Trends in infant mortality in American Indians and Alaska Natives

American Indians/Alaska Native (AI/AN) experience health disparities in the form of a higher infant mortality rate (IMR) in comparison to non-Hispanic Whites. According to the CDC/NCHS 2005 linked birth/infant death linked data set, the AI/AN IMR of 8.06/1000 exceeded the non-Hispanic White IMR of 5.76/1000. Furthermore, among AI/AN, the postneonatal IMR represents a higher proportion of IMR than among other US sub-populations. Previous studies have attributed the high posteneonatal IMR in AI/AN to higher rates of Sudden Infant Death Syndrome and accidents.

Using the 1995-‘99 and 2000-‘04 Centers for Disease Control and Prevention's National Center for Health Statistics national linked birth/infant death data, we examined neonatal and postneonatal IMR among AI/AN and Whites. During these time intervals, we compared the neonatal and postneonatal IMR between AI/AN and Whites. All statistical analyses were performed using SAS version 8.0 software (SAS Institute Inc. Cary, NC)

For AI/AN and Whites, infant mortality rates declined by 5% between 1995-‘99 and 2000-‘04; however, AI/AN infants were 1.5 times as likely to die as Whites during both time intervals. Between 2000-'04, the neonatal IMR was 4.4 among AI/AN, and 3.8 among Whites, while the postneonatal IMR was 2.3 times higher among AI/AN in comparison to that of Whites (4.3 among AI/AN and 1.9 among Whites). Further analysis will examine causal contributing differences by race. While the overall IMR has decreased in AI/AN, disparities in postneonatal IMR persist. Inquiry into sources of the difference in rate will assist public health professionals in addressing this health disparity.