Evaluation of Public Health Surveillance – Infant Mortality

Infant mortality (IM) and morbidity are monitored by multiple public health agencies, an interagency approach that ensures extensive data and information are captured to assess the needs of the population so that effective health promotion, education programs, and polices can be signed to improve maternal birth outcomes and infant health outcomes. The Centers for Disease Control and Prevention’s National Center for Health Statistics provides infant mortality rates and statistical data in partnership with the National Vital Statistics System (NVSS). Additionally, they provide information on trends and causes of infant mortality with detailed analyses of IM patterns. (CDC, n.d.) The advantage of the National Center for Health Statistics is the availability of data describing the number of infant deaths in each state categorized from highest to lowest rate. The limitation of the data is omission of state specific characteristics that may affect the level of mortality and disparities. Inclusion of race classification of decedents strengthens mortality data and can assist in efforts to reduce disparities in my target population and other minoritized populations. 

Used to identify high risk groups of women and infants in forty-seven states, the Pregnancy Risk Assessment Monitoring System (PRAMS) collects population-based data on maternal attitudes and experiences before, during, and after pregnancy to help inform public health infant mortality prevention efforts. The advantage of this type of surveillance is that it provides data from a holistic approach throughout the lifecycle of pregnancy and prior to pregnancy, as each phase of pregnancy provides key indicators of health and birth outcomes. (CDC, n.d.) There is a limitation in the data sets provided given 100% of states are not represented. To improve these surveillance systems, an increase in state participation is needed while also including more detailed demographics that enable the assessment of health inequities and disparities in infant mortality. The PRAMS questionnaire is utilized to access details about preconception and prenatal care, breastfeeding, and health insurance coverage. The questionnaire could be improved by included questions specifically about healthcare provider experience (perception of quality of care) to provide a comparison of this data across racial/ethnic groups. 

References

Centers for Disease Control and Prevention. (n.d.) Reproductive health. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality-cdcdoing.htm

ESPEY, D. K., JIM, M. A., RICHARDS, T. B., BEGAY, C., HAVERKAMP, D., & ROBERTS, D. (2014). Methods for improving the quality and completeness of mortality data for american indians and alaska natives. American Journal of Public Health (1971), 104(S3), S286-S294.  https://doi.org/10.2105/AJPH.2013.301716