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 Infant Mortality Toolkit

​​​​​​​State Infant Mortality (SIM) Toolkit: A Standardized Approach for Examining Infant Mortality 

The State Infant Mortality Collaborative (SIMC)
Between 2004-2006, the Centers for Disease Control and Prevention (CDC), the Association of Maternal & Child Health Programs (AMCHP), and the National March of Dimes partnered on a multiyear project that supported five multidisciplinary state teams interested and able to address their high rates of infant mortality. The State Infant Mortality Collaborative (SIMC) was established in response to the 2002 increase in the infant mortality rate, as well as persistent racial and ethnic disparities in infant mortality rates. The five state teams that participated in the SIMC – Delaware, Hawaii, Louisiana, Missouri and North Carolina – were selected based on their increasing, stagnant or high infant mortality rates. The membership of each team was comprised of key stakeholders and included the Title V MCH director or designee, scientists and maternal and child health (MCH) epidemiologists or other scientific representative, policy/program decision makers, and community partners. The project focused on the practical application of MCH epidemiology to discern the underlying factors responsible for high rates of infant death and to identify opportunities for intervention. The goal of the SIMC was to assist state public health agencies in investigating their increasing, persistent or high infant mortality rates. With many states experiencing increases for several years, this collaborative also brought national experts together to work with the teams. For two years, state teams explored possible explanations for current infant mortality trends. Additionally, state participants and national experts worked together to develop a State Infant Mortality (SIM) Toolkit to assist states in these investigations.  

The Purpose and Objectives of the SIM Toolkit  
This toolkit is the product of the lessons learned from the SIMC, and the experiences and guidance of the five teams that provided the framework for the material contained within this document. The overall purpose of this toolkit is to assist with the analysis and interpretation of available perinatal-related data. It is envisioned that a standardized approach to the infant mortality assessment process presented here will help those concerned with infant mortality programs and data in their states, counties, urban areas, tribal regions, or other population-based areas to identify needs and tailor programs aimed at improving maternal, child, and infant health. The SIMC toolkit has several objectives:

  • Emphasize the importance of infant mortality as a key indicator of population health

  • Provide a framework to assist states, counties, tribes and/or urban areas in selecting appropriate indicators of infant mortality with corresponding data sources

  • Use case examples to illustrate methodological and statistical approaches to analyzing the data and interpreting findings

  • Offer a foundation to translate findings into programs and policies in order to reduce infant mortality

The audience for the toolkit is multifaceted; the toolkit is constructed to be used by a team of staff comprised of at minimum an MCH or perinatal epidemiologist, an MCH program director or other MCH program staff, and an MCH policymaker or MCH staff person that understands policy developed for MCH populations. Therefore, specific sections of the toolkit are targeted for these different audiences. No one staff person should be expected to read the toolkit from cover to cover. For example, the resources section of helpful formulas may only be of interest to the epidemiologist, while the case studies may be of more interest to the program and policy staff. As such, this toolkit is meant to be a reference tool used as needed rather than adopted as a regular resource by MCH programs. 

The State Infant Mortality Toolkit

Produced in collaboration with:  

   March of Dimes logo 


Suggested citation:
State Infant Mortality Collaborative: Infant Mortality Toolkit. State Infant Mortality (SIM) Toolkit: A Standardized Approach for Examining Infant Mortality. N.p., 01 Nov 2013. Web. [insert access date]. <>. 

 State Practice Corner

The state practice corner offers examples of how other states use the Infant Mortality Toolkit and compiles resources developed and shared by toolkit users. If you developed a resource from the Toolkit, or you know someone who has, please let us know!

About these tools:​ The four PowerPoint slide sets available for download were developed by Elizabeth J. Conrey, PhD, RD. These slides are a subset from the course titled: The Epidemiology of Maternal and Infant Health for State and Local Practitioners, given at The Ohio State University Summer Program in Population Health. This course featured extensive content that brings the Infant Mortality Toolkit to life for state and local practitioners. Dr. Conrey shared these slides to assist others who may wish to use the content of the Infant Mortality Toolkit as a training tool. The examples provided within the slide sets are from the Ohio Department of Health and used with permission. The word file is an example of an evaluation that could be used after the using the slide sets. All materials are available for you to download and customize; please attribute the content appropriately.​