|
Reproductive Health Indicator: Mortality
Measures: Infant mortality rate; Neonatal rate; Postneonatal rate; Perinatal mortality rate
Tracking populations with higher infant and perinatal mortality rates may provide leads to potential environmental problems. It will assist in targeting outreach with educational and other interventions and improve understanding of geographic variation, time trends and demographic patterns in infant death.
Overall, congenital malformations and chromosomal abnormalities are the leading cause of infant mortality (20 percent of deaths). Disorders related to short gestation and low birthweight are second, making up 16.6 percent of deaths. However, the leading cause of death varies over the first year of life, and combining all causes during the first year of life obscures the importance of different causes in different periods of time.
Oregon EPHT tracks the following four measures of mortality:
- Infant mortality - number of deaths occurring at less than 1 year of age in a given year (less than 366 days in leap year) divided by the number of live births in the same year;
- Neonatal mortality - number of deaths occurring at less than 28 days of age in a given year divided by the number of live births in the same year;
- Postneonatal mortality - number of deaths from 28 days to 1 year of age (less than 366 days in a leap year) in a given year divided by the number of live births in the same year;
- Perinatal mortality - the number of fetal deaths at 28+ weeks gestation plus infant deaths less than 7 days old divided by the number of live births plus fetal deaths at 28+ weeks gestation in the same year.
The national rates have remained essentially unchanged since 2000 when the infant mortality rate was 6.9/1,000. In 2003, Oregon ranked 12th in the nation for low infant mortality, tied with Washington and behind the New England states and other western states of California, Alaska and Utah.
There are higher infant mortality rates in the more rural versus the more urban counties in Oregon, and this may be associated with a number of factors including access to and quality of care, educational levels, maternal characteristics and possible environmental exposures. No conclusions can be drawn without additional studies that explore this pattern and evaluate the numerous possible explanations for the differences.
For ease of making comparisons between the mortality measures that were that were described above and table 5 below provides a summary of the infant, neonatal, postneonatal and perinatal mortality rates and counts for Oregon and for all counties from 2000 to 2005. All counties had more than 50 births during this time period.
NOTE: Mortality rates are based on live births except the perinatal mortality rate, which also includes fetal deaths of more than 28 weeks gestation.
Table 1: 2000–2005 infant (< 1 year old) mortality rate per 1000 live births, by county and year.
Table 2: 2000–2005 neonatal (<28 days old) mortality rate per 1000 live births, by county and year.
Table 3: 2000–2005 postneonatal (≥ 28 days to <1 year old) mortality rate per 1000 live births, by county and year.
Table 4: 2000-2005 perinatal (≥ 28 weeks gestation to < 7 days old) mortality rate per 1000 live births and fetal deaths ≥ 28 weeks gestation, by county and year.
Table 5: 2000–2005 infant , neonatal, postneonatal, and perinatal mortality rates, per 1000 live births, by county (*perinatal rates are per 1000 live births & fetal deaths ≥28 weeks gestation).
Graph 1: Infant mortality (< 1 year) rate per 1,000 live births summarized for 2000 to 2006, by county.
Map 1: Infant (<1 year) mortality rate, shown in three statistical categories: higher than, similar to, or lower than the Oregon rate.
____________________________________________________________________________________________________
Table 1: 2000–2005 infant (< 1 year old) mortality rate per 1000 live births, by county and year.
To protect confidentiality, percentage and counts are not shown in cases where the number of births in the county for the year is less than ten (***). Percentages calculated with less than ten events (count) may be unreliable.
