Academic journal article International Journal of Child and Adolescent Health

Infant Mortality in Indiana: Perceived Beliefs and Attitudes of Individuals Living in the State

Academic journal article International Journal of Child and Adolescent Health

Infant Mortality in Indiana: Perceived Beliefs and Attitudes of Individuals Living in the State

Article excerpt

Introduction

Historically, Indiana has had a higher infant mortality rate than other states in the United States, especially those in the Midwest region. In particular, for more than a century, Indiana has reported an infant mortality rate of greater than 6.9 and has consistently been ranked among the worst in the nation (1). In 2013, there were 594 infant deaths across the state of Indiana, creating an alarming infant mortality rate of 7.1 (1). This rate was higher than the national average of 5.96 and higher than the Healthy People 2020 goal of 6.0.

Recent state-level assessments revealed that the primary causes of infant mortality include: preterm births, congenital malformations, disorders related to short gestation and low birth rate, sudden infant death syndrome (SIDS), maternal complications during pregnancy, and injuries such as suffocation (1). These factors have been known to account for more than half of all infant deaths, with preterm birth being the most frequent cause (2). Lifestyle factors, such as smoking during pregnancy and obesity also influence the state's infant mortality (1). The Indiana smoking rate during pregnancy of 15.7% nearly doubled that of the national average of 8.5% (1). This ranks Indiana among the top ten worst states in the nation. Second-hand smoke also has a strong correlation with infant mortality. Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine than infants who die from other causes (3). Overall, Indiana ranks last (50th) among all of the states for adult smoking rates (4). There are, however, numerous smoke-free initiatives that are being implemented across the state. Indiana also has a high ranking of adults who smoke indoors, as well as outdoors, and in the workplace (4).

While data suggest that social, economic, and environmental factors are the root causes of these disparities, individuals in local communities who are directly or indirectly impacted by infant mortality might have a different perspective on the issue. In order for individuals to come together in their local communities and address these issues related to infant mortality, they must be first be made aware that infant mortality is a problem. Exploring the community members' perceptions about infant mortality can assist in the development of educational initiatives and community interventions that are tailored for specific populations. Another area of interest is identifying the most influential and appropriate 'spaces and places' for dispersing educational materials and for disseminating information to the public. Understanding the causes of infant death provides a perspective on a population's need for resources, policies, and healthcare that influence the health of Indiana's most vulnerable population.

Aim

The study explored what individuals currently living in Indiana perceive as important for disseminating information about infant mortality. Specifically, the research questions under examination are:

* Are individuals living in Indiana aware of the state's infant mortality rate?

* What places/networks do these individuals consider to be the most effective in delivering information about maternal and child health?

* In what ways do individuals think infant mortality should be addressed?

Methods

This study used a self-administered eight-item survey. The survey included demographic information such as gender, age, race/ethnicity, and current city. Participants were also asked if Indiana's infant mortality rate was higher than the national average, and their ideas for decreasing it. Participants rated the places/ networks that might be ideal to provide education about infant mortality. These places/ networks were: faith based organizations, hospitals, community health centers, doctor's offices, schools, local health departments, TV/radio, social media, posters, and word of mouth. Questions were a mixture of categorical (yes/ no), ordinal (Likert scale ranging from 1 to 5), and open-ended questions. …

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