Description: Infant mortality rate is the number of deaths of babies less than 1 year of age per 1,000 live births each year.

Sources: County and State data: North Carolina State Center for Health Statistics (NC SCHS), Statistics and Reports: Vital Statistics, "Infant Mortality Statistics"; http://www.schs.state.nc.us/data/vital.cfm

National data: Center for Disease Control and Prevention, Center for Health Statistics (CHS); http://www.cdc.gov/nchs/products/nvsr.htm

Note: To view comparisons, click indicator title and the toggle comparisons.

* Denotes data that should be used with caution. For example, the State Center for Health Statistics notes that infant mortality rates based on less than 10 deaths are unreliable and should be interpreted with caution. . Please also review the 5 year aggregate data for infant mortality.

Over the past five years, the infant mortality rate in Buncombe County has fluctuated with a peak of 10.1 deaths/1000 live births in 2013. Rates in North Carolina and the United States have been very gradually decreasing over time and North Carolina's 2015 rate is 7.3 deaths/1000 live births. In Buncombe County, this fluctuation is most likely due to the small size in relation to the state and county. In 2015, the rate decreased to 4.6 deaths/1000 lives births. While it may be necessary to interpret this rate with caution because of its instability due to small numbers, increase in infant mortality in 2013 and 2014 brings attention to the health of Buncombe County women and infants.

Asheville City Schools; Buncombe County Child Protection Team & Child Fatality Prevention Team; Buncombe County Health and Human Services (BCHHS); BCHHS School Health (School nurses) Program; Buncombe County Prenatal Safety Net- MAHEC; Buncombe County Schools; Children First/Communities in Schools; Community Care of Western North Carolina (CCWNC) OB Case Management; Community Service Navigators; Eliada Home; Family Planning and STD Clinics; Goodwill; Grandfather Home; Guardian Ad Litem; Mount Zion Community Development Project NAF (Nuturing Asheville and Area Families) & Project EMPOWER (Education Means Power); Mountain Area Health Education Center (MAHEC) Family Health; MAHEC Obstetrics & Gynecology; Pisgah Legal Services; Planned Parenthood; Western North Carolina AIDS Project; Western North Carolina Community Health Services (WNCCHS); YWCA- MotherLove Program; Youth Educators and Advocates for Health (YEAH)

We know that these factors reduce infant mortality:

1. Ensure pregnant women have access to and receive adequate prenatal care.
2. Reduce the number of teen pregnancies.
3. Reduce the number of pre-term babies(<37 weeks gestation) by
   • Reducing the number of women using drugs and alcohol during pregnancy
   • Reducing the number of women who smoke during pregnancy
   • Increase the amount of folic acid a woman gets before and during pregnancy
   • Increase the number of women that maintain a healthy weight during pregnancy, since obesity has been linked to pre-term labor.
   • Increase the number of women that choose natural child birth, by reducing planned c-sections or medically induced labors.
4. Increase the number of mothers that breastfeed their infants.
5. Decrease infant exposure to secondhand smoke and other risk factors for Sudden Infant Death Syndrome “SIDS”.
6. Encourage “back to sleep” programs that highlight the importance of putting babies to sleep on their backs
7. Increase the number of women that graduate high school. Higher levels of education are linked to better infant care.

In our community these programs are working to make an impact in the populations they serve:

Nurse-Family Partnership® (NFP) is an evidence-based community health programs that partners registered nurses with low-income, first-time mothers. Home visits begin during pregnancy and continue through the child's second birthday.

The goal of the program is to provide the care and support necessary for a health pregnancy, ensure the resources and ability to provide care for the family, and teach financial management.¹ Forming long-lasting, supportive relationships between nurse and mother, evidence shows NFP improves the long-term results of health, education, and economic self-sufficiency. On a community level, NFP works to break the ongoing cycle of poverty by empowering some of the most vulnerable members of our population.¹

Nurse-Family Partnership® was established in Buncombe County in October of 2009. The program has served over 100 families and continues to grow with goals of improving women's preventive and prenatal health practices, early childhood development and family financial independence.² Other home-visiting programs in Buncombe County use similar, effective methods to improve birth, motherhood, and early childhood outcomes.

For a review of NFP's effectiveness go here.

In other communities these programs and strategies are working:

Ohio's Community Health Access Project (CHAP) supports the work of Community Health Workers in Richland County Ohio and operates the local Pathways Community HUB. The HUB Model is an evidence based community care coordination approach focused on reaching those at greatest risk, comprehensively evaluating their risk factors and accountably reducing them. The work is done by culturally connected community health workers (CHWs), nurses and social workers. They reach out to engage those populations most at risk. Using specific checklists they identify risk factors. Working as a team with nurses, social workers and in physicians they assure that identified risk factors are addressed with specific Pathways that require confirmed evidence based and best practice intervention.

Their work and the Pathways that document the outcome focused steps, assure individuals connect to primary care and prevention services, behavioral health, housing, food, clothing, adult education and employment. Consistent with National Quality Forum (NQF) guidelines of care coordination, each at risk individual receives a comprehensive assessment. All identified issues within that assessment are prioritized and worked though making sure they connect to the interventions needed. Connection to the interventions that address the identified risk factors confirms that each health, social and behavioral health factor has been addressed and results in reduced risk, reduced stress, improved outcomes and reduced cost.

To access the HUB Manual go here.