|
2000
|
2001
|
2002
|
2003
|
2004
|
2005
|
All Years
|
|
rate(count)
|
rate(count)
|
rate(count)
|
rate(count)
|
rate(count)
|
rate(count)
|
rate(count)
|
Oregon
|
5.5
|
(254)
|
5.3
|
(240)
|
5.7
|
(258)
|
5.6
|
(257)
|
5.4
|
(246)
|
5.8
|
(266)
|
5.6
|
(1521)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Baker
|
0.0
|
(0)
|
6.5
|
(1)
|
5.7
|
(1)
|
20.5
|
(3)
|
13.3
|
(2)
|
18.3
|
(3)
|
10.4
|
(10)
|
Benton
|
1.3
|
(1)
|
2.4
|
(2)
|
1.3
|
(1)
|
5.2
|
(4)
|
4.0
|
(3)
|
5.1
|
(4)
|
3.2
|
(15)
|
Clackamas
|
5.5
|
(23)
|
3.6
|
(15)
|
3.4
|
(14)
|
3.5
|
(14)
|
3.9
|
(16)
|
2.9
|
(11)
|
3.8
|
(93)
|
Clatsop
|
10.4
|
(4)
|
2.6
|
(1)
|
13.9
|
(6)
|
16.3
|
(6)
|
5.0
|
(2)
|
2.4
|
(1)
|
8.4
|
(20)
|
Columbia
|
0.0
|
(0)
|
3.8
|
(2)
|
5.8
|
(3)
|
5.6
|
(3)
|
4.2
|
(2)
|
0.0
|
(0)
|
3.2
|
(10)
|
Coos
|
4.8
|
(3)
|
5.2
|
(3)
|
1.6
|
(1)
|
4.8
|
(3)
|
6.3
|
(4)
|
8.0
|
(5)
|
5.1
|
(19)
|
Crook
|
14.0
|
(3)
|
4.1
|
(1)
|
18.6
|
(4)
|
4.3
|
(1)
|
0.0
|
(0)
|
13.6
|
(3)
|
8.7
|
(12)
|
Curry
|
6.4
|
(1)
|
5.7
|
(1)
|
6.7
|
(1)
|
0.0
|
(0)
|
12.8
|
(2)
|
0.0
|
(0)
|
5.3
|
(5)
|
Deschutes
|
7.6
|
(11)
|
8.1
|
(12)
|
3.4
|
(5)
|
7.0
|
(11)
|
5.4
|
(9)
|
2.2
|
(4)
|
5.5
|
(52)
|
Douglas
|
6.6
|
(7)
|
9.2
|
(10)
|
7.7
|
(8)
|
9.9
|
(11)
|
5.4
|
(6)
|
7.3
|
(8)
|
7.7
|
(50)
|
Gilliam
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
Grant
|
0.0
|
(0)
|
31.7
|
(2)
|
0.0
|
(0)
|
15.4
|
(1)
|
14.5
|
(1)
|
0.0
|
(0)
|
10.1
|
(4)
|
Harney
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
30.3
|
(2)
|
13.2
|
(1)
|
15.2
|
(1)
|
8.6
|
(4)
|
Hood River
|
11.1
|
(4)
|
3.3
|
(1)
|
3.1
|
(1)
|
3.4
|
(1)
|
12.8
|
(4)
|
3.4
|
(1)
|
6.4
|
(12)
|
Jackson
|
2.9
|
(6)
|
6.1
|
(13)
|
8.5
|
(18)
|
4.7
|
(10)
|
5.7
|
(12)
|
3.6
|
(8)
|
5.2
|
(67)
|
Jefferson
|
9.4
|
(3)
|
3.3
|
(1)
|
19.4
|
(6)
|
9.5
|
(3)
|
6.4
|
(2)
|
12.6
|
(4)
|
10.1
|
(19)
|
Josephine
|
5.2
|
(4)
|
13.5
|
(10)
|
6.8
|
(5)
|
6.2
|
(5)
|
7.5
|
(6)
|
10.1
|
(8)
|
8.2
|
(38)
|
Klamath
|
8.4
|
(7)
|
6.1
|
(5)
|
7.9
|
(6)
|
7.2
|
(6)
|
6.8
|
(5)
|
12.3
|
(10)
|
8.1
|
(39)
|
Lake
|
0.0
|
(0)
|
14.3
|
(1)
|
27.4
|
(2)
|
28.6
|
(2)
|
17.5
|
(1)
|
28.2
|
(2)
|
18.9
|
(8)
|
Lane
|
7.3
|
(27)
|
5.9
|
(21)
|
8.6
|
(30)
|
8.3
|
(31)
|
5.2
|
(18)
|
6.0
|
(21)
|
6.9
|
(148)
|
Lincoln
|
15.9
|
(7)
|
4.8
|
(2)
|
16.1
|
(7)
|
0.0
|
(0)
|
10.8
|
(5)
|
2.4
|
(1)
|
8.5
|
(22)
|
Linn
|
4.3
|
(6)
|
6.7
|
(9)
|
4.3
|
(6)
|
5.9
|
(8)
|
5.7
|
(8)
|
7.3
|
(10)
|
5.7
|
(47)
|
Malheur
|
3.8
|
(2)
|
6.4
|
(3)
|
8.3
|
(4)
|
15.4
|
(7)
|
2.2
|
(1)
|
11.3
|
(5)
|
7.8
|
(22)
|
Marion
|
6.6
|
(30)
|
5.7
|
(26)
|
4.3
|
(19)
|
6.9
|
(32)
|
4.7
|
(22)
|
6.2
|
(29)
|
5.7
|
(158)
|
Morrow
|
6.6
|
(1)
|
11.1
|
(2)
|
12.9
|
(2)
|
5.4
|
(1)
|
0.0
|
(0)
|
0.0
|
(0)
|
6.0
|
(6)
|
Multnomah
