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N.C. Reports lowest minority infant mortality rate in state's history


North Carolina
Department of Health and Human Services



Contact: Carol Schriber

Infant mortality rate remains the lowest in North Carolina’s history

RALEIGH – The North Carolina infant mortality rate stayed at 8.2 deaths per 1,000 live births in 2003, unchanged from the 2002 rate, which was the lowest in the state’s history. The infant mortality rate in North Carolina has decreased by 62.2 percent since 1973. In the last ten years alone, it has dropped by 22.6 percent (since 1993).

“While we’ve made good progress in reducing North Carolina’s infant mortality rate—we are no longer the highest in the nation as we were 15 years ago—there is still a lot of room for improvement,” said State Health Director Leah Devlin. “Although our rate is one of the best in the South, we are still far above the national rate and there is still a big gap between minority and white rates. Preventing premature births, which often result in infant death, remains one of our most persistent and critical public health challenges.”

According to a Centers for Disease Control and Prevention (CDC) preliminary report, North Carolina ranked 40th in the nation in infant mortality in 2003 (based on provisional data; final numbers may change slightly). Ten states had higher 2003 infant death rates than North Carolina (Alabama, Arkansas, Delaware, Georgia, Louisiana, Maryland, Michigan, Mississippi, South Carolina and Tennessee). The rate for the United States was 6.7 deaths per 1,000 live births, based on the provisional data.

Devlin said that the state needs to focus its efforts on the health of women before they become pregnant, because the majority of births in North Carolina are unplanned. “We need to work with women of child-bearing age to ensure that they are healthy prior to conception,” she explained. “That means improving physical fitness and nutrition, reducing tobacco use, addressing other substance use effectively, detecting sexually transmitted diseases early, and improving overall health. These are strategies that will benefit all women.”

“Another critical issue in reducing infant deaths is to make certain that family planning services are available to all women of childbearing age,” Devlin said.

Last year there were 118,292 live births in the state and 967 deaths of babies under one year of age. Of those live births, 59.6 percent were to white non-Hispanics, 22.8 percent to black non-Hispanics, 13.6 percent to Hispanics, and 1.4 percent to American Indians, with the remaining 2.7 percent to other racial/ethnic groups.

The infant mortality rate for minorities was 14.0 deaths per 1,000 live births last year, while the rate for white infants was 5.9 deaths per 1,000 live births. The overall minority infant mortality rate was more than twice the rate for whites, a disparity that has persisted over the years even as both annual rates have continued to decline.

The infant mortality rate for Hispanics has been comparable to that for white non-Hispanics, an average of 6.0 deaths per 1,000 live births from 2001 through 2003 for both groups. For black non-Hispanics, the average rate for that three-year period was 15.0, while for American Indians it was 10.8. 
“Reducing infant mortality remains one of public health’s top priorities, along with eliminating the disparity between white and minority infant mortality rates,” said Devlin.

Prematurity and low birth weight accounted for nearly 19 percent of the infant deaths in 2003. For babies between 29 days and one year of age, Sudden Infant Death Syndrome (SIDS) was the most common cause of death, accounting for just over 30 percent of the deaths of babies in this age range.

“Many infant deaths can be prevented,” Devlin said. “About 100 babies die of SIDS every year in North Carolina. Placing infants on their backs when they sleep is very important for reducing the risk for SIDS. The General Assembly passed the 2003 Prevent SIDS law requiring licensed childcare providers to position babies 12 months of age or under on their backs for sleeping. The North Carolina Healthy Start Foundation and the N.C. Division of Child Development have been working hard to ensure that childcare providers receive SIDS prevention training through the Infant/Toddler Safe Sleep and Sudden Infant Death Syndrome Risk Reduction in Child Care Program, ITS-SIDS. To date, 21,145 child care providers have been trained. In turn, many caregivers are telling parents how to reduce the risk of SIDS.”

“More women are also being encouraged to take folic acid before pregnancy in order to prevent serious birth defects of the spine and brain,” Devlin added. “The North Carolina Folic Acid Awareness Campaign appears to be working. Led by the N.C. Folic Acid Council, N.C. Chapter of the March of Dimes and the N.C. Division of Public Health, the campaign—along with fortification of food with folic acid—has resulted in a 75 percent reduction in neural tube defects (NTD) in babies born in Western North Carolina, a region with some of the highest NTD rates in the country. The greatest challenge now is reaching the women who are at greatest risk for NTD and who are not taking daily multivitamins.”

“These are but two ways to reduce infant mortality; many other efforts are also under way. It will take the combined talents, knowledge, energy and will of communities, health care providers, state and local agencies, families and individuals to reduce infant mortality and eliminate racial disparities across North Carolina,” Devlin said.

For data tables and more information on infant mortality, visit the State Center for Health Statistics web site,


Core infant mortality data tables (N.C. 2003 Final Infant Death Rates by County (white and minority); N.C. Infant Death Rates by County 2002, 2003, 1999-2003 (total population); N.C. Infant Deaths and Rates 1973-2003 (state rates only; total population); N.C. Resident Infant Mortality Rates and Percentage of Live Births by Race/Ethnicity, 2001-2003. Graph: N.C. Resident Infant Mortality Rates, 1974-2003 (total population, white and minority rates) [PDF format, 74 kb.]

Expanded set of data tables (

NOTE TO REPORTERS: On the infant mortality data tables, PLEASE NOTE THAT MANY COUNTY RATES ARE BASED ON VERY SMALL NUMBERS. Rates based on fewer than 10 deaths are considered “unstable” or unreliable because a drop or rise of just one or two deaths yields a very different rate, which can result in large rate fluctuations from year to year. In such cases, a multi-year average usually gives a more stable rate and a more realistic picture of infant mortality in that county. 

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