NCDHHS doubles down on commitment to health equity through new State Health Improvement Plan

North Carolina’s infant deaths in 2018 reached their lowest rate in the 31 years they have been tracked, decreasing for a third straight year to 6.8 deaths per 1,000 live births down 4.2 percent from the previous year’s rate of 7.1 per 1000 live births, according to Governor Roy Cooper’s Office.

According to the newly released 2018 North Carolina Infant Mortality Report, 806 infant deaths were recorded to residents of the state in 2018 compared to 852 in 2017. Both the percent decline and the total numbers reported in 2018 are all-time lows.

“These numbers are encouraging but there is more work to do,” said Gov. Cooper. “Reducing infant mortality remains the first goal in our North Carolina Early Childhood Action Plan.”

The report reflects that notable disparities persist in infant mortality, particularly among African Americans. The African American infant mortality rate reached an all-time low, decreasing by 9% since 2016 to 12.2 in 2018, but it is still more than twice the white infant mortality rate at 5.0 in 2018. 

Governor Cooper’s Early Childhood Action Plan set a goal for reducing the statewide infant mortality disparity ratio from 2.5 to 1.92. The N.C. Perinatal Health Strategic Plan also focuses on infant mortality and maternal health, particularly the importance of addressing equity, as healthier women tend to have healthier birth outcomes.

“Infant health is an indicator of societal health and reducing it requires a continued comprehensive effort,” said Mandy Cohen, M.D., Secretary of the NC Department of Health and Human Services. “It should come as no surprise that a baby’s health is impacted by a mother’s health, reinforcing why North Carolina needs to expand access to affordable health insurance.”

Research published in 2018 in the American Journal of Public Health found that states that expanded Medicaid saw a greater rate of decline in infant mortality, with greater rates of decline among African American infants.

Historically, North Carolina is among states with the highest rates of infant mortality.

~In 1988 the rate was 12.6 deaths per 1,000 live births (9.6 for white North Carolinians per 1,000 live births and 19.8 per 1,000 live births for African Americans).

~Leading causes of infant mortality in North Carolina are preterm birth and low birth weight, birth defects, Sudden Unexpected Infant Death (SUID), maternal complications of pregnancy, labor, and delivery, and other perinatal conditions.

~The rate is impacted by a wide range of social, behavioral and health risk factors, including poverty, racism, education, tobacco use, obesity, and access to medical care before and during pregnancy.



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