From American Public Health Association
Disparities in Infant Mortality
Posted 04/01/2004
http://www.medscape.com/viewarticle/472721?mpid=26886
Nearly 28,000 infants died before their first birthday in 2000 -- an infant
mortality rate of 6.9 per 1000 live births. The U.S. infant mortality rate is
higher than that in 27 other nations -- more than twice as both Hong Kong and
Sweden.[1]Infant Mortality Rates Vary Based on Race and Ethnicity
The 2000 infant mortality rate per 1000 live births for babies born to:[1]
African Americans was 13.6.
Native Americans was 8.2.
Hispanics was 5.6.
Asian/Pacific Islanders was 4.8.
Whites was 5.7.
African-Americans. African-American infants are more than twice as likely to
die before their first birthday as white infants.[1] In addition,African-
American infant mortality rates are increasing.[4] The rate of SIDS among
African-Americans is twice that of whites.[3]
Hispanics. Overall, Hispanic infants do not have higher mortality rates than
other groups.[6] But this rate does not reflect the diversity within this
group -- the Puerto Rican infant mortality rate was 7.8 per 1,000 live
births in
1998.[4]
American Indians/Alaska Natives. American Indians and Alaska Natives have an
infant death rate almost double that for whites.[2] American Indians and
Alaska Natives experience high rates of SIDS and fetal alcohol syndrome
(FAS).[4]
Native Hawaiian/Pacific Islander. Native Hawaiian and other Pacific Islander
infant mortality rates are 31 percent greater than that of whites.[3]
Asians. Asians have a lower infant mortality rate than whites, but the
highest rate of infant deaths from birth defects.[3]
Causes of infant mortality vary based on race and ethnicityPrematurity/low
birth weight is the leading cause of death in the first month of life. Birth
defects are the leading cause of death in the first year of life.[1]
African-Americans. The rate of deaths due to prematurity/low birthweight for
black infants was nearly four times that for white ones.[1]
Hispanics. Hispanics/Latinos, in particular Puerto Ricans, exhibit a high
rate of central nervous system anomalies, which include spina bifida,
anencephaly, and congenital hydrocephalus.[4]
Some Potential Reasons for Disparities in Infant Mortality
Age. Younger and older mothers have higher preterm birth rates.[1]
Cigarette smoking. Smoking is a potential factor for low birth weight and
growth retardation. Asian/Pacific Islanders smoke the least and American
Indian/Alaska Natives smoke the most.[4]
Alchohol consumption. Alcohol consumption is a potential factor in poor
pregnancy outcomes. Whites and American Indian/Alaska Natives have the
highest
alcohol consumption and Asian/Pacific Islanders have the lowest.[4]
Unintended pregnancy. Births resulting from unwanted conceptions may suffer
from elevated risks of infant mortality and low birth weight. In one
study,African-American women indicated 29 percent of their births in the
previous five
years were unintended as opposed to 9.2 percent of white women.[4]
Cultural. Mexican Americans reported more prenatal stress, less support from
the baby's father, and more drug/alcohol use.
Obesity. Asian/Pacific Islanders have the lowest obesity rate and
African-Americans have the highest.[4]
Unequal Care. Rates of prenatal care in the first trimester:[6]
85 percent for whites.
77 percent for Native Hawaiians/Pacific Islanders.
75 percent for Hispanics.
74 percent for African-Americans.
69 percent for American Indians/Alaska Natives.
Education. More educated pregnant women have greater rates of prenatal care
during the first trimester than less educated pregnant women.[6]