Between 1997 and 2000, Alabama’s average infant mortality rate (IMR) was the lowest in the history of the state, with 9.8 (601) infant deaths per 1,000 live births. There has been an unwavering decline in the IMR since 1991. Although Alabama’s IMR is the lowest on record for the state, it still ranks among the highest rates in the nation. It is still more than 20% higher than the United States average provisional rate of 6.9 deaths per 1,000 live births for the same period.