|
6.4
|
(61)
|
4.9
|
(45)
|
4.9
|
(46)
|
4.8
|
(45)
|
5.8
|
(54)
|
6.3
|
(60)
|
5.5
|
(311)
|
Polk
|
5.3
|
(4)
|
2.7
|
(2)
|
10.4
|
(8)
|
2.6
|
(2)
|
9.7
|
(8)
|
2.4
|
(2)
|
5.5
|
(26)
|
Sherman
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
***
|
***
|
11.1
|
(1)
|
Tillamook
|
4.2
|
(1)
|
4.2
|
(1)
|
4.1
|
(1)
|
7.9
|
(2)
|
0.0
|
(0)
|
3.7
|
(1)
|
3.9
|
(6)
|
Umatilla
|
1.9
|
(2)
|
5.7
|
(6)
|
0.9
|
(1)
|
7.1
|
(8)
|
1.9
|
(2)
|
9.4
|
(10)
|
4.5
|
(29)
|
Union
|
13.3
|
(4)
|
3.2
|
(1)
|
10.5
|
(3)
|
0.0
|
(0)
|
0.0
|
(0)
|
6.1
|
(2)
|
5.5
|
(10)
|
Wallowa
|
14.3
|
(1)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
2.7
|
(1)
|
Wasco
|
6.5
|
(2)
|
0.0
|
(0)
|
3.4
|
(1)
|
11.5
|
(3)
|
11.3
|
(3)
|
3.4
|
(1)
|
5.9
|
(10)
|
Washington
|
2.9
|
(22)
|
4.3
|
(32)
|
5.2
|
(39)
|
3.5
|
(27)
|
5.5
|
(42)
|
5.4
|
(41)
|
4.5
|
(203)
|
Wheeler
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
Yamhill
|
5.9
|
(7)
|
7.6
|
(9)
|
7.5
|
(9)
|
4.3
|
(5)
|
4.3
|
(5)
|
7.8
|
(9)
|
6.2
|
(44)
|
_________________________________________________________________________________________________
Table 2: 2000–2005 neonatal (<28 days old) mortality rate per 1000 live births, by county and year.
To protect confidentiality, percentage and counts are not shown in cases where the number of births in the county for the year is less than ten (***). Percentages calculated with less than ten events (count) may be unreliable.
____________________________________________________________________________________________________
Table 3: 2000–2005 postneonatal (≥ 28 days to <1 year old) mortality rate per 1000 live births, by county and year.
To protect confidentiality, percentage and counts are not shown in cases where the number of births in the county for the year is less than ten (***). Percentages calculated with less than ten events (count) may be unreliable.
____________________________________________________________________________________________________
Table 4: 2000-2005 perinatal (≥ 28 weeks gestation to < 7 days old) mortality rate per 1000 live births and fetal deaths ≥ 28 weeks gestation, by county and year.
To protect confidentiality, percentage and counts are not shown in cases where the number of births in the county for the year is less than ten (***). Percentages calculated with less than ten events (count) may be unreliable.
____________________________________________________________________________________________________
Table 5: 2000–2005 infant, neonatal, postneonatal, and perinatal mortality rates, per 1000 live births, by county (*perinatal rates are per 1000 live births & fetal deaths ≥28 weeks gestation).
Percentages calculated with less than ten events (count) may be unreliable.
