Excess infant mortality among Native Hawaiians: Identifying determinants for preventive action

A