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Racial disparity in infant mortality rates widens in USA

Deaths among black infants more than double those of white

OnMedica Staff

Tuesday, 29 January 2008

The disparity in infant mortality between blacks and whites in the USA has widened.

According to a report in the January American Journal of Obstetrics & Gynecology, total infant mortality rates in 1995-2000 were 4.9 per 1000 for whites and 11.4 per 1000 for African Americans, representing 35% and 31% declines, respectively, since 1985-1988.

"The increasing U.S. racial disparity of infant mortality rates between blacks and whites is largely influenced by changes in the survival of infants born earlier and smaller, not changes in birthweight-gestational age distribution," said author Dr Martha Slay Wingate, from the University of Alabama at Birmingham.

Dr Wingate and colleagues examined trends in birthweight-gestational age distributions and related infant mortality for African American and white women and calculated the estimated excess annual number of African American infant deaths.

For both groups, a greater proportion of infant deaths occurred among births <28 weeks or <1500 grams.

Both groups also showed increases in the percentage of very low birthweight infants (<1500 g), the researchers note, with white infants increasing from 0.4-0.6% and African American infants increasing from 1.4-1.9% of all births.

As in the past, low birthweight African American infants were more likely to survive than white infants, but the survival advantage decreased during the interval studied.

At the same time, the racial disparity in infant mortality rates for normal-weight infants continued to grow.

These changes translate into an estimated 3,303 excess African American infant deaths annually during the 1995-2000 period, with slightly more than 20% of the excess deaths among infants 2500g or greater or at term or beyond. More than two-thirds of the excess deaths were among very low birthweight (and very preterm) infants.

"Despite an increase in the rate of low birthweight white infants, racial disparity in infant mortality has widened, suggesting a possible inconsistency by race in access to risk-appropriate levels of medical care and technology," Dr Wingate said. "Prenatal care, while not a panacea for preterm birth, may play a role in addressing these access-to-care issues."

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