Current Trends Infant Mortality -- United States, 1988

In 1988, 38,910 infants less than 1 year of age died in the United States, 502 fewer than in 1987. The infant mortality rate of 10.0 infant deaths per 1000 live births was the lowest final rate ever recorded; the rate was 10.1 in 1987. This report summarizes final 1988 infant mortality data based on information from death certificates compiled by CDC's National Center for Health Statistics' Vital Statistics System (1) and compares findings with those for 1987.

In this report, cause-of-death statistics are based on the underlying cause of death* recorded on the death certificate by the attending physician, medical examiner, or coroner in a manner specified by the World Health Organization and endorsed by CDC.

In 1988, for white infants, the mortality rate was 8.5 per 1000 live births, compared with 8.6 in 1987; the rate for black infants was 17.6 per 1000 live births, compared with 17.9 in 1987.

From 1987 to 1988, the neonatal (infants less than 28 days of age) mortality rate declined from 6.5 to 6.3 deaths per 1000 live births. In 1988, the neonatal mortality rate for white infants was 5.4 per 1000 live births, compared with 5.5 in 1987; the rate for black infants was 11.7 per 1000 live births, compared with 11.5 in 1987.

The postneonatal (infants aged 28 days-11 months) mortality rate per 1000 live births in 1988 was 3.6 for the third consecutive year. In 1988, for white infants, the postneonatal mortality rate also remained the same as the previous 2 years (3.1 per 1000); for black infants, the rate was 6.2 per 1000, compared with 6.1 per 1000 in 1987.

The rank order of the 10 leading causes of infant death differed by race (Table 1). For white infants, the leading cause of death was congenital anomalies, accounting for 24.8% of all deaths among white infants. For black infants, the leading cause of death was sudden infant death syndrome (SIDS), accounting for 12.8% of all deaths among black infants. Four of the 10 leading causes accounted for 42.2% of the difference in infant mortality rates for black and white infants (disorders relating to short gestation and unspecified low birth weight, 17.9% of the difference; SIDS, 11.2%; respiratory distress syndrome, 7.9%; and newborn affected by maternal complications of pregnancy, 5.2%).

The four leading causes of death accounted for 54.3% of all deaths among white infants and 45.3% of all deaths among black infants. Reported by: Div of Vital Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note:Infant mortality is one of the most widely used general indices of health in the United States and other countries. The United States continues to have an infant mortality rate higher than that in many other developed countries.

The decrease in infant mortality has slowed for both white and black infants--since the late 1970s for white infants and since 1981 for black infants. Since 1960, neonatal mortality rates have decreased for both races, but the rate for white infants has declined faster than for black infants--an average annual decrease of 4% for white infants, compared with 3% for black infants. In contrast, from 1960 through 1988, the postneonatal rate decreased faster for black infants than for white infants--an average annual decrease of 3% for black infants and an average annual decrease of 2% for white infants.

One of the national health objectives for the year 2000 is to reduce the infant mortality rate to no more than 7 per 1000 live births compared with 10.1 per 1000 live births in 1987 (2). The rate of decline slowed from 4.7% per year during the 1970s to 2.8% per year during the 1980s. If the 2.8% decline during the 1980s continues, the infant mortality objective for the year 2000 will be achieved.

The mortality data presented here are important in tracking the health of the nation by identifying groups of infants at greater risk for particular diseases and premature death, thereby improving the efficiency of health education and disease prevention efforts.

References

1. NCHS. Advance report of final mortality statistics, 1988. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1990. (Monthly vital statistics report; vol 39, no. 7, suppl).

2. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS) 91-50212.

*Defined by the World Health Organization's International Classification of Diseases, Ninth Revision (ICD-9) as "(a) the disease or injury which initiated the train of morbid events leading directly to death, or (b) the circumstances of the accidents or violence which produced the fatal injury."

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