Claire Fiddian-Green is the President & CEO of the Richard M. Fairbanks Foundation.

Indiana is making progress toward a critical goal of lowering our state’s infant mortality rate, according to Indiana Department of Health findings released last month. From 2017 to 2018, we saw the biggest decline in infant mortality in six years. The overall rate dipped from 7.3 of every 1,000 babies dying in their first year of life to 6.8 per 1,000 in 2018. That means 43 fewer babies died in 2018 compared to 2017, at 559 compared to 602.

These results are worth celebrating, but as Indiana Health Commissioner Dr. Kristina Box notes, persistent racial disparities remain. For example, while infant death rates among Black babies declined by 16% from 2017 to 2018, the infant mortality rate for non-Hispanic white infants was 6.0 deaths per 1,000 infants in 2018 compared to a rate of 13.0 for Black infants. The data underscore the reality that even more concerted efforts by cross-sector partners will be required if we are to continue making progress.

Key contributing factors to the rate of infant mortality include obesity and tobacco use. In 2018, the obesity rate among adult Hoosiers was higher for women than men (34.2% vs. 33.9%) and higher for Black adults than white adults (41.7% versus 33.0%). This disparity by race is a contributing factor to the racial disparity in Indiana’s infant mortality rate. In addition, Indiana’s smoking rate for pregnant women contributes to overall infant mortality rates. In 2017, 13.5% of pregnant women in Indiana smoked versus a national rate of 6.9%. To make further inroads in addressing Indiana’s infant mortality rate, we must tackle these two preventable factors.

According to, Indiana ranks in the bottom fifth nationwide on these important and preventable health metrics:

  • Obesity: 40th
  • Tobacco use: 41st

Another concerning indicator: Indiana ranks 49th for public health funding, which limits our state’s ability to implement effective, evidence-based solutions that can address underlying causes of poor health outcomes.

Indiana’s low health rankings are not new. As we have previously shown in the Foundation’s comprehensive analyses of tobacco use, opioid use disorder and obesity in Indiana, our state’s low rankings represent preventable deaths as well as higher healthcare costs for Hoosier taxpayers and employers.

The recent decline in Indiana’s infant mortality rate is encouraging, but we can’t stop here. Stakeholders across all sectors must each play a role in significantly improving Hoosier health outcomes – thereby contributing to a continued decrease in our state’s infant mortality rate.

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