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Summary

Infant mortality (deaths of liveborn infants during the first year of life) is often used as a standard measure of a population's health. The leading causes of infant death in the United States and in Washington State include birth defects, SIDS (Sudden Infant Death Syndrome), and disorders related to prematurity and low birth weight. While infant mortality declined rapidly from 1900 to 1950, improvements have been gradual since 1950, and infant mortality rates for African Americans and American Indians have remained substantially higher than those for other races.

A number of factors have contributed to improvements in infant mortality in Washington State in the 1990s. The First Steps program, Washington's Medicaid expansion for low income pregnant women that started in August 1989, has increased access to prenatal care and has provided enhanced prenatal care. First Steps' enhanced prenatal services have been associated with decreases in low birth weight for certain high-risk women. Surfactant therapy for respiratory disease has reduced mortality among very low birth weight infants although the estimated reduction in infant mortality attributed to surfactant therapy is rather low (3%) (Schwartz et al., 1994). In 1992-94, pediatric providers and the Back to Sleep media campaign began to tell mothers to place their babies on their backs for sleep. SIDS rates have fallen dramatically for some groups since Back to Sleep has become a standard message for parents of newborn babies.

This report describes changes in infant mortality and SIDS in particular. Because death rates for Hispanic and Asian/Pacific Islander infants are generally no higher than the overall state rate, this brief report will focus on death rates for African American and American Indian infants.

Infant Mortality Rates: All Washington Infants vs. African American and American Indian Infants

In Washington State, the overall rate of infant death has decreased by 44% from 9.1 per 1000 (1988-89) to 5.1 per 1000 (1999-2000).

For African American and American Indian infants, the death rate decreased by 46% from 15.9 per 1000 (1988-89) to 8.6 per 1000 (1999-2000). The death rate for African American and American Indian infants remains 1.9 times greater than the rate for white infants (4.6 per 1000 in 1999-2000).

Modified: Thursday November 17 2005

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