|
Infant
|
Neonatal
|
Postneonatal
|
Perinatal
|
|
< 1 year
|
< 28 days
|
≥ 28 days to <1 year
|
≥ 28 wks gestation to <7 days
|
|
rate (count)
|
rate (count)
|
rate (count)
|
rate (count)
|
Oregon
|
5.6
|
(1,521)
|
3.7
|
(1,011)
|
1.9
|
(510)
|
1.1
|
(292)
|
|
|
|
|
|
|
|
|
|
Baker
|
10.4
|
(10)
|
5.2
|
(5)
|
5.2
|
(5)
|
1.0
|
(1)
|
Benton
|
3.2
|
(15)
|
2.6
|
(12)
|
0.6
|
(3)
|
0.2
|
(1)
|
Clackamas
|
3.8
|
(93)
|
2.7
|
(65)
|
1.2
|
(28)
|
0.9
|
(23)
|
Clatsop
|
8.4
|
(20)
|
4.6
|
(11)
|
3.8
|
(9)
|
1.7
|
(4)
|
Columbia
|
3.2
|
(10)
|
1.6
|
(5)
|
1.6
|
(5)
|
0.3
|
(1)
|
Coos
|
5.1
|
(19)
|
4.3
|
(16)
|
0.8
|
(3)
|
0.5
|
(2)
|
Crook
|
8.7
|
(12)
|
4.4
|
(6)
|
4.4
|
(6)
|
2.2
|
(3)
|
Curry
|
5.3
|
(5)
|
3.2
|
(3)
|
2.1
|
(2)
|
1.1
|
(1)
|
Deschutes
|
5.5
|
(52)
|
3.9
|
(37)
|
1.6
|
(15)
|
0.8
|
(8)
|
Douglas
|
7.7
|
(50)
|
5.2
|
(34)
|
2.5
|
(16)
|
2.0
|
(13)
|
Gilliam
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
Grant
|
10.1
|
(4)
|
10.1
|
(4)
|
0.0
|
(0)
|
5.1
|
(2)
|
Harney
|
8.6
|
(4)
|
8.6
|
(4)
|
0.0
|
(0)
|
0.0
|
(0)
|
Hood River
|
6.4
|
(12)
|
4.3
|
(8)
|
2.1
|
(4)
|
2.7
|
(5)
|
Jackson
|
5.2
|
(67)
|
3.8
|
(48)
|
1.5
|
(19)
|
0.9
|
(11)
|
Jefferson
|
10.1
|
(19)
|
5.9
|
(11)
|
4.3
|
(8)
|
1.1
|
(2)
|
Josephine
|
8.2
|
(38)
|
4.5
|
(21)
|
3.7
|
(17)
|
0.9
|
(4)
|
Klamath
|
8.1
|
(39)
|
5.4
|
(26)
|
2.7
|
(13)
|
0.6
|
(3)
|
Lake
|
18.9
|
(8)
|
9.4
|
(4)
|
9.4
|
(4)
|
2.4
|
(1)
|
Lane
|
6.9
|
(148)
|
4.1
|
(88)
|
2.8
|
(60)
|
1.2
|
(25)
|
Lincoln
|
8.5
|
(22)
|
5.4
|
(14)
|
3.1
|
(8)
|
0.4
|
(1)
|
Linn
|
5.7
|
(47)
|
4.1
|
(34)
|
1.6
|
(13)
|
0.8
|
(7)
|
Malheur
|
7.8
|
(22)
|
6.0
|
(17)
|
1.8
|
(5)
|
0.7
|
(2)
|
Marion
|
5.7
|
(158)
|
3.6
|
(99)
|
2.1
|
(59)
|
1.4
|
(38)
|
Morrow
|
6.0
|
(6)
|
5.0
|
(5)
|
1.0
|
(1)
|
1.0
|
(1)
|
Multnomah
|
5.5
|
(311)
|
3.6
|
(203)
|
1.9
|
(108)
|
1.1
|
(64)
|
Polk
|
5.5
|
(26)
|
4.0
|
(19)
|
1.5
|
(7)
|
1.7
|
(8)
|
Sherman
|
11.1
|
(1)
|
11.1
|
(1)
|
0.0
|
(0)
|
0.0
|
(0)
|
Tillamook
|
3.9
|
(6)
|
1.3
|
(2)
|
2.6
|
(4)
|
1.3
|
(2)
|
Umatilla
|
4.5
|
(29)
|
2.5
|
(16)
|
2.0
|
(13)
|
0.9
|
(6)
|
Union
|
5.5
|
(10)
|
3.3
|
(6)
|
2.2
|
(4)
|
2.2
|
(4)
|
Wallowa
|
2.7
|
(1)
|
2.7
|
(1)
|
0.0
|
(0)
|
0.0
|
(0)
|
Wasco
|
5.9
|
(10)
|
4.7
|
(8)
|
1.2
|
(2)
|
1.2
|
(2)
|
Washington
|
4.5
|
(203)
|
3.3
|
(148)
|
1.2
|
(55)
|
0.8
|
(38)
|
Wheeler
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
0.0
|
(0)
|
Yamhill
|
6.2
|
(44)
|
4.3
|
(30)
|
2.0
|
(14)
|
1.3
|
(9)
|
____________________________________________________________________________________________________
Graph 1: Infant mortality (< 1year) rate per 1,000 live births summarized for 2000 to 2006, by county.
Rates are shown with their 95% Confidence Intervals (CI). Counties whose entire CI lies above or below the Oregon average (indicated by the dotted vertical line) have rates that are significantly higher or lower, respectively, than the Oregon average. If the CI includes the Oregon average, the county is considered statistically similar to the Oregon average.
__________________________________________________________________________________________________
Map 1: Infant (<1 year) mortality rate, shown in three statistical categories: higher than, similar to, or lower than the Oregon rate.
Data are summarized for 2000 to 2006. Statistical significance was determined by comparing the 95% confidence interval of the county rate with the State rate.
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