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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.053744v1 96/12/2222    most recent Submit a response View responses View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Tomashek, K. M. Articles by Flowers, L. M. Search for Related Content PubMed PubMed Citation Articles by Tomashek, K. M. Articles by Flowers, L. M. Related Collections Influenza

Kay M. Tomashek, MD, MPH, Cheng Qin, MD, Jason Hsia, PhD, Solomon Iyasu, MBBS, MPH, Wanda D. Barfield, MD, MPH and Lisa M. Flowers, MPA

At the time of the study, all authors worked in the Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Atlanta, Ga. Kay M. Tomashek and Cheng Qin are with the Maternal and Infant Health Branch, Division of Reproductive Health, CDC. Jason Hsia and Lisa M. Flowers are with Information Technology, Statistics and Surveillance Branch, Division of Reproductive Health, CDC. Wanda D. Barfield is with the Applied Sciences Branch, Division of Reproductive Health, CDC. Solomon Iyasu is with the Office of Counterterrorism and Pediatric Drug Development, Division of Pediatric Drug Development, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, Md.

Correspondence: Requests for reprints should be sent to Kay M. Tomashek, Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, Mail Stop K-23, 4770 Buford Highway, NE, Atlanta, GA 30341–3717 (e-mail: kct9{at}cdc.gov).

Objectives. 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 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.

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