Defining Health and Wellness - Infant Mortality

Since 1940 the infant mortality rate in the United States has declined by approximately 85%—from about forty-seven deaths per one thousand live births in 1940 to less than seven deaths per one thousand live births in 2003. (See Figure 1.1.) The NCHS reports that in 2002 the infant mortality rate rose for the first year since 1958, from 6.8% in 2001 to 7%. An analysis of this slight increase revealed that it was attributable to deaths that occurred during the first week of life, which were probably related to an increase in the number of VLBW infants. In 2003 there was a small but not statistically significant decline in the infant mortality rate. (See Table 1.5.)

Advances in neonatology (the medical subspecialty concerned with the care of newborns, especially those at risk) have contributed to the huge decline in infant death rates. Infants born prematurely or with LBWs, who were once likely to die, can survive life-threatening conditions because of the development of neonatal intensive care units (NICUs). Improved access to health care also has contributed to the decline, as well as public health initiatives that have educated Americans about how to prevent sudden infant death syndrome (SIDS)—specifically the "Back to Sleep" campaign teaching caregivers to place sleeping infants on their backs. Nonetheless, despite the tremendous improvements in neonatal treatment, increased access to care, and more widespread education, during the years 2000–02 African-American infants were more than twice as likely as white and Hispanic infants to die before their first birthdays. (See Figure 1.2.) In 2002 the national death rate for African-American infants was 13.8 per one thousand live births, compared with 5.8 per one thousand live births for white infants and 5.6 per one thousand live births for Hispanic infants. (See Table 1.6.)

FIGURE 1.1 Infant, neonatal, and postnatal mortality rates, 1940–2003 Donna L. Hoyert, et al., "Figure 3. Infant, Neonatal, and Postnatal Mortality Rates: United States, 1940–2003," in Deaths: Final Data for 2003, Health E-Stats, Centers for Disease Control and Prevention, National Center for Health Statistics, January 19, 2006, http://www.cdc.gov/nchs/products/pubs/pubd/hestats/finaldeaths03/finaldeaths03.htm (accessed January 24, 2006)

Table 1.7 shows the U.S. infant mortality rate compared with those of other industrialized nations. The United States had higher infant mortality rates than twenty-seven other countries in 2002 and at least twice the rate of infant deaths as Sweden, Spain, Singapore, Norway, Japan, Hong Kong, and Finland.