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Infant Mortality Rate (5 year) for Buncombe - Total (with comparisons)

6.3/10002015

Data Description & Source

Description: Infant mortality rate is the number of deaths of babies less than 1 year of age per 1,000 live births each year. If the number of deaths is less than 50, the rate should be viewed as unstable and interpreted with caution. These rates are based on 5-year aggregates with the year shown indicating the last year of the 5-year period.

Notes: The "Infant Mortality Statistics" report for years prior to 2010 does not present data by race and ethnicity the same way. The data prior to 2010 appears as "white" and "minority" and is not comparable to more recent years. Only totals (not by race or ethnicity) are included for years prior to 2010.

Sources: County and State data: Data available from North Carolina State Center for Health Statistics (NC SCHS), Statistics and Reports: Vital Statistics. Several reports are listed on this webpage. Click on section called, NC Vital Statistics, Vol. I (select a year): http://www.schs.state.nc.us/data/vital/volume1/201...

National data: Center for Disease Control and Prevention, Center for Health Statistics (CHS); http://www.cdc.gov/nchs/products/nvsr.htm

To view comparisons, click indicator title and the toggle comparisons.

Story Behind the Curve

his 5 year IM aggregate rate in Buncombe County has been gradually increasing from 5.2 deaths/1000 live births in 2011 to 6.3 deaths/1000 live births in 2015. Rates in North Carolina and the United States have been very gradually decreasing over time and North Carolina's 2015 rate is 7.2 deaths/1000 live births. Because the Buncombe County rate relies on a much smaller population size, may have greater fluctuations over time. This increase brings attention to the health of Buncombe County women and infants.

The main causes of infant mortality is preterm birth and/or low birth weight. In Buncombe County, a majority of neonatal deaths are related to prematurity and post neonatal deaths are due to sleep related infant deaths. Additionally, poverty, unemployment, and low education levels of mothers and parents increase the risk of infant mortality. In addition, risks are further impacted by race and ethnicity as well as age. In 2015, African Americans had 8.3 times the risk of infant mortality when compared to the white population in Buncombe County. While this yearly figure can be significantly influenced by one death due to small numbers, the five year aggregate still shows African American babies have 3.1 times the risk of infant mortality compared to white infants.

Included below is a graph of the annual rate. Annually over the past seven years, the infant mortality rate in Buncombe County has fluctuated where the rates in North Carolina and the United States have been very gradually decreasing. This fluctuation is most likely due to the small population and lower number of births in relation to the state and country. There was a peak in the annual rate of 10.1 deaths/1000 live births in 2013. While it is necessary to interpret this rate with caution, the two-fold increase in infant deaths, rising from 13 deaths in 2012 to 27 deaths in 2013, is of significant concern. In 2015, the rate decreased to 6.3 deaths/1000 lives births. In addition, the significant disparity between African American infant mortality rates and White infant mortality rates is very concerning.



What Works

We know that these factors reduce infant mortality:

  • Ensure pregnant women have access to and receive adequate prenatal care.
  • Reduce the number of teen pregnancies.
  • Reduce the number of pre-term babies(<37 weeks gestation) by
    • Reducing the number of women using drugs and alcohol during pregnancy
    • Reducing the number of women who smoke during pregnancy
    • Increase the amount of folic acid a woman gets before and during pregnancy
    • Increase the number of women that maintain a healthy weight during pregnancy, since obesity has been linked to pre-term labor.
    • Increase the number of women that choose natural child birth, by reducing planned c-sections or medically induced labors.
  • Increase the number of mothers that breastfeed their infants.
  • Decrease infant exposure to secondhand smoke and other risk factors for Sudden Infant Death Syndrome “SIDS”.
  • Encourage “back to sleep” programs that highlight the importance of putting babies to sleep on their backs
  • Increase the number of women that graduate high school. Higher levels of education are linked to better infant care.


Workgroup members have identified that these are key to reducing infant mortality:

  • Improve preconception health care delivery
  • Combating racism
  • Increasing postpartum and inter-conception support


In other communities these programs and strategies are working:

Access to care and community collaboration:

Ohio's Community Health Access Project (CHAP) supports the work of Community Health Workers in Richland County Ohio and operates the local Pathways Community HUB. The HUB Model is an evidence based community care coordination approach focused on reaching those at greatest risk, comprehensively evaluating their risk factors and accountably reducing them. The work is done by culturally connected community health workers (CHWs), nurses and social workers. They reach out to engage those populations most at risk. Using specific checklists they identify risk factors. Working as a team with nurses, social workers and in physicians they assure that identified risk factors are addressed with specific Pathways that require confirmed evidence based and best practice intervention.

Their work and the Pathways that document the outcome focused steps, assure individuals connect to primary care and prevention services, behavioral health, housing, food, clothing, adult education and employment. Consistent with National Quality Forum (NQF) guidelines of care coordination, each at risk individual receives a comprehensive assessment. All identified issues within that assessment are prioritized and worked though making sure they connect to the interventions needed. Connection to the interventions that address the identified risk factors confirms that each health, social and behavioral health factor has been addressed and results in reduced risk, reduced stress, improved outcomes and reduced cost.

To access the HUB Manual go here.


Fatherhood Initiatives:

Emerging research shows that increased paternal involvement during pregnancy and infancy reduces infant mortality and that racial/ethinic disparities may be reduced through increasing paternal involvement. Below are evidence based intervention to increase paternal involvement.

Boot Camp for New Dads® or Daddy Boot Camp® is a father-to-father community-based workshop that aims to inspire and equip men to become confidently engaged with their infants, support their mates, and personally navigate their transformation into dads. It offers Dads-to-be the tools and knowledge needed to feel confident on their journey to becoming new fathers. Experienced dads, who have been trained as coaches, teach dads-to-be how to hold, comfort, diaper, swaddle and play with their infant while being able to support the new mom as well. Multiple health systems in North Carolina currently offer this class including Carolinas Health Care, Cone Health, UNC Health Care, and WakeMed.

Father-Friendly Check-Up™ is a tool to help organizations assess the degree to which their operations encourage father involvement. See here.

24/7 Dad® is a comprehensive fatherhood program available with tools, strategies, and exercises for fathers of all races, religions, cultures, and backgrounds. Itt focuses on the characteristics men need to be good fathers 24 hours a day, 7 days a week like masculinity, discipline, and work-family balance – and helps men evaluate their parenting skills.

The Nurturing Fathers Program is and evidence-based, 13-week training course deisgned to teach parents and nurturing skills to men. The class addresses creating safe, loving, stable, and nurtured families; positive discipline tools taught through a uniquely father-friendly method for successful child behavior management; effective family communication techniques to strengthen the father-child and father-mother relationships; how to stop fighting and arguing by using proven-effective strategies for conflict resolution and problem solving; how to achieve cooperation and teamwork in family life.

Action Plan

Now:

  • Get data from Child Task Force on root causes
  • Research evidence based strategies
    • Ohio Model
  • Minority Equity Conference August 19th
  • Stories from communities most impacted
    • Create work groups and plan for obtaining

6-12 Months

  • Expand invitations to people who should be at the table
  • Look into Safety Coalition and Family Justice Center as a way of conveying urgency and increasing political will

1-3 Years

  • Gap analysis/map of women’s experience from preconception through baby’s first year

Beyond

  • TBD
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