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Executive SummaryIntroductionExplore the Health of Women, Children and InfantsFindingsThe Health of Women and Children between StatesThe Health of Women and Children within StatesHealthy Communities for ChildrenClinical Preventive Services for ChildrenRacial Disparities in Measures of MortalityVariations in SmokingMeasures of Women's HealthBehaviors | Measures of Women’s HealthCommunity & Environment | Measures of Women’s HealthPolicy | Measures of Women’s HealthClinical Care | Measures of Women’s HealthOutcomes | Measures of Women’s HealthMeasures of Infants' HealthBehaviors | Measures of Infants’ HealthCommunity & Environment | Measures of Infants’ HealthPolicy | Measures of Infants’ HealthClinical Care | Measures of Infants’ HealthOutcomes | Measures of Infants’ HealthMeasures of Children's HealthBehaviors | Measures of Children’s HealthCommunity & Environment | Measures of Children’s HealthPolicy | Measures of Children’s HealthClinical Care | Measures of Children’s HealthOutcomes | Measures of Children’s HealthState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaUnited StatesAppendixData Sources and Measures of Women’s HealthData Sources and Measures of Infants’ HealthData Sources and Measures of Children’s HealthMethodologyModel DevelopmentAmerica’s Health Rankings® Health of Women and Children Steering GroupThe Team

Infant Mortality

Over 23,000 US infants died in 2014. Significant progress has been made in the past 50 years to reduce infant mortality, but the US rate remains consistently higher than other developed countries. The top five causes of infant death are birth defects, preterm birth and low birthweight, maternal complications of pregnancy, sudden infant death syndrome, and injuries. These causes account for 57% of infant deaths. The infant mortality rate is significantly higher for non-Hispanic blacks, unmarried mothers, and mothers younger than 15 years. Differences in infant mortality rates across the United States are largely driven by socioeconomic status.

Number of infant deaths (before age 1) per 1,000 live births

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Data source: National Vital Statistics System, 2012–2013 For details: www.americashealthrankings.org/ALL/IMR_MCH



Low Birthweight

Low birthweight (LBW) — one of the five leading causes of US infant mortality — indicates current and future child health as well as maternal health. Potential medical problems in infants with LBW include respiratory distress syndrome, bleeding in the brain, heart problems, retinopathy, and intestinal disorders. There may be a connection between LBW and chronic adulthood diseases such as type 2 diabetes and coronary heart disease. Women who smoke are nearly twice as likely to have a LBW baby as women who do not smoke. Other significant maternal risk factors include diabetes, high blood pressure, insufficient weight gain during pregnancy, unemployment, and low education or income level.

Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth

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Data source: National Vital Statistics System, 2014 For details: www.americashealthrankings.org/ALL/lowbirthweight_MCH



Neonatal Mortality

Infant mortality is divided into two age periods: neonatal (birth to 27 days) and postneonatal (28 to 364 days). Approximately two-thirds of all infant deaths occur in the neonatal period. The leading causes of neonatal mortality include disorders related to short gestation and low birthweight, congenital malformations, and maternal complications. Improving access to and use of ongoing prenatal care may reduce the risk of neonatal mortality by addressing maternal obesity, tobacco, and alcohol use. In addition, home health visits after birth could help reduce the incidence of sudden infant death syndrome and accidents, which also contribute to neonatal mortality.

Number of deaths during first 28 days of life (0 to 27 days) per 1,000 live births

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Data source: National Vital Statistics System, 2014 For details: www.americashealthrankings.org/ALL/neonatal_mortality



Preterm Birth

Preterm birth is the greatest contributor to infant death and a leading cause of long-term neurological disabilities. The risk of death or serious disability is higher the earlier the baby is born, with most preterm birth-related deaths occurring in babies who were born very prematurely (before 32 weeks). While causes of preterm birth are numerous and not well understood, there are several known risk factors. These include maternal age, race/ethnicity, low income or education, high stress levels, high blood pressure, prior preterm birth, carrying more than one baby, tobacco and alcohol use, intrauterine infection, and late prenatal care.

Percentage of live births before 37 weeks gestation

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Data source: National Vital Statistics System, 2014 For details: www.americashealthrankings.org/ALL/pretermbirth_MCH