonatal care vary significantly. [read more]

Healthy Families Equals Healthy Babies

By Stacey D. Cunningham, MSW, MPH
Executive Director, National Healthy Start Association 

Annually, those of us in the world of public health and maternal and child health designate September as the month to focus on efforts that will increase the public’s awareness of infant mortality. From family festivals in the park to lectures on health and racial inequities, many of us will be engaging communities around the issues and factors that impact infant mortality. It is no secret that the health of our families is essential to the health of our country. That is why, this year the National Healthy Start Association developed the theme Healthy Families = Healthy Babies for National Infant Mortality Awareness Month. We know that when our families are healthy, so are we.[read more]

SIDS National Resources for Title V Programs

Suzanne Bronheim
Director, National SUID/Child Death and Pregnancy Loss Center, National Center for Cultural Competence
Georgetown University Center for Child & Human Development

Sandra J. Frank, JD, CAE
Executive Director
Association of SIDS & Infant Mortality Programs/Project IMPACT

Marian Sokol
First Candle/National SUID & Child Death and Pregnancy Loss Program Support Center 

The Maternal and Child Health Bureau supports states in their efforts to reduce deaths due to SIDS and to support families who have suffered a sudden unexpected infant death of any sort. With Special Projects of Regional and National Significance (SPRANS) funding, the Bureau has funded four resource centers that offer information and technical assistance to professionals and the public: the National SIDS Resource Center ; the National SUID/CD and PL Project; the National Program Support Center (PSC); and Project Impact.  [read more]

Association of SIDS and Infant Mortality Programs: A National Network of SIDS, SUID and Infant Mortality Professionals

The Association of SIDS and Infant Mortality Programs (ASIP) was formed in 1987 with support and encouragement of the Maternal and Child Health Bureau (MCHB). ASIP maintains close ties with maternal and child health programs and continues to be a leading national organization for professionals whose scope of work includes risk reduction or bereavement support for families that have experienced an infant death. In that capacity, ASIP helped develop and co-sponsor the Back to Sleep campaign. Hailed as one of the most effective public health interventions in modern history, the campaign led to a 50 percent decrease in SIDS between 1992 and 2003. [read more]

Member to Member

Member states were asked the following question:

What is your advice to other state agencies, organizations and communities that are looking to tackle infant mortality by focusing on racism and racial inequities?  [read more]






Success Stories

The Alaska Infant Safe Sleep Initiative 

By Debbie Golden, RN, BC, MS
Perinatal Nurse Consultant
State of Alaska
Division of Public Health
Section of Women's, Children's and Family Health

A high and stable rate of postneonatal mortality in Alaska (3.6/1000 live births in 2008[i]), and the belief that the majority of these deaths are preventable, have led the Alaska Section of Women’s, Children’s and Family Health (WCFH) to focus recent research and outreach on this tragic outcome. Alaska Native infants have a postneonatal mortality rate 2.3 times higher than the rate for non-Native infants, yet one WCFH study found that this increased risk was almost all explained by higher proportions among Alaska native mothers of women with less than 12 years of education, women who were unmarried and did not indicate a father on the infant birth certificate, and women who reported prenatal alcohol or tobacco use.[ii]  [read more]

Wisconsin Launches Several New Initiatives

By Patrice Mocny Onheiber, MPA
Director, Disparities in Birth Outcomes
Bureau of Community Health Promotion
Wisconsin Division of Public Health, Department of Health Services

Millie Jones, PA, MPH
Family Health Clinical Consultant
Wisconsin Division of Public Health 

Wisconsin’s African American infant mortality rate in 2004 was the highest in the nation, at 19.2 per 1,000 live births, (a black-white infant mortality rate of 4.3, nearly twice the United States ratio). A sense of urgency has resulted in a number of new initiatives for Wisconsin’s MCH program, local officials and community advocates. [read more]

Fetal and Infant Mortality Review (FIMR): Addressing Local Health Disparities and Providing Insight for State Program and Policy Development

By Kathleen Buckley, MSN
Director, National Fetal and Infant Mortality Review Program
American College of Obstetricians and Gynecologists  

Community based FIMR is an action-oriented continuous quality improvement process leading from review of cases to community action that improves service systems and resources for all women, infants and families, but especially those in communities with disparities in infant outcomes. Three components of the FIMR process are especially valuable in addressing disparities: 1) the diverse coalition/community partnership building component of the process itself; 2) inclusion of the voice of local families who experienced an infant loss and 3) the outcome interventions. [read more]

View from Washington

How Health Reform Might Impact Infant Mortality

By Brent Ewig, MHS
Director of Public Policy & Government Affairs, AMCHP

September is infant mortality awareness month, so now is an opportune time to look at how provisions included in health reform might impact this leading MCH issue. First the bad news: there is unfortunately no explicit mention of reducing infant mortality in any of the four health reform bills passed by Congressional Committees to date. The good news is that each of these proposals would extend affordable health insurance to the estimated one in five women of childbearing age who are currently uninsured. [read more

Who's New

ASTHO Leadership Meets with New CDC Director, Dr. Tom Frieden

 As part of an ASTHO leadership visit to CDC in Atlanta several ASTHO members and staff had the opportunity to meet with Dr. Tom Frieden, the newly appointed CDC Director. Dr. Frieden shared his priorities with ASTHO, which are an informative look at potential future directions for the CDC. [read more]

Special Announcement

CDC Funding for its SUID Case Registry Project

The Centers for Disease Control and Prevention's (CDC) Division of Reproductive Health announces that it has awarded five states funding to participate in CDC's Sudden Unexpected Infant Death (SUID) Case Registry pilot project. The purpose of the pilot project is to enhance state-based SUID information collection systems that will eventually form the basis of a national SUID Case Registry. After completing a feasibility study in 2007, the CDC identified the National Center for Child Death Review (NCCDR) and their web-based data collection tool as the most efficient system to integrate SUID case investigation information. [read more]

Get Involved

AMCHP to Host a Webinar on Worksite Wellness Programs for Women’s Health
AMCHP will host a webinar on “Worksite Wellness Programs for Women's Health & MCH” on September 24 from 3 to 4:30 p.m. (EDT) as part of its Women's Health Information Series. Presenters will include Steve Ableman, MBA, CHE- Director, Worksite Wellness Programs, March of Dimes; Karen Hench, RN, MS- Division of Healthy Start and Perinatal Services, MCHB/HRSA/DHHS; and Kristina Helmer, Health Educator, Division of Health Protection and Promotion Sedgwick County Health Department. [read more]

Call for Abstracts
The National Healthy Start Association is seeking abstract submissions for both poster and oral presentations that are research-focused, clinical-focused, or program-focused for their 2010 Annual Spring Conference. The deadline for abstracts is by October 23 at 5 p.m. (EDT). [read more]

National Infant Mortality Awareness Month Events
The Office of Minority Health (OMH) has developed a webpage for National Infant Mortality Awareness Month events. [read more]

Submit Your Best Practice Today
AMCHP is seeking submissions of best practices in maternal and child health from around the country. Whether it’s an effective campaign to promote breastfeeding, an outstanding home visiting program, or a proven early intervention program for young children, get the word out about your best practice. [read more]

Data and Trends

PeriStats - Your Online Source for Perinatal Statistics

The PeriStats website developed by the March of Dimes Perinatal Data Center offers state-specific perinatal data, including detailed data for the largest cities and counties in the United States, and is available free of charge.  [read more]  


View and download resources on Infant Mortality. [read more]

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