Infant mortality trends and differences between American Indian/Alaska Native infants and white infants in the United States, 1989-1991 and 1998-2000.
OBJECTIVE
To describe changes in infant mortality rates, including birthweight-specific rates and rates by age at death and cause.


METHODS
We analyzed US linked birth/infant-death data for 1989-1991 and 1998-2000 for American Indians/Alaska Native (AIAN) and White singleton infants at > or =20 weeks' gestation born to US residents. We calculated birthweight-specific infant mortality rates (deaths in each birthweight category per 1000 live births in that category), and overall and cause-specific infant mortality rates (deaths per 100000 live births) in infancy (0-364 days) and in the neonatal (0-27 days) and postneonatal (28-364 days) periods.


RESULTS
Birthweight-specific infant mortality rates declined among AIAN and White infants across all birthweight categories, but AIAN infants generally had higher birthweight-specific infant mortality rates. Infant mortality rates declined for both groups, yet in 1998-2000, AIAN infants were still 1.7 times more likely to die than White infants. Most of the disparity was because of elevated post-neonatal mortality, especially from sudden infant death syndrome, accidents, and pneumonia and influenza.


CONCLUSIONS
Although birthweight-specific infant mortality rates and infant mortality rates declined among both AIAN and White infants, disparities in infant mortality persist. Preventable causes of infant mortality identified in this analysis should be targeted to reduce excess deaths among AIAN communities.
Tomashek
Kay M
KM
Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Atlanta, Ga 30341-3717, USA. kct9@cdc.gov
Qin
Cheng
C
Hsia
Jason
J
Iyasu
Solomon
S
Barfield
Wanda D
WD
Flowers
Lisa M
LM
D000059:Accidents / Q000401:mortality; D000413:Alaska / Q000453:epidemiology; D001724:Birth Weight; D002423:Cause of Death / Q000639:trends*; D000013:Congenital Abnormalities / Q000208:ethnology / Q000401:mortality; D003467:Cultural Deprivation; D003644:Death Certificates; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D009309:National Center for Health Statistics, U.S.; D011203:Poverty / Q000208:ethnology; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013398:Sudden Infant Death / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*