The Indiana Department of Health (IDOH) Division of Fatality Review and Prevention (FRP) is seeking funding to continue and improve the existing SUID/SDY surveillance program in Indiana. FRP will strengthen the annual collection of high-quality, timely SUID/SDY case data, including information on disparities and social determinants of health (SDOH). FRP will continue to promote practices to standardize case review, data collection, and data entry and improve infant death scene investigations throughout the state. With the proposed project, FRP will continue to build on existing partnerships with internal and external stakeholders and identify new opportunities for networking, collaboration, and data sharing with local communities. FRP will work with communities at highest risk for SUIDs to develop and implement data-driven prevention strategies.
Between 2015 and 2019, there were 528 SUIDs in Indiana, an average of 105.6 deaths per year. For 99% of these deaths, at least one unsafe risk factor was present (n=525). The most commonly identified unsafe sleep risk factors were infants sleeping in adult beds (52% of deaths, n=276) and infants bedsharing with at least one adult (51%, n=269). These two risk factors were not mutually exclusive. Racial and ethnic disparities in SUID rates are evident in Indiana. SUID rates per 100,000 live births for non-Hispanic Black infants were almost four times those of non- Hispanic White infants (350.5 and 90.2 respectively). In 2020, SUIDs were the third leading cause of all infant deaths in Indiana, but for Black infants, SUIDs were the second leading cause death. Indiana has an average of 63 SDYs each year, with 188 deaths between 2019 and 2021.
The majority of these deaths were determined to have been associated with cardiac-related conditions, such as cardiomyopathy or arrhythmias, and possible genetic forms of epilepsy. The rate for SDYs in Indiana for 2019 through 2021 was 0.79 deaths per 1,000 live births, with the non-Hispanic Black mortality rate more than double the non-Hispanic White rate (1.80 and 0.71 deaths per 1,000 live births respectively.)
To address the disparities, findings of community participatory listening sessions will be used to develop effective infant safe sleep messaging for use among high-risk populations.
Listening sessions will be held in four counties in Indiana with high rates of SUIDs overall and large disparities in SUID rates. The listening sessions will explore parental perceptions and experiences with infant safe sleep, as well as their reactions to actual infant safe sleep campaign materials. A better understanding of what is meaningful to parents as it relates to infant sleep will be crucial in the development of future messaging to prevent deaths.