1. By Ogechi Nna 1

2. Infant Mortality Factors Infant Mortality is defined as the number of infant deaths under one year of age. Infant mortality rate is one of the key indicators of a nation's health status.  Maternal health  Quality and access to medical care  Socioeconomic conditions  Public health practices. 2

3. What Is A Health Disparity: A Health Disparity is a health condition or disease that is higher for one group than the general population. I.e. Not equal. Ex. Diabetes, Lung Cancer, Mortality Rate, & Obesity 3

4. Why Infant Mortality is a Health Disparity The Infant Mortality rate for African-Americans is at a startling high compared to other races. Race Education Social Economic Status 4

5. Mortality Rate of Developed Nations (Figure 1) 5

6. Infant Mortality in the United States The United States is currently 176 th in the world in infant mortality with a rate of 6.06 deaths per 1000 lives. In 2006, the mortality rate among African-American infants was 13.8 deaths per 1,000 live births. This was 2 ½ times the rate among Caucasians (5.6 per 1,000) and Hispanic infants (5.5 per 1,000). 6

7. Causes Of Infant Mortality Causes Congenital Malformations Low Birth Rate Sudden Infant Death Syndrome 7

8. Low Birth Weight in the U.S. (Figure 2) 8

9. Infant Mortality In Massachusetts Although every race experiences infant mortality, African-Americans suffer from a higher infant mortality rate. In 2007, the infant morality rate for African-Americans in Massachusetts was 2.6 times higher than Caucasians. African-Americans suffered 10.2 deaths per 1,000 live births, while Caucasians experienced 3.9 deaths per 1,000 live births. 9

10. Infant Mortality by Race/Hispanic Ethnicity: Massachusetts Total Area IMR PercentState IMR Percent Caucasian4.0 African-American11.0 Hispanic7.1 Asian/Pacific Islander 2.6 10 (Figure 3) From MassChip 2006-2008

11. 11 (Figure 4) From Mass.gov (2003 - 2005)

12. Worcester’s Infant Death Rate  Worcester's infant mortality rate more than doubled from 2004 to 2005, reaching 13.9 deaths per 1,000 live births - the highest rate in the state.  The city's rate is up from 6.6 in 2004, with a three-year average of 8.2 deaths per 1,000 births. 12

13. Infant Mortality by Race/Hispanic Ethnicity: Worcester Area IMR PercentState IMR Percent Caucasian4.84.0 African-American14.111.0 Hispanic17.47.1 Asian/Pacific IslanderN/A2.6 13 (Figure 5) From MassChip 2006-2008

14. Factors Affecting Infant Mortality In Massachusetts and Worcester 1. Education:  Babies born to mothers with less education are more likely to die before reaching their first birthdays.  The Infant Mortality rate for mother s with 13-15 years of education is 40% higher then those with 16 or more years of education. 14

15. Factors Affecting Infant Mortality In Worcester and Massachusetts Cultural and Language Barriers: Infertility: Massachusetts has the highest rate in vitro fertilization No Prenatal’sLow Birth Weight Other Factors: poverty, smoking, and other socioeconomic forces. 15

16. Reducing Infant Mortality in Massachusetts and the U.S. Worcester Healthy Start Initiative - Helps women get pre- and post- natal health services available for free to all pregnant women and families with babies. WIC - Provides nutritious foods, nutrition education, and referrals to health and other social services to participants at no charge. Prams– The Pregnancy Risk Assessment Monitoring System, collects state-specific, population- based data on maternal attitudes and experiences before, during, and shortly after pregnancy. 16

17. Conclusion Year2002200320042005200620072008 African- American Infant Mortality Rate in the U.S 14.4 14.0 13.8 13.7 13.813.3N/A African- American Infant Mortality Rate in MA 11.612.711.69.411.210.211.7 Since 2002, the infant mortality rate for African-Americans is steadily increasing. Programs such as WIC, Worcester Healthy Start Initiative, and Prams is working with the government to end the Infant Mortality disparity. Most importantly, receive prenatal care ! 17 (Figure 6) Source: Massachusetts Department of Public Health from 1999-2008 & The CDC

18. References Center for Disease Control and Prevention. (2011, February 16). PRAMS-Pregnancy Risk Assessment Monitoring System| CDC Reproductive Health. Centers for Disease Control and Prevention. Retrieved July 17, 2011, from http://www.cdc.gov/PRAMS/ Cooney, Elizabeth & Plourd, Kate (2007, January 24). Infant mortality rate doubles in Worcester; City's 13.9 deaths per 1,000 births leads state The Free Library. (2007). Retrieved July 17, 2011 from http://www.thefreelibrary.com/Infant mortality rate doubles in Worcester; City's 13.9 deaths per...-a0160494040 Department of Public Health. (2010, April 5). Race/Hispanic Ethnicity Report - Birth and Perinatal Indicators. Mass.Gov. Retrieved July 17, 2011, from www.mass.gov/Eeohhs2/.../masschip/.../hsicountyworcester.rtf (Figure 3 & 5) Department of Public Health. (June, 2007). Regional Health Status Indicators Boston Massachusetts. Mass.gov. Retrieved July 12, 2011, from http://www.mass.gov/Eeohhs2/docs/dph/research_epi/boston_region_report.pd f (Figure 4) 18

19. References MacDorman, M. F., Ph.D.., Mathews, T., & M.S.. (2009, November). Products - Data Briefs - Number 23 - November 2009. Centers for Disease Control and Prevention. Retrieved July 13, 2011, from http://www.cdc.gov/nchs/data/databriefs/db23.htm (Figure 1) Massachusetts Department of Public Health. (2010, April 5). MassCHIP Massachusetts Community Health Information Profile.Massachusetts Department of Public Health. Retrieved July 14, 2011, from http://www.mass.gov/Eeohhs2/docs/dph/masschip/perinatal_trends/perinataltr endscity_townlawrence.rtf (Figure 6) Resources and Services Administration. (n.d.). Health Status, Infants - Child Health USA 2008-2009. U.S. Department of Health and Human Resources. Retrieved July 11, 2011, from http://mchb.hrsa.gov/chusa08/hs (Figure 2) The Office Of Minority Health. (2007). Infant mortality disparities fact sheet - african americans. Retrieved from http://minorityhealth.hhs.gov/templates/content.aspx?ID=6903&lvl=2&lvlID=117 Umass Medical School. (n.d.). UMass Medical School - Worcester.Welcome to the University of Massachusetts Medical School - Worcester. Retrieved July 19, 2011, from http://www.umassmed.edu/pap/pubs/partners/infant_mortality.aspx 19