-Source: United States Census Bureau

Infant Health

• Fertility rates -- the total number of babies born each year per 1,000 women ages 15-44 declined steeply among all women from 1960 to 1985, then rose somewhat until 1990, when about 4.16 million babies were born in the United States. This number was the highest reported since 1962 (4.17 million) near the end of the Baby Boom. Fertility rates then declined again. From 1960 to 1999, fertility fell 54.3% among black women (from 153.5 live births per 1,000 to 70.1 in 1999) and 42.5% among white women (from 113.2 to 65.1 births). Fertility rates were 36% higher among black women than white women in 1960, but were only about 7.1% higher in 1999.

• The birth rate among black teenage women (under 18 years old) has also declined substantially, from 14.8 per 1,000 in 1970 to 8.2 in 1999. However, this remains over twice the rate for white teenaged women (3.7 per 1,000).

• Although birth rates among black teenagers have declined, birth rates have fallen even more rapidly among black women over age 20. A consequence of this is that the percentage of black children who were born to teenage mothers is relatively high (20.6%) almost twice the corresponding percentage for white children (11.9%).

• Teenage mothers are more likely to deliver premature babies and babies with low birth weight (defined as those weighing less than 2,500 grams (or about 5.5 pounds) at birth). The lower birth rates among teenagers, declines in smoking during pregnancy, and improved prenatal care have helped reduce these infant health problems and infant death rates.

• The rate of low birth weight babies among all women was 7.45 per 1,000 live births in 1999. The rate among black women (13.1 per 1,000), was the highest for any racial or ethnic group, and was twice the rate among white women (6.6).

Infant Mortality -Neonatal

• Infant mortality in the total population has declined significantly, from 26.0 per 1,000 live births in 1960 to 7.2 in 1998.

• Neonatal mortality (deaths from birth to 28 days of life) primarily reflects the health status of the mother during pregnancy. Neonatal deaths account for most infant deaths among both blacks and whites, and blacks have higher mortality rates in both neonatal and post-neonatal periods.

• Neonatal mortality rates have significantly decreased since 1960. The rates among black women fell 78.8% from 44.3 per 1,000 in 1960 to 9.4 in 1998. The rates declined 82.5% among white women, from 22.9 per 1,000 in 1960 to 4.0 in 1998.

• The greater decline in neonatal deaths among white women than black women left the latter with a neonatal mortality rate in 1998 that was more than twice that of white women (9.4 versus 4 respectively).

• Many neonatal deaths are due to either to birth defects (e.g., heart or chromosomal abnormalities) or to a baby being born prematurely. Birth defects cause about 25% of neonatal deaths. About 11% of babies are born prematurely, and complications from premature birth cause about 20% of neonatal deaths each year. Other leading causes of infant deaths include sudden infant death syndrome, respiratory distress syndrome, and maternal pregnancy complications. In 1998, these leading causes accounted for more than half of all infant deaths.

Infant Mortality-Postneonatal

• In contrast to neonatal mortality, post-neonatal deaths (from 28 days to one year of life) have less to do with problems at birth and more to do with the child's living conditions and quality of healthcare. Post-neonatal deaths are more commonly caused by accidents and environmental hazards (e.g., lead poisoning), and are less likely to be caused by birth defects.

• Post-neonatal deaths also declined substantially between 1960 and 1998. The greatest reduction was among children born to black women, where the rate fell 73.3% from 1960 to 1998, ( although there were small increases in the late 1980s). Post-neonatal mortality fell 64.9% among whites during this period.

• The greater decline in post-neonatal death rates among children born to black women compared to those born to white women reduced the racial gap. Nevertheless, in 1998, babies born to black women were almost twice as likely to die between 28 days and one year after birth (4.4 per 1,000) than were babies born to white women (2.4 per 1,000).

• Birth defects are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. Of about 120,000 U.S. babies born each year with a birth defect, 8,000 die during their first year of life. In addition, birth defects are the fifth-leading cause of years of potential life lost and contribute substantially to childhood morbidity and long-term disability. The causes of about 70% of all birth defects are unknown.

References

National Center for Health Statistics. 1998. Health, United States, 1998 With Socioeconomic Status and Health Chartbook (Hyattsville, MD: National Center for Health Statistics).

National Center for Health Statistics. Health, United States, 2000, With Urban and Rural Health Chartbook. http://www.cdc.gov/nchs/data/hus/hus01.pdf

National Center for Health Statistics. 1998.Birth Defects and Pediatric Genetics. http://www.cdc.gov/ncbddd/bd/

The March of Dimes. 1998. National Perinatal Statistics. http://www.modimes.org/ HealthLibrary2/factsfigures/stats.htm

United States Census Bureau.1993. We the American Women. http://www.census.gov/apsd/wepeople/we-8.pdf

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