Objective. To determine the effect of infant, maternal, and community-level risk factors on the racial disparity in postneonatal mortality rate due to unintentional injuries (28-365 days, PNMR-INJURIES) among urban African-American and white infants.
Methods. We analyzed a linked dataset of 1992-1995 Illinois vital records, 1990 US census income data, and 1995 Chicago public health information. Chicago communities with 1 or more ecologic risk factors (low median family income, high rates of unemployment, homicide and lead poisoning) were classified as impoverished.
Results. In Chicago, African-American (AA) infants (N=104,656) had a three-fold greater PNMR-INJURIES than white infants (N=52,954): 3/1,000 vs. 1.1/1,000; RR=2.9 (2.8-3.2). Only 21% of AA, compared to 91% of white, infants resided in non-impoverished neighborhoods; p<0.0001. In these areas, the racial disparity in PNMR-INJURIES tended to narrow as infant and maternal risk status improved. In a multiple logistic model of non-impoverished infants, the adjusted odds ratio of postneonatal death due to injuries was 1.1 (0.7-1.6) for AA.
Conclusions. We conclude that the profound racial differential in residential environments underlies the African-American infant’s three-fold greater postneonatal mortality rates due to unintentional injuries. This finding has public health relevance to the attainment of the year 2010 Federal Health Objective calling for the elimination of racial disparities in infant outcome.
Learning Objectives: 1. To understand that urban African-American infants have a three-fold greater postneonatal mortality rate due to unintentional injuries than non-Latino urban white infants. 2. To understand that African-American and white infants are exposed to the extremes of residential environments. 3. To understand that the racial disparity in postneonatal mortality rate due to unintentional injuries narrows among infants who reside in non-impoverished neighborhoods.
Keywords: Infant Mortality, Ethnicity
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.