title: Disparities in Infant Mortality by Race Among Hispanic and Non-Hispanic Infants.
abstract: OBJECTIVE
  U.S.-born Hispanic infants have a well-documented health advantage relative to other minority groups. However, little published research has examined racial heterogeneity within the Hispanic population, in relation to health outcomes. The current study aims to explore possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. Methods Data were drawn from 2007 to 2008 NCHS Cohort Linked Live Birth-Infant Death Files, restricted to deliveries of Hispanic black, Hispanic white, non-Hispanic black (NHB) and non-Hispanic white mothers (NHW) (n = 7,901,858). Adjusted odds ratios for first week mortality, neonatal, postneonatal, and overall infant mortality were calculated for each group, using NHW as the reference group.
  
  
  RESULTS
  A distinct health gradient was observed in which NHB infants (n = 1,250,222) had the highest risk of first week (aOR 2.29, CI 2.21-2.37), neonatal (aOR 2.23, CI 2.17-2.30), postneonatal (aOR 1.74, CI 1.68-1.81), and infant mortality (aOR 2.05, CI 2.00-2.10) compared to NHW infants (n = 4,578,150). Hispanic black infants (n = 84,377) also experienced higher risk of first-week (aOR 1.28 (1.12-1.47), neonatal (aOR .27, CI 1.13-1.44), postneonatal (aOR 1.34, CI 1.15-1.56), and infant mortality (aOR 1.30, CI 1.18-1.43) compared to both NHW and Hispanic white infants (n = 1,989,109). Conclusions for Practice: Risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes. Our findings suggest implications of racial heterogeneity on infant health outcomes, and provide insight into the role of race as a social construct.
authors.affiliation: Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, 1300 University Boulevard, CH 215F, Birmingham, AL, 35233, USA. smithwd@uab.edu.
authors.forename: Whitney S
authors.initials: WS
authors.lastname: Rice
authors.affiliation: Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, 1115 W. Call St., Tallahassee, FL, 32306, USA.
authors.forename: Samantha S
authors.initials: SS
authors.lastname: Goldfarb
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard., RPHB 320, Birmingham, AL, 35294, USA.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Brisendine
authors.affiliation: University of Wisconsin School of Medicine and Public Health, 210 MLK Jr. Blvd, Rm 507, Madison, WI, 53703, USA.
authors.forename: Stevie
authors.initials: S
authors.lastname: Burrows
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard., RPHB 310C, Birmingham, AL, 35294, USA.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Wingate
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000208:ethnology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: African-American health; Ethnic and racial disparities; Fetal; Latino health; Perinatal and infant mortality; Vital statistics