The 130th Annual Meeting of APHA

Abstract #39784

Eileen Rillamas-Sun, MPH and Tamara Dumanovsky, PhD. Office of Family Health, New York City Department of Health, 2 Lafayette St., 18th Fl., Box 34A, New York, NY 10007, 212-442-1759, erillama@health.nyc.gov

Background: Consistent with nationwide trends over the past decade, infant mortality rates in NYC have declined dramatically, from 11.4 per 1,000 live births in 1991 to 6.9 in 1999. The postneonatal mortality rate (PNMR) has shown a similar decline from 3.5 to 2.0. Despite this decline, ethnic disparities persist. In 1999, the PNMR was 3.1 for blacks, 1.6 for Puerto Ricans and 1.0 for whites. Objective: To detail ethnic disparities in PNMR in NYC over time by cause of death and by mother's demographic characteristics and infant vital records data; to determine whether epidemiological data for the mother and for the infant are sufficient to explain persistent ethnic disparities in PNMR. Methods: All data were obtained from NYC-DOH Office of Vital Statistics annual linked birth-death files. Cause of death classifications are based on CDC's Postneonatal Mortality Surveillance study (Scott et al., 1998). Descriptive analyses compare demographic and epidemiological characteristics of postneonatal infant deaths within categories of ethnicity and cause of death. Results: In 1999, blacks accounted for 27% of all births and 42% of all postneonatal deaths; whereas for Puerto Ricans the comparable numbers are 10% and 8%; for other Hispanics 23% and 17%; and for whites 29% and 15%. Additionally, a higher proportion of black postneonatal deaths are attributed to preventable causes (for 1997-99): injury (12.8% v. 9.9% citywide) and SIDS (16.9% v. 14.2%). More detailed analyses examine trends over time. Conclusions: Ethnic disparities in PNMR are most evident in preventable causes of death, suggesting that social and economic factors need to be considered alongside medical and epidemiological ones.

Learning Objectives:

(
• To explore how differences in categorization by cause of death impacts analyses of ethnic disparities in postneonatal mortality. (
• To develop methodologies for understanding and interpreting these disparities at a community level. (
• To prioritize interventions based on preventable v. non-preventable causes of death.

Keywords: Infant Mortality, Ethnicity

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.