Unfortunately, not all racial and ethnic groups have reached that record-low infant mortality rate. In 2001 the infant mortality rate for white infants was 5.7 deaths per one thousand live births, less than half the rate of 13.3 for African-American infants. Rates for Native American/Alaska Native, Hispanic, and Asian/Pacific Islander babies were 9.7, 5.4, and 4.7, respectively. The infant mortality rate for Native Americans/Alaska Natives went up from the previous year. (See Table 5.2.)
The National Center for Health Statistics listed the ten leading causes of infant mortality in the United States in 2002. (See Table 5.3.) Birth defects were the primary cause of infant mortality (140.7 deaths per one hundred thousand live births). Premature delivery or low birth weight was the second leading cause of infant mortality (114.4). Sudden Infant Death Syndrome (SIDS) (50.6), complications of pregnancy (42.9), complications in the placenta or umbilical cord (25.3), respiratory distress (23.8), accidents (22.2), bacterial sepsis (18.3), circulatory system diseases (16.1), and intrauterine hypoxia/birth asphyxia (14.4) completed the list.
Although infant mortality rates are decreasing for the African-American population, the CDC reported that infant mortality rates in 2002 were more than twice as high for African-American infants than for non-Hispanic white infants. (See Table 5.4.) Premature birth/low birth weight was the leading cause of death for African-American infants (310.9 per one thousand live births) and was particularly high compared with the rate for white infants (135 per one thousand live births). For unknown reasons, African-American infants are also at a much higher risk of SIDS than white infants.
Sudden Infant Death Syndrome (SIDS)
Sudden Infant Death Syndrome (SIDS; sometimes called crib death), the unexplained death of a previously
TABLE 5.1
| Life expectancy at birth according to race and sex, selected years 1900–2001 | |||||||||
| [Data are based on death certificates] | |||||||||
| All races | White | Black or African American1 | |||||||
| Specified age and year | Both sexes | Male | Female | Both sexes | Male | Female | Both sexes | Male | Female |
| 1Data shown for 1900–60 are for the nonwhite population. | |||||||||
| 2Death registration area only. The death registration area increased from 10 states and the District of Columbia in 1900 to the coterminous United States in 1933. | |||||||||
| 3Includes deaths of persons who were not residents of the 50 states and the District of Columbia. | |||||||||
| 4Life expectancies (LEs) for 2000 were revised and may differ from those shown previously. LEs for 2000 were computed using population counts from Census 2000 and replace LEs for 2000 using 1990-based postcensal estimates. | |||||||||
| 5Life expectancies for 2001 were computed using 2000-based postcensal estimates. | |||||||||
| Notes: Populations used for computing life expectancy and other life table values for 1991–1999 are postcensal estimates of U.S. resident population, based on the 1990 census. | |||||||||
| SOURCE: Adapted from "Table 27. Life Expectancy at Birth, at 65 Years of Age, and at 75 Years of Age, according to Race and Sex: United States, Selected Years 1900–2001," in Health, United States, 2003, Centers for Disease Control and Prevention, National Center for Health Statistics, 2003, http://www.cdc.gov/nchs/data/hus/tables/2003/03hus027.pdf (accessed September 3, 2004) | |||||||||
| At birth | Remaining life expectancy in years | ||||||||
| 19002,3 | 47.3 | 46.3 | 48.3 | 47.6 | 46.6 | 48.7 | 33.0 | 32.5 | 33.5 |
| 19503 | 68.2 | 65.6 | 71.1 | 69.1 | 66.5 | 72.2 | 60.8 | 59.1 | 62.9 |
| 19603 | 69.7 | 66.6 | 73.1 | 70.6 | 67.4 | 74.1 | 63.6 | 61.1 | 66.3 |
| 1970 | 70.8 | 67.1 | 74.7 | 71.7 | 68.0 | 75.6 | 64.1 | 60.0 | 68.3 |
| 1980 | 73.7 | 70.0 | 77.4 | 74.4 | 70.7 | 78.1 | 68.1 | 63.8 | 72.5 |
| 1985 | 74.7 | 71.1 | 78.2 | 75.3 | 71.8 | 78.7 | 69.3 | 65.0 | 73.4 |
| 1990 | 75.4 | 71.8 | 78.8 | 76.1 | 72.7 | 79.4 | 69.1 | 64.5 | 73.6 |
| 1991 | 75.5 | 72.0 | 78.9 | 76.3 | 72.9 | 79.6 | 69.3 | 64.6 | 73.8 |
| 1992 | 75.8 | 72.3 | 79.1 | 76.5 | 73.2 | 79.8 | 69.6 | 65.0 | 73.9 |
| 1993 | 75.5 | 72.2 | 78.8 | 76.3 | 73.1 | 79.5 | 69.2 | 64.6 | 73.7 |
| 1994 | 75.7 | 72.4 | 79.0 | 76.5 | 73.3 | 79.6 | 69.5 | 64.9 | 73.9 |
| 1995 | 75.8 | 72.5 | 78.9 | 76.5 | 73.4 | 79.6 | 69.6 | 65.2 | 73.9 |
| 1996 | 76.1 | 73.1 | 79.1 | 76.8 | 73.9 | 79.7 | 70.2 | 66.1 | 74.2 |
| 1997 | 76.5 | 73.6 | 79.4 | 77.1 | 74.3 | 79.9 | 71.1 | 67.2 | 74.7 |
| 1998 | 76.7 | 73.8 | 79.5 | 77.3 | 74.5 | 80.0 | 71.3 | 67.6 | 74.8 |
| 1999 | 76.7 | 73.9 | 79.4 | 77.3 | 74.6 | 79.9 | 71.4 | 67.8 | 74.7 |
| 20004 | 77.0 | 74.3 | 79.7 | 77.6 | 74.9 | 80.1 | 71.9 | 68.3 | 75.2 |
| 20015 | 77.2 | 74.4 | 79.8 | 77.7 | 75.0 | 80.2 | 72.2 | 68.6 | 75.5 |
healthy infant, was the third leading cause of infant mortality in the United States in 2002 and the leading cause of death of infants one month to one year of age. In 1992 the American Academy of Pediatrics recommended that babies sleep on their backs to reduce the risk of SIDS and launched its "Back to Sleep" campaign to educate parents. It had been a long-held belief that the best position for babies to sleep was on their stomachs. The American SIDS Institute reported that the Back to Sleep campaign had resulted in the reduction of SIDS cases by 52% between 1990 and 2000. Other risk factors for SIDS include maternal use of drugs or tobacco during pregnancy, low birth weight, and poor prenatal care.
STUDIES ON THE CAUSES OF AND RISK FACTORS FOR SIDS. A number of recent studies have considered the possible causes of and risk factors for SIDS. One study, ongoing since 1985, conducted by Dr. Hannah Kinney of Harvard Medical School in Boston, Massachusetts, found a brain defect believed to affect breathing in babies who died of SIDS ("SIDS Risk Prevention Research Begins to Define Physical Abnormalities in Brainstem, Points to Possible Diagnostic/Screening Tools," PR Newswire, October 18, 1999). Researchers suggest that as carbon dioxide levels rise and oxygen levels fall during sleep, the brains of some babies do not get the signal to regulate breathing or blood pressure accordingly to make up for the change. This condition is particularly dangerous for infants sleeping on their stomachs or on soft bedding. According to a May 2002 article in Clinical Psychiatry News ("Brainstem Abnormality May Be Culprit in SIDS Subset: Maternal Smoking Tied to Abnormality"), the study had shifted its focus to maternal cigarette smoking in the first trimester of pregnancy as a possible cause of the brain abnormality.
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