Trends in the Well-Being of America's Children and Youth, 2000. HC 1.1 Infant Mortality

01/01/2000

Infancy is defined as the first year of life and is commonly divided into two periods. The first is the neonatal period which is the first 27 days of life. The second is the postnatal period which is 28 days to 1 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, overall, are congenital anomalies, disorders relating to a short gestation period and low birthweight, and sudden infant death syndrome (SIDS).1 In 1994, 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 and 1996.2 Infant deaths due to SIDS have been declining since 1989,3 including nearly a 12 percent drop between 1996 and 1997.4

The U.S. infant mortality rate has decreased rapidly over the past three decades, largely due to medical developments over this time. Between 1960 and 1998, the rate fell from 26.0 to 7.2 infant deaths per 1,000 live births (see Figure HC 1.1.A). There was a steep decline in the rate of neonatal deaths (from 18.7 to 4.8 infant deaths per 1,000 live births) and a smaller, more gradual decline in the rate of postneonatal deaths (from 7.3 to 2.4 infant deaths per 1,000 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 1995, the rate of infant deaths per 1,000 live births was 3.9 in Finland, 4.3 in Japan, 5.3 in Germany, and 6.1 in England and Wales, compared with 7.6 deaths per 1,000 live births in the United States. The Russian Federation, in contrast, had an infant mortality rate of 18.2 deaths per 1,000 live births in 1995.5

Differences by Race and Hispanic Origin. While infant mortality rates have declined for all races and ethnic groups in the United States, there is, nevertheless, considerable variation by race and Hispanic origin (see Figure HC 1.1.B). Specifically:7

  • For white infants, the infant mortality rate declined by 74 percent between 1960 and 1998—from 22.9 to 6.0 deaths per 1,000 live births (see Table HC 1.1.A).
  • For black infants, the infant mortality rate declined by 69 percent between 1960 and 1998—from 44.3 to 13.8 deaths per 1,000 live births (see Table HC 1.1.A).
  • For Hispanic infants, the infant mortality rate declined by 33 percent between 1985 and 1998—from 8.6 to 5.8 deaths per 1,000 live births (see Table HC 1.1.A).
  • For Asian/Pacific Islander infants, the infant mortality rate declined by 34 percent from an average of 8.3 deaths per 1,000 live births during the period 1983-1985 to 5.5 deaths per 1,000 live births in 1998 (see Table HC 1.1.B).6
  • For American Indian/Alaska Native infants, the infant mortality rate declined by 33 percent from an average of 13.9 deaths per 1,000 live births during the period 1983-1985 to 9.3 deaths per 1,000 live births in 1998 (see Table HC 1.1.B).

Figure HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States: Selected years, 1960a-1998

Figure HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States: Selected years, 1960a-1998

a Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

Sources: Anderson, Kochanek, & Murphy, 1997, Tables 25 and 26. Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970, data from the Center for Disease Control, National Center for Health Statistics, 1996, (Table 2-2); Center for Disease Control, National Center for Health Statistics, 1988, (Table 2-19); Ventura, et al., 1998, Births and Deaths, Table 14.


Figure HC 1.1.B Infant mortality rates (deaths per 1,000 live births) in the United States, by race and Hispanic origin:a Selected years, 1960b,c-1998

Figure HC 1.1.B Infant mortality rates (deaths per 1,000 live births) in the United States, by race and Hispanic origin:a Selected years, 1960b,c-1998

a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race. Hispanic rates not available prior to 1985. Infant mortality by Hispanic origin was 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; 49 states and the District of Columbia from 1993 to 1996; and all 50 states and the District of Columbia in 1997.

b Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

c Data for 1960 are by race of child; all other years are by race of mother.

Sources: Anderson, Kochanek, & Murphy, 1997; Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970 data from the Center for Disease Control, National Center for Health Statistics, 1996; Peters, Kochanek, & Murphy, 1998; 1996 United States Deaths, Table 26.


Table HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States, by race and Hispanic origin:a Selected years, 1960-1998

  1960b,c 1970 1980 1985 1990 1991 1992 1993 1994 1995 1996 1997 1998
Infantd total 26.0 20.0 12.6 10.6 9.2 8.9 8.5 8.4 8.0 7.6 7.3 7.2 7.2
White 22.9 17.6 10.9 9.2 7.6 7.3 6.9 6.8 6.6 6.3 6.1 6.0 6.0
Black 44.3 33.3 22.2 19.0 18.0 17.6 16.8 16.5 15.8 15.1 14.7 14.2 13.8
Hispanic 8.6 7.8 7.5 6.8 6.7 6.5 6.1 5.9 6.0 5.8
Neonatale total 18.7 15.1 8.5 7.0 5.8 5.6 5.4 5.3 5.1 4.9 4.8 4.8 4.8
White 17.2 13.7 7.4 6.0 4.8 4.5 4.3 4.3 4.2 4.1 4.0 4.0 4.0
Black 27.8 23.2 14.6 12.6 11.6 11.2 10.8 10.7 10.2 9.8 9.6 9.4 9.4
Hispanic 5.4 5.0 4.6 4.3 4.1 4.1 4.0 3.8 3.9 3.9
Postneonataltotal 7.3 4.9 4.1 3.7 3.4 3.4 3.1 3.1 2.9 2.7 2.5 2.5 2.4
White 5.7 4.0 3.5 3.2 2.8 2.8 2.6 2.5 2.4 2.2 2.1 2.0 2.0
Black 16.5 10.1 7.6 6.4 6.4 6.3 6.0 5.8 5.6 5.3 5.1 4.8 4.4
Hispanic 3.2 2.8 2.8 2.5 2.6 2.5 2.1 2.1 2.0 1.9

