Infant mortality; Community health; Community characteristics


Community Health and Preventive Medicine | Maternal and Child Health


Infant mortality (IM) rate is a key indicator of population health and has been gradually improving in the United States. However, it is still a public health problem among minority and low-income communities. Maternal factors explain some of the variation, but community-level factors may also be a contributor. This study examines measures to identify a set of indicators that explain variations in IM at the community-level. Data for 77 communities in a city were obtained from local health databases. We used multivariable linear regression models to examine the strength of the association between IM and maternal, population, community wealth, and social capital characteristics. Community-level IM rates ranged from 2.1 – 25.6 deaths per 1,000 live births in 2000-2002. The final model explained 75% of the variation in IM rates at the community-level (R2=0.75). The model included a high percentage of low birth weight babies, a decline in mothers who began prenatal care in the second trimester, an increase in the percentage of Hispanics, increased unemployment rates, an increase in the percentage of veterans, an increased rate of foreign-born residents, and smaller average family sizes. Social capital variables, homicide rate and vacant housing, were also significant in the final model. Identifying communities at risk for high IM rates is imperative to improve maternal and child health outcomes because of shortages in public health resources. The development of a parsimonious set of community-level indicators can assist public health practitioners in targeting their resources to prevent infant mortality in high-risk communities.