Alabama infant mortality decreases, but still higher than national average

Doctor cutting baby's umbilical cord. (Getty)

Alabama’s overall infant mortality rate fell in the recent years but remains higher than the national average, with racial disparities in infant deaths getting worse.

The state’s infant mortality rate in 2022 was 6.7 per 1,000 live births, a decrease from 7.6 per 1,000 in 2021 but higher than the national average of 5.6 , according to Alabama Department of Public Health (ADPH).

The report defined infant mortality as a death occurring in the first year after birth.

Dr. Scott Harris, ADPH’s state health officer, told an ADPH state committee board meeting Thursday that the report highlights the “fantastic work that our perinatal folks have been doing,” but that conversations will continue with board members and state officials on how to further reduce the state’s infant mortality rates.

Alabama Gov. Kay Ivey delivers the State of the State address on Tuesday, Feb. 6, 2024 in Montgomery, Ala. (Stew Milne for Alabama Reflector)

“We submitted a lot of ideas to them, and then we learned in the State of the State that [Gov. Kay Ivey] proposed funding for that. We’re very excited about that, and we’re working very hard on trying to do that,” Harris said.

In the Feb. 6 State of the State address, Ivey announced a pilot program to conduct health checkups for pregnant people at 9 county health departments in areas of need.

“Folks, there is nothing more important than our Alabama families, and we must come together to find common ground on meaningful ways to support them,” she said during the speech.

Harris said he approached Ivey with new ideas for providing prenatal care using county health departments before her State of the State speech.

The report will be presented to the Legislature. In a letter included in the report, dated Jan. 10, 2024, Harris stated that it’s essential that the state address racial disparities and poor health outcomes in the maternal and infant health crisis.

The state infant mortality rate for Black infants was 12.4 per 1,000 live births in 2022, an increase over the 11 deaths per 1,000 in 2018. For white infants, the mortality rate in 2022 was 4.3 per 1,000, an all-time low.

White infants account for 69.8% of births in Alabama but make up 44.5% of deaths. Black infants account for 28% of births but 51.4% of deaths.

Harris said the health of the mother and infant are “interwoven” and that officials must address factors including poverty, education levels and access to medical care.

“Despite advances in health care, the black infant mortality rate is consistently twice the rate for white mothers,” Harris wrote in the January letter.

Counties in the Black Belt had some of the highest rates of infant mortality, well above the state average. Perry County’s infant mortality rate was 20.4 deaths per 1,000 live births. Pickens, Sumter, Perry, Conecuh and Butler counties followed respectively, with rates between 15.1 and 15.6 rate of mortality per 1,000 live births.

Many medical centers in the Black Belt don’t have labor and delivery units , forcing many expectant mothers to drive hours to have infants delivered.

25 counties in Alabama as maternity deserts , lacking obstetrics services or obstetricians available for residents, according to a 2022 report from the March of Dimes. Another 21 counties are classified as places with low access to maternity care.

The report identified birth defects as the leading cause of infant mortality, with 69 cases in the state in 2022. Sudden unexplained death followed with 47 cases and preterm and low-birth weight with 38 cases.

“With the purpose to improve, promote, and protect health, it is essential that we address the factors that contribute to racial disparities and poor health outcomes in mothers and infants,” Harris stated in the letter.

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