 a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race. Hispanic rates not available prior to 1985. Infant mortality by Hispanic origin was 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; 49 states and the District of Columbia from 1993 to 1996; and all 50 states and the District of Columbia in 1997.

b Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

c Data for 1960 are by race of child; all other years are by race of mother.

d Under one year old.

e Under 28 days old.

f Twenty-eight days to one year old.

Sources: Anderson, Kochanek, & Murphy, 1997; Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970 data from the Center for Disease Control, National Center for Health Statistics, 1996; Peters, Kochanek, & Murphy, 1998; 1996 United States Deaths, Table 26; Kramorow, et al., 1999, Health.


Table HC 1.1.B Infant mortality rates (deaths per 1,000 live births) in the United States, by detailed racea and Hispanic origin:b Selected years, 1983-1998

  1983-1985 1986-1988 1989-1991 1995 1996 1997 1998
Infant (all races) 10.6 9.8 9.0 7.6 7.3 7.2 7.2
White 9.0 8.2 7.4 6.3 6.1 6.0 6.0
Black 18.7 17.9 17.1 14.6 14.1 13.7 13.8
American Indian/Alaska Native 13.9 13.2 12.6 9.0 10.0 8.7 9.3
Asian/Pacific Islander 8.3 7.3 6.6 5.3 5.2 5.0 5.5
Chinese 7.4 5.8 5.1 3.8 3.2 4.0
Japanese 6.0 6.9 5.3 5.3 4.2 3.5
Filipino 8.2 6.9 6.4 5.6 5.8 6.2
Hawaiian and part Hawaiian 11.3 11.1 9.0 6.6 5.6 10.0
Other Asian or Pacific Islander 8.6 7.6 7.0 5.5 5.7 5.7
Hispanic 9.2 8.3 7.6 6.3 6.1 6.0 5.8
Mexican American 8.8 7.9 7.2 6.0 5.8 5.8 5.6
Puerto Rican 12.3 11.1 10.4 8.9 8.6 7.9 7.8
Cuban 8.0 7.3 6.2 5.3 5.1 5.5 3.6
Central and South American 8.2 7.6 6.6 5.5 5.0 5.5 5.3
Other and unknown
Hispanic 9.9 9.0 8.2 7.4 7.7 6.2 6.5

 a Estimates are based on specified race or national origin of mother.

b Estimates for separate race groups include Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Data from the National Linked Files of Live Births and Infant Deaths. Health, United States, 1996-97, Table 20; MacDorman, & Atkinson, 1998, Tables A and C; MacDorman, & Atkinson, 1997, Tables A and C; MacDorman & Atkinson, 1999.


1 Ventura, S.J., Anderson, R.N., Martin, J.A., & Smith, B.L. 1998. Births and Deaths: Preliminary Data for 1997. National Vital Statistics Report 47 (4). Hyattsville, MD: National Center for Health Statistics.

2 Singh, G.K., Kochanek, K.D., & MacDorman, M.F. 1994. Advance Report of Final Mortality Statistics, 1994. Monthly Vital Statistics Report 45 (3 Supp.). Hyattsville, MD: National Center for Health Statistics.

3 Ibid.

4 As reported in Ventura, S.J., Anderson, R.N., Martin, J.A., & Smith, B.L. 1998. Births and Deaths: Preliminary Data for 1997.

5 World Health Organization: World Health Statistics Annuals Vols. 1990-1996. Geneva; United Nations: Demographic Yearbook 1996. New York; Centers for Disease Control & Prevention, NCHS. Vital Statistics of the United States, 1995. Washington: Public Health Service.

6 Infant mortality data for Asians/Pacific Islanders and American Indians/Alaska Natives are presented from the National Linked Files of Live Births and Infant Deaths in Table HC 1.1.B. Rather than relying solely on death certificate data, which may underestimate mortality for infants of Hispanic origin or of races other than white and black, data from the National Linked Files of Live Births and Infant Deaths use race from birth certificates and, therefore, provide more accurate data for these populations. The National Linked Files of Live Births and Infant Deaths data are available for 1983- 1991, 1995-1996, and 1998.

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