New York State Department of Health Issues Report On Infant Mortality

Between 2016 and 2019 the Number of New York State Infant Deaths Declined by 12%

Data Indicates That Racial and Ethnic Disparities in Infant Mortality Continue to Persist

ALBANY, N.Y. (June 1, 2023) – The New York State Department of Health today released the report, Infant Mortality in New York State, 2016-2019, showing during that time period the number of New York State infant deaths declined by 12%. This decline exceeded the overall national decline of 5% during the same period. The full report can be found here.

"In spite of the overall progress, I am concerned about the persistent increase in infant mortality among non-Hispanic Black infants, which is indicative of long standing health disparities." Acting State Health Commissioner Dr. James McDonald said. "As a pediatrician, I have witnessed these inequalities. The Department remains committed to preventing widening disparities and ensuring that all babies have a fair chance to thrive and grow."

The report highlights racial and ethnic disparities in infant mortality in New York State, including:

  • The infant mortality rate among Non-Hispanic Black infants has increased slightly over time from 8.37 deaths per 1,000 live births in 2016 to 8.46 deaths per 1,000 live births in 2019.
  • In 2019, the infant mortality rate for Non-Hispanic Black infants was 2.8 times higher than that of Non-Hispanic White infants and Hispanic infants.
  • During both the neonatal (first month of life) and postneonatal (one month through one year of life) periods, Non-Hispanic Black infants were more likely to die compared to other racial/ethnic groups.

Factors such as employment status, income, where you live, housing, transportation, food security, access to healthy foods, stress, social support, healthcare coverage, and quality of medical care received all contribute to disparities in infant health.

In collaboration with partners, the Department is involved in a statewide effort to reduce the instances of infant mortality and decrease disparities. The agency has implemented several initiatives to reduce infant deaths and improve birth outcomes.

Since 2017, the Department has worked to update New York State regulations for the state's birthing hospitals, which are organized under Regional Perinatal Centers, that provide the highest level of support to individuals and hospitals in their region. The updated regulations will reflect current national standards of obstetrical and neonatal care and perinatal levels of care, changes in health care systems and reimbursements, as well as hospital restructuring and other corporate structural changes.

Access to comprehensive maternal and infant health services has been expanded under Medicaid. In 2022, postpartum coverage for individuals eligible for either Medicaid or Child Health Plus was expanded from 60 days to 12 months, with the goal of improving health equity and healthcare access across the state. Medicaid expansion includes reimbursement for the following services provided to pregnant and postpartum populations: registered dieticians who provide nutrition services, community health workers and patient family navigators for care coordination and peer support services, Bluetooth-enabled devices for telehealth/remote patient monitoring services, midwifery services, and expanded coverage of Non-Invasive Perinatal Testing (NIPT) for pregnant people of all ages.

The Newborn Bloodspot Screening (NBS) Program currently performs laboratory testing for 50 diseases, following national recommendations for NBS programs. The program ensures that every newborn in the state receives newborn bloodspot screening as a public health service at no cost. The program also performs follow-up case management to ensure newborns with positive screening results receive appropriate diagnostic testing and treatment.

The Department is working with the Office of Children and Family Services and other partners to promote safe sleep practices and prevent infant deaths caused by an unsafe sleep environment, using several strategies including legislative and policy efforts; robust public awareness campaigns using media outlets; hospital-based education programs centered on the ABCs of Safe Sleep (Babies should sleep Alone, on their Backs, in a safe Crib, and in a Smoke-free home); distribution of infant safe sleep starter kits (includes a Pack 'N Play, two fitted crib sheets, bug net, cotton sleep sack, and infant safe sleep literature) for those in need; as well as home-based visiting programs to support and educate parents and caregivers during the prenatal and postpartum periods. More information and resources on infant safe sleep can be found here.

Beginning in 2018, in response to the growing incidence of opioid use during pregnancy, the New York State Perinatal Quality Collaborative (NYSPQC) partnered with the American College of Obstetricians and Gynecologists (ACOG) District II, Healthcare Association of New York State (HANYS), Greater New York Hospital Association (GNYHA), and the National Institute for Children's Health Quality (NICHQ) to work with New York State birthing hospitals through a quality improvement learning collaborative. The New York State Opioid Use Disorder (OUD) in Pregnancy and Neonatal Abstinence Syndrome (NAS) Project seeks to support birthing hospitals to provide appropriate and respectful care to individuals with OUD during pregnancy and improve the care of infants with NAS.

To further improve birth outcomes, in 2021, the NYSPQC implemented another facility-based, quality improvement collaborative, the New York State Birth Equity Improvement Project (NYSBEIP). The goals of the NYSBEIP are to assist New York State birthing hospitals in identifying how individual and systemic racism impact birth outcomes at their facility and improving both the Home visiting programs are a cornerstone of public health efforts to support pregnant and parenting families, as these programs improve numerous short- and long-term outcomes for mothers, infants, and families.

Under the Department's Maternal and Infant Early Childhood Home Visiting (MIECHV) Initiative, grant funds have supported the expansion of two specific evidenced-based home visiting models, Nurse Family Partnership (NFP) and Healthy Families New York (HFNY) . These home-visiting programs complement other evidence-based programs operating in New York, as well as other traditional models that include community outreach, home visits, public health nursing, community health workers, and doulas.

The Perinatal and Infant Community Health Collaborative (PICHC) Initiative was launched in July 2022 with a five-year, $14 million annual fund that was awarded to 26 programs in New York State to support the development, implementation, and coordination of collaborative community-based strategies to improve perinatal and infant health outcomes – including preterm birth, low birth weight, infant mortality, and maternal mortality – and eliminate racial, ethnic, and economic disparities in those outcomes. Within a reproductive justice framework, PICHC programs implement both individual-level strategies to address perinatal and infant health behaviors, and community-level strategies, using a collective impact approach, to address social determinants that impact health outcomes.

The report recommended that the Department take some of the following measures: Engaging Regional Perinatal Centers, their affiliate hospitals, and communities to address the individual needs of each region including education, training, and quality improvement initiatives; developing and implementing social media strategies to help individuals of reproductive age understand the importance of healthy choices and improved pregnancy outcomes and have access to supports needed for healthy choices; identifying provider shortage areas and working with partners, such as SUNY, to provide support for recruitment and retention strategies in provider shortage areas; and encouraging the utilization of standardized infant death investigation procedures to improve cause-of-death certification and providing training to medical examiners and coroners on infant death investigation.

The Department remains committed to supporting families to ensure that all babies have a fair chance to long and healthy lives.

The New York State Community Health Indicator Reports - Maternal and Infant Health Indicators are located here. The New York State Maternal and Child Health Dashboard can be found here.