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MCHB
NATIONAL OUTCOME MEASURES
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Outcome Measure #1: The infant mortality rate per 1,000 live births.
Outcome Measure #2: The ratio of the black infant mortality rate to the white infant mortality rate.
Outcome Measure #3: The neonatal death rate (deaths to infants under 28 days) per 1,000 live births.
Outcome Measure #4: Postneonatal (28 to 364 days) deaths per 1,000 live births
Outcome Measure #5: Perinatal deaths (neonatal deaths under 7 days and fetal deaths of _ 20 weeks gestation) per 1,000 live births.
Measure #6: The child death rate per 100,000 children aged 1-14
Outcome Measure #1: The infant mortality rate per 1,000 live births.
GOAL To reduce the number of infant deaths.
DEFINITIONS
Numerator: Number of deaths to infants from birth through 364 days of age.
Denominator: Number of live births. Units: 1000 Text: Rate per thousand
HEALTHY PEOPLE 2000 OBJECTIVE Objective 14.1 Reduce the infant mortality rate to no more than 7/1000 live births.
DATA SOURCE and DATA ISSUES Vital records collected by the State.
SIGNIFICANCE All countries of the world measure the infant mortality rate as an indicator of general health status. The U.S. has made progress in reducing this rate, but the rate of decline has slowed in the last 10 years. There is still significant racial disparity, as noted in the Healthy People 2000 Mid-course Review. Rates are much higher in the lower social class and in the lowest income groups across all populations.
DISTANCE LEARNING RESOURCES:
Infant Mortality Trend Analysis: This tutorial describes how the state of Hawaii used trend analysis to gain a better understanding of its infant mortality rates. (Training module at MCH Analytic Skills Online). Register for module here.
Calculating IMR in SAS: This tutorial discusses software issues involved when calculating rates from individual level data. We demonstrate an approach in SAS for generating correct numerators and denominators, producing output with infant mortality rates on a per 1,000 basis. In order to complete this tutorial, sample SAS datasets and SAS programs are provided. (Training module at MCH Analytic Skills Online). Register for module here.
Outcome Measure #2: The ratio of the black infant mortality rate to the white infant mortality rate.
GOAL To reduce the disparity (ratio) between the Black and White infant mortality rates.
DEFINITIONS
Numerator: The Black infant mortality rate per 1,000 live births.
Denominator: The White infant mortality rate per 1,000 live births. Units: 1 Text: Ratio
HEALTHY PEOPLE 2000 OBJECTIVE Objective 14.1 and 14.1a. Reduce the infant mortality rate to no more than 7/1000 live births. Reduce the Black infant mortality rate to no more than 11/1000 live births.
DATA SOURCE and DATA ISSUES Vital records collected by the State.
SIGNIFICANCE All countries of the world measure the infant mortality rate as an indicator of general health status. The U.S. has made progress in reducing this rate, but the rate of decline has slowed in the last 10 years. There is still significant racial disparity, as noted in the Healthy People 2000 Mid-course Review. Rates are much higher in the lower social class and in the lowest income groups across all populations. The disparity (ratio) for Black infant mortality is over twice the White rate. Black women are twice as likely as White women to experience prematurity, low birth weight, and fetal death.
Outcome Measure #3: The neonatal death rate (deaths to infants under 28 days) per 1,000 live births.
GOAL To reduce the number of neonatal deaths.
DEFINITIONS
Numerator: Number of deaths to infants under 28 days.
Denominator: Number of live births. Units: 1000 Text: Rate per thousand
HEALTHY PEOPLE 2000 OBJECTIVE Objective 14.1d Reduce the neonatal mortality rate to no more than 4.5 per 1,000 live births.
DATA SOURCE and DATA ISSUES Vital records collected by the State.
SIGNIFICANCE Neonatal mortality is a reflection of the health of the newborn and reflects health status and treatment of the pregnant mother and of the baby after birth.
Outcome Measure #4: Postneonatal (28 to 364 days) deaths per 1,000 live births
GOAL To reduce the number of postneonatal deaths.
DEFINITIONS
Numerator: Number of deaths to infants 28 through 364 days of age.
Denominator: Number of live births. Units: 1000 Text: Rate per thousand
HEALTHY PEOPLE 2000 OBJECTIVE Objective 14.1g Reduce the postneonatal deaths to 2.5/1000 live births or less.
DATA SOURCE and DATA ISSUES Vital records collected by the State.
SIGNIFICANCE This period of mortality reflects the environment and the care infants receive. SIDS deaths occur during this period and have been recently reduced due to new infant positioning in the U.S. Poverty and a lack of access to timely care are also related to late infant deaths.
Outcome Measure #5: Perinatal deaths (neonatal deaths under 7 days and fetal deaths of _ 20 weeks gestation) per 1,000 live births.
GOAL To reduce the number of perinatal deaths.
DEFINITIONS
Numerator: Number of fetal deaths _ 20 weeks gestation plus deaths occurring under 7 days.
Denominator: Live births + fetal deaths. Units: 1000 Text: Rate per thousand
HEALTHY PEOPLE 2000 OBJECTIVE Related to Objective 14.1d and 14.2 Reduce the neonatal mortality to no more than 4.5 per 1,000 live births. Reduce the fetal death rate (20 or more weeks gestation) to no more than 5 per 1,000 live births plus fetal deaths.
DATA SOURCE and DATA ISSUES Vital records collected by the State.
SIGNIFICANCE Perinatal mortality is a reflection of the health of the pregnant woman and newborn and reflects the pregnancy environment and early newborn care.
Outcome Measure #6: The child death rate per 100,000 children aged 1-14
GOAL To reduce the death rate of children aged 1-14.
DEFINITION
Numerator: Number of deaths among children aged 1-14 years.
Denominator: Number of children aged 1-14. Units: 100,000 Text: Rate per hundred thousand
HEALTHY PEOPLE 2000 OBJECTIVE No HP 2000 Objective, but found as an age-related objective. Reduce the death rate for children by 15% to no more than 28 per 100,000 children aged 1-14.
DATA SOURCE and DATA ISSUES Child death certificates are collected by State vital records. Data on total number of children comes from the Census.
SIGNIFICANCE While children's likelihood of survival increases dramatically after the first year of life, the child death rate remains of concern. The child death rate has decreased in the last decade, falling from 33.8 in 1985 to 28.8 in 1992. The DHHS's strategic plan identifies improvements in the rates of preventable death as part of priority goals for children and youth.