Defining Health and Wellness - Infant Mortality

Since 1960 the infant mortality rate in the United States has declined 72 percent—from twenty-six deaths per 1,000 live births in 1960 to 6.8 deaths per 1,000 live births in 2001. Advances in neonatology (the medical sub-specialty 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 low birthweights, who were once likely to die, can survive life-threatening conditions because of the development of neonatal intensive care units (NICUs). However, despite the tremendous improvements in neonatal treatment, African-American infants are more than twice as likely as white and Hispanic infants to die before their first birthday. In 2001 the national death rate for African-American infants was 13.3 per 1,000 live births (which, however, is a slight decrease from 13.5 per 1,000 live births in 2000 and fourteen per 1,000 live births in 1999), compared with 5.7 per 1,000 live births for white infants and 5.4 per 1,000 live births for Hispanic infants. (See Table 1.8.)

Table 1.9 shows the U.S. infant mortality rate compared to those of other industrialized nations. The United States had higher infant mortality rates than twenty-seven other countries in 1999 and seven times as many deaths as Singapore, fourteen times as many deaths as Sweden and Japan, and twenty-eight times as many deaths as Hong Kong, the nations with the lowest infant mortality rates.

Leading Causes of Infant Mortality

Birth defects are the leading cause of infant mortality in the United States. Some of the more serious birth defects are anencephaly, spina bifida, and Down syndrome. According to the CDC, of babies born in the United States, 3 percent have birth defects. The CDC estimates that about 120,000 babies are born with birth defects each year and of these, about 8,000 will die during their first year of life. Many of those who survive will suffer from lifelong disabilities.

In 2001 birth defects (identified as "congenital malformations, deformations and chromosomal abnormalities" by the International Classification of Diseases, Tenth Revision, 1992) accounted for 20 percent of all infant deaths. (See Table 1.10.) Although many birth defects are impossible to prevent, those caused by maternal alcohol consumption and other drug consumption during pregnancy can be prevented.

Disorders related to short gestation (premature birth) and low birthweight were the second leading cause of infant mortality (16 percent). Among African-American infants, they were the leading cause of death (21.6 percent). Other causes of infant deaths were sudden infant death syndrome (SIDS); maternal complications of pregnancy; and complications of the placenta, cord, and membranes. These five leading causes of infant mortality accounted for more than half the total infant deaths. (See Table 1.10.)