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Alabama’s Infant Mortality Rate Lowest Ever in 2017

Alabama’s Infant Mortality Rate Lowest Ever in 2017

The Alabama Department of Public Health announced the infant mortality rate of 7.4 deaths per 1,000 live births in 2017 is the lowest in Alabama history and is an improvement over the 2016 rate of 9.1. A total of 435 infants born in Alabama died before reaching 1 year of age in 2017; 537 infants died in 2016.

While there is a longstanding disparity between birth outcomes for black and white infants, the infant mortality rate for black infants declined to an all-time low in 2017, and the infant mortality rate for white infants was the second lowest. The rate of 11.2 for black infants was an improvement over the 15.1 rate in 2016, and the rate of 5.5 for white infants was a drop over the 6.5 rate for whites in 2016.

Alabama enjoyed many positive indicators. Teen births and smoking during pregnancy are risk factors that contribute to infant mortality, and both are continuing to decline. The percentage of births to teens (7.3) and the percentage of births to mothers who smoked (9.6) are the lowest ever recorded in Alabama, with the largest decrease among teen mothers. There was also a decline in the number of infants born weighing less than 1,000 grams and infant deaths to those small infants.

While there was a significant decline in infant mortality, the percent of low weight births and births at less than 37 weeks gestation remained the same. Statisticians look at average infant mortality rates for three-year periods. Between the years 2015 through 2017, the combined rate of 8.3 was tied with the years 2009 through 2011 as the two lowest three-year rates of infant mortality in Alabama.

“Due to the sharp decline in the infant mortality rate for 2017, the Alabama Center for Health Statistics worked diligently to ensure all infant deaths were reported,” Center Director Nicole Rushing said. “A decrease in the number of infant deaths reported was seen at almost all hospitals.”

State Health Officer Dr. Scott Harris said, “We are encouraged with the progress in improved pregnancy outcomes we are seeing, but many challenges remain such as addressing persistent racial disparities, the opioid epidemic and ensuring access to health care.”

Gov. Kay Ivey said, “We must continue our efforts to reduce the number of families who experience the profound sadness of infant deaths. Alabama has developed an infant mortality reduction plan that includes a pilot project to reduce infant mortality by 20 percent in five years.”

Components of the pilot project being conducted in Macon, Montgomery and Russell counties include home visitation, preconception and interconception health care, screening for substance use, domestic violence and depression, safe sleep education, and breastfeeding promotion.

The top three leading causes of infant deaths in 2017 that accounted for 43.4 percent of infant deaths were as follows:

  • Congenital malformations, deformations and chromosomal abnormalities
  • Disorders related to short gestation and low birth weight
  • Sudden infant death syndrome

These top causes of infant deaths parallel those for the U.S. as a whole in 2016.

Graphs and detailed charts are available at the Alabama Department of Public Health website at

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Alabama’s Infant Mortality Rate Increased in 2016

Alabama’s Infant Mortality Rate Increased in 2016

According to the Alabama Department of Public Health the state’s infant mortality rate of 9.1 infant deaths per 1,000 live births in 2016 is the highest since 2008. This represents the deaths of 537 infants who did not reach 1 year of age. There were 59,090 live births in 2016.

“Our infant mortality rate is troubling and disheartening and trending in the wrong direction. Challenges include ensuring mothers have access to healthcare before, during, and after pregnancy, reducing premature births, the opioid epidemic, and addressing persistent racial disparities,” said Acting State Health Officer Dr. Scott Harris.

For reasons not fully understood, disparities in infant mortality by race continue to persist. One major predictor of a woman’s likelihood of delivering a baby preterm is her race. The infant mortality rate for black infants was more than twice that of white infants. The 2016 black infant mortality rate was 15.1 per 1,000, a slight decrease from the 2015 infant mortality rate of 15.3.

According to Dr. Paul Jarris, chief medical officer of the March of Dimes, race or ethnicity does not cause preterm birth, but some racial and ethnic groups face challenges related to racism that have a profoundly negative impact on birth outcomes:  inequities in health care, housing, jobs, neighborhood safety, food security and income. For white mothers, infant mortality increased from a record low rate of 5.2 in 2015 to 6.5 in 2016. Of note, the top three leading causes of infant death remain the same:  congenital malformation, premature births, and Sudden Infant Death Syndrome.

The percent of preterm births increased in 2016 from 11.7 percent to 12.0 percent. Infants born preterm, before 37 weeks gestation, are more likely to die before their first birthday or face life-long disabilities or chronic health conditions. Low birth weight infants, defined as those weighing less than 5 pounds, 8 ounces, are more than 20 times more likely to die than infants of normal weight. The percent of low weight births in 2016 declined slightly from 10.4 in 2015 to 10.3 in 2016.

Approximately 75 percent of births in 2016 were to women who had adequate prenatal care; 2.1 percent of births were to mothers with no prenatal care. In many states, including Alabama, women whose incomes are not low enough for Medicaid but cannot afford health insurance can qualify for Medicaid once they become pregnant and coverage lasts throughout pregnancy and a few weeks after.

On a positive note, as seen nationally, the percent of birth to teenagers in Alabama continues to trend downward to its lowest ever recorded of 7.7 percent in 2016.

Maternal smoking decreased to 10.1 percent of all live births, the lowest ever recorded. Of the mothers who smoked during pregnancy, 8.1 percent of births were to teen mothers and 10.3 percent of births were to adults.

Strategies to reduce infant mortality in Alabama:

  • Increase the use of progesterone to women with a history of prior preterm birth.
  • Reduce tobacco use among women of childbearing age.
  • Encourage women to wait at least 18 months between giving birth and becoming pregnant again.
  • Expand the Well Woman Preventive visit to provide pre-conception and inter-conception care.
  • Continue safe sleep education efforts.
  • Continue collaborative efforts to address the opioid epidemic.
  • Expand the Fetal and Infant Mortality Review activities at the community level.


  • Identifying, studying, and learning the factors that play a role in infant survival; implementing initiatives at the community level to improve infant health and vitality statewide.
  • Establishing a Maternal Mortality Review Committee to analyze the maternal deaths that occur within the state so as to improve maternal health outcomes.

Graphs and detailed charts are available at

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