HEALTH CONDITIONS
HEALTH CARE

HC 1.1.A

INFANT MORTALITY

Infancy is commonly divided into the neonatal period, the first 27 days of life, and the postneonatal period, 28 days to less than one year. About two-thirds of infant deaths occur during the neonatal period (although advances in neonatology in recent decades have greatly improved the chances that infants will survive this period). The three leading causes of death to infants (one year and younger) are congenital anomalies, disorders relating to a short gestation period and low birth weight, and sudden infant death syndrome (SIDS).¹ In 1995, SIDS dropped from the second to the third leading cause of infant mortality. The SIDS decline accounted for nearly one-third of the total drop in infant mortality in 1995.²

The U.S. infant mortality rate has decreased rapidly over the past three decades. Between 1960 and 1995³ the rate fell from 26.0 to 7.5 infant deaths per thousand live births (see Figure HC 1.1.A.1). There was a steep decline in the rate of neonatal deaths (from 18.7 to 4.8 infant deaths per thousand live births) and a smaller, more gradual decline in the rate of postneonatal deaths (from 7.3 to 2.7 infant deaths per thousand live births).

International Comparisons. Despite declines in recent decades, the U.S. infant mortality rate ranks among the highest of industrialized nations. For example, in 1992, the rate of infant deaths per thousand live births was 4.5 in Japan, 6.6 in the United Kingdom, 6.8 in France, and 6.2 in Germany, compared to 8.5 deaths per thousand live births in the United States in that year.⁴ The Russian Federation, in contrast, has an infant mortality rate of 18.4 deaths per thousand live births.

Differences by Race and Ethnicity. While infant mortality rates have declined for all races and ethnic groups in the United States, there is nevertheless considerable variation by race and ethnicity (see Figure HC 1.1.A.2). Specifically:³
 

• For white infants, the infant mortality rate has declined by 72 percent between 1960 and 1995 — from 22.9 to 6.3 deaths per thousand live births (see Table HC 1.1.A.1).
• For black infants, the infant mortality rate has declined by 66 percent between 1960 and 1995 — from 44.3 to 14.9 deaths per thousand live births (see Table HC 1.1.A.1).
• For Hispanic infants, the infant mortality rate has declined by 24 percent between 1985 and 1994 — from 8.6 to 6.5 deaths per thousand live births (see Table HC 1.1.A.1).

  
  For Asian infants, the infant mortality rate has declined by 20 percent from an average of 8.3 deaths per thousand live births during the period 1983-1985 to an average of 6.6 deaths per thousand live births during the period 1989-1991⁵ (see Table HC 1.1.A.2).

• For Native American infants, the infant mortality rate declined by nine percent from an average of 13.9 deaths per thousand live births during the period 1983-1985 to an average of 12.6 deaths per thousand live births during the period 1989-1991 (see Table HC 1.1.A.2).

 

Figure HC 1.1.A.1  Infant, Neonatal, and Postneonatal Deaths Per Thousand Live Births, 1960-1995

Notes: Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia. Data by race for 1960 are by race of child; all other years are by race of mother. Data for 1995 are preliminary.
Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. Table 23 for totals and race breaks. Data for 1994 and 1995 data from: “Births and Deaths: United States, 1995.” Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996.
 

Figure HC 1.1.A.2  Infant Deaths Per Thousand Live Births, by Race and Hispanic Origin,a 1960-1995

Note: ^aHispanic rates not available prior to 1985. Infant mortality by Hispanic-origin reported by 17 States and the District of Columbia in 1985; 45 States, New York State (excluding New York City), and the District of Columbia in 1990; 47 States, New York State (excluding New York City), and the District of Columbia in 1991; 48 states and the District of Columbia in 1992; and 49 States and the District of Columbia in 1993 and 1994. bIncludes births and deaths of persons who were not residents of the 50 states and the District of Columbia. cData by race for 1960 are by race of child; all other years are by race of mother. dData for 1995 are preliminary.
Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996 (table 23 for totals and race breaks). 1970 data from: National Center for Health Statistics. Vital Statistics of the United States, 1992. Vol. II, Mortality, Part A. Washington: Public Health Service. 1996 (table 2-2). Hispanic data for 1985 from: National Center for Health Statistics: Vital Statistics of the United States, 1985, Vol. II, Mortality, Part A. Washington: Public Health Service. 1988 (table 2-19). 1990 Hispanic data from: Monthly Vital Statistics Report. Vol. 41, No. 7 (Supplement), January, 1993 (table 26). 1991 Hispanic data from: Monthly Vital Statistics Report, Vol. 42, No. 2 (Supplement), August, 1993 (table 25). 1992 Hispanic data from: Monthly Vital Statistics Report, Vol. 43, No. 6 (Supplement), March, 1995 (table 28). 1993 Hispanic data from: Monthly Vital Statistics Report, Vol. 44, No. 7(s), February, 1996 (table 32). 1994 Hispanic data from: Singh, G.K., Kochanek, K.D., and MacDorman, M.F. “Advance Report of Final Mortality Statistics, 1994.” Monthly Vital Statistics Report, Vol. 45, No. 3. Hyattsville, Maryland: Public Health Service, 1996 (table 25). Data for 1994 and 1995 from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L. and Freedman, M.A. “ Births and Deaths: United States, 1995.” Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996 (table 13).
 
