The 130th Annual Meeting of APHA

Abstract #41301

Elizabeth Knurek, MPH¹, Rick Haverkate, MPH¹, Sandra King, RN, BSN¹, and Geradine Simkins, RN, CNM, MSN². (1) Health Services Division, Inter-Tribal Council of Michigan, Inc, 3601 Mackinaw Trail, Sault Ste. Marie, MI 49783-9286, 906.635.4208, knurek.elizabeth@mcleodusa.net, (2) Perinatal Nurse Consultant, Birthways Midwifery, Inc., Michigan Inter-tribal Council, 275 Cemetery Rd, Maple City, MI 49664

Little is published describing the epidemiology of infant mortality within American Indian populations. The MITC’s Healthy Start project has explored factors related to high infant mortality in Michigan. National initiatives which address racial disparities in infant mortality tend to focus on preventing neonatal deaths associated with low birth weight. In Michigan, there are high American Indian infant deaths in the neonatal period; disparity is higher in the post neonatal period, calling into question low birth weight as the focus for intervention. A deeper understanding of factors associated with American Indian infant mortality is needed. Michigan vital record data from 1995 to 2000 were analyzed using descriptive statistics and frequency analyses to identify causes of infant death and probable contributing factors. A combined file was constructed with data on infants who survived and infants who died. Data for each case was re-coded by birth weight status and various maternal factors. GIS was used to code each case for geographical proximity to regional perinatal centers and pediatric practices. Logistic regression was then used to identify factors associated with infant death. The American Indian infant mortality rate is two to three times higher than the rate for White infants. The leading cause is SIDS, accounting for about 30% of the total disparity. While results confirm the role of birth weight in death, the overall incidence of lbw is moderate and does not account for the majority of excess deaths. Results identify other factors contributing to mortality independent of birth weight.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the unique epidemiology of infant mortality in the American Indian population.
• Improve the effectiveness of MCH prevention efforts aimed at American Indian populations by using data to identify significant underlying factors associated with excess infant death.

Keywords: American Indians, Infant Mortality

Related Web page: itcmi.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.