Background: Prior to 1999, Pima County lacked local linked birth data on fetal and infant mortality. Perinatal Periods of Risk (PPOR), an approach advocated by CityMatCH, was used to examine inequalities of fetal-infant mortality among different ethnic groups and to plan community interventions. Methods: We studied fetal-infant mortality in Pima County between 1998 through 2001. PPOR inclusion standards and analysis were used. Groups of mothers identified as high risk were compared to a reference group (RG) of White, non-Hispanic women, older than 20 years with more than 12 years of education. Cause of death was determined by reviewing death certificates using the 1990 International Classification of Diseases. Lastly, we calculated sudden infant death syndrome (SIDS) rates by mother’s race. Results:  

PPOR Fetal-Infant Mortality Rates per 1000 Still-births plus Births. Pima County 1998 – 2001

                        Reference  African Am  Am Indian  Hispanic  White   All         

Overall                 5.4               20.4            13.4             8.3        12.1    9.0   

Postneonatal        0.8                  5.7              6.0             1.5          2.9    2.0   

SIDS                    0.2                 2.3              1.3             0.5         1.4    0.7    

Conclusions: Based on this data, intervention opportunities were identified targeting high risk populations. Post neonatal deaths were higher than the RG among three of the groups. Infants born to African American mothers had 11.5 times greater risk, than the RG, of dying from SIDS. Community partners agreed to collaborate in a Back-to-Sleep education campaign of Safe-sleep materials, Baby-baskets and SIDS’ billboards. The PPOR approach helped us to identify a high risk population and better plan for a SIDS intervention.