 

Table HC 1.1.A.1 nfant, Neonatal, and Postneonatal Deaths per Thousand Live Births, by Race and Hispanic Origin, 1960-1995
			1960a,b	1970	1980	1985	1990	1991	1992	1993	1994	1995c
			———	———	———	———	———	———	———	———	———	———
Infant (under one year)
Death Rate			26	20	12.6	10.6	9.2	8.9	8.5	8.4	8	7.5
	White		22.9	17.6	10.9	9.2	7.6	7.3	6.9	6.8	6.6	6.3
	Black		44.3	33.3	22.2	19	18	17.6	16.8	16.5	15.8	14.9
	Hispanicd		—	—	—	8.6	7.8	7.5	6.8	6.7	6.5	—
Neonatal (under 28 days)
Death Rate			18.7	15.1	8.5	7	5.8	5.6	5.4	5.3	5.1	4.8
	White		17.2	13.7	7.4	6	4.8	4.5	4.3	4.3	4.2	4
	Black		27.8	23.2	14.6	12.6	11.6	11.2	10.8	10.7	10.2	9.6
	Hispanicd		—	—	—	5.4	5	4.6	4.3	4.1	4.1	—
Postneonatal (28 days to under one year)
Death Rate			7.3	4.9	4.1	3.7	3.4	3.4	3.1	3.1	2.9	2.7
	White		5.7	4	3.5	3.2	2.8	2.8	2.6	2.5	2.4	2.2
	Black		16.5	10.1	7.6	6.4	6.4	6.3	6	5.8	5.6	5.3
	Hispanicd		—	—	—	3.2	2.8	2.8	2.5	2.6	2.5	—
Notes: aIncludes births and deaths of persons who were not residents of the 50 states and the District of Columbia.  bData by race for 1960 are by race of child; all other years are by race of mother.   cData for 1995 are preliminary.  dInfant mortality by Hispanic-origin reported by 17 States and the District of Columbia in 1985; 45 States, New York State (excluding New York City), and the District of Columbia in 1990; 47 States, New York State (excluding New York City), and the District of Columbia in 1991; 48 States and the District of Columbia in 1992; and 49 States and the District of Columbia in 1993 and 1994.  Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996 (table 23 for totals and race breaks). 1970 data from: National Center for Health Statistics. Vital Statistics of the United States, 1992. Vol. II, Mortality, Part A. Washington: Public Health Service. 1996 (table 2-2). Hispanic data for 1985 from: National Center for Health Statistics: Vital Statistics of the United States, 1985, Vol. II, Mortality, Part A. Washington: Public Health Service. 1988 (table 2-19). 1990 Hispanic data from: Monthly Vital Statistics Report. Vol. 41, No. 7 (Supplement), January, 1993 (table 26). 1991 Hispanic data from: Monthly Vital Statistics Report, Vol. 42, No. 2 (Supplement), August, 1993 (table 25). 1992 Hispanic data from: Monthly Vital Statistics Report, Vol. 43, No. 6 (Supplement), March, 1995 (table 28). 1993 Hispanic data from: Monthly Vital Statistics Report, Vol. 44, No. 7(s), February, 1996 (table 32). 1994 Hispanic data from: Singh, G.K., Kochanek, K.D., and MacDorman, M.F. "Advance Report of Final Mortality Statistics, 1994." Monthly Vital Statistics Report, Vol. 45, No. 3. Hyattsville, Maryland: Public Health Service, 1996 (table 25). Data for 1994 and 1995 from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L. and Freedman, M.A. " Births and Deaths: United States, 1995." Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996 (table 13).

 
 

Table HC 1.1.A.2  Infant, Neonatal, and Postneonatal Deaths Per Thousand Live Births for Asians and Native Americans, Combined Years: 1983-1985, 1986-1988 and 1989-1991
					1983-1985	1986-1988	1989-1991
					——————	——————	——————
Infant (under 1 year)
	Infant Death Rate (All Races)				10.6	9.8	9
		Asiana			8.3	7.3	6.6
		Native Americanb			13.9	13.2	12.6
Neonatal (under 28 days)
	Neonatal Death Rate (All Races)				6.9	6.3	5.7
		Asiana			5.2	4.5	3.9
		Native Americanb			6.7	5.9	5.9
Postneonatal (28 days to one year)
	Postneonatal Death Rate (All Races)				3.7	3.5	3.3
		Asiana			3.1	2.8	2.6
		Native Americanb			7.2	7.3	6.7
aIncludes Pacific Islanders.  bIncludes Alaskan Natives.   Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Data computed by the Division of Health and Utilization Analysis from data compiled by the Division of Vital Statistics for the National Linked Files of Live Births and Infant Deaths.

² Press release from the U.S. Department of Health and Human Services. "Reduction in SIDS Deaths Helps Bring Low Infant Mortality." October 9, 1996.

³ 1995 data are preliminary.

⁴ National Center for Health Statistics. "Health, United States, 1995." Hyattsville, Maryland: Public Health Service. 1996.

⁵ Infant mortality data for Asians and Native Americans are presented from the national linked birth and infant death files in Table HC 1.1.A.1. Rather than relying solely on the often inaccurate reporting of race on death certificates of infants, the linked files use race from birth certificates and, therefore, provide more accurate data for these populations. The National Linked Birth and Infant Death Files data are available from 1983-1991. The linked files will be produced on a regular basis again beginning with 1995 data.