Differences in infant mortality by race, nativity status, and other maternal characteristics

Article Abstract:

A study was carried out of infant mortality among both white and black mothers in the years 1983 and 1984; data from the national files of linked birth and infant death records (which permit knowledge about the same individual's birth and death) for the US were analyzed (with the exception of California, Texas, and Washington). The mothers were classified as black (926,000 births) or white (4.4 million births), and as foreign- or native-born (nativity status). Results showed that 7 percent of singleton births to women of either race were to foreign-born mothers. Mothers were classified as being at high, moderate or low risk for a poor outcome of pregnancy according to educational and marital status, and the number of other children they had. Eleven percent of black births, and 28 percent of white births, were at low risk, while 22 and 4 percent, respectively, of black and white births were at high risk. The adjusted risk of infant mortality was 22 percent lower for black foreign-born mothers than for black native-born mothers; the risks for white mothers did not differ substantially according to nativity status. Black foreign-born women had a smaller proportion of low- and very-low-birth-weight babies than black native-born women, while white mothers had differences associated with nativity in the other direction, i.e. more such infants were born to foreign-born mothers. The effects of nativity on infant mortality are discussed in detail. Nativity was more closely associated with mortality for blacks than whites; black foreign-born mothers had 22 percent lower neonatal mortality, and 24 percent lower postneonatal mortality, than blacks born in the US. White mothers of either nativity status had similar neonatal mortality and 20 percent lower postneonatal mortality among the foreign-born. For blacks, infant mortality almost doubled for the high-risk group relative to the low-risk group: for whites, it almost tripled. Prenatal care use varied among the risk groups, and attention to this issue would do much to reduce mortality. Aggressive efforts are needed to reduce infant mortality among poor people. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The growing neglect of American children

Article Abstract:

Despite the often-heard slogan 'children are our greatest national resource,' little is being done to maintain and preserve that resource. Children are the poorest members of our society. They comprise more than 50 percent of the Medicaid population, and receive less than 20 percent of every health dollar. Medicaid fees are so low that many physicians will not care for these patients. There are 37 million children living in poverty, and most are uninsured or underinsured. A large percentage of pregnant women are uninsured, and many receive no prenatal care during the first trimester (three months) of pregnancy. Infant mortality is higher in the US than in some third world countries. Immunization schedules are not being met for very young children; teenage pregnancies are on the rise; and low-birth-weight, which can be prevented in many cases, leaves babies at increased risk of illness and disabling conditions. If these issues are not dealt with positively, our 'resources' may soon become liabilities. The health care system for children and pregnant women must be restructured so that it is equally available to all in need. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Economic aspects, Services, Poor children, Child health services

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Mortality among infants of black as compared with white college-educated parents

Article Abstract:

Black infants with college-educated parents may have a higher risk of dying from complications associated with low birth weight than white infants with college-educated parents. A study compared the number of deaths among 42,230 black infants with college-educated parents to 865,128 white infants with college-educated parents. The infant mortality rate was 10.2 deaths per 1,000 live births among black infants, compared with 5.4 per 1,000 liver births among white infants. Seven percent of black infants weighed less than 2,500 grams (g) at birth, compared with three percent of white infants. Seventy-two percent of black infants who died had a low birth weight, compared with 52 percent of white infants. The mortality rate was the same among black infants and among white infants who weighed more than 2,500 g at birth. The health of college-educated black women may be poorer than that of college-educated white women, and they may not receive the same quality of prenatal care.

Ethnic groups, Mortality and race, African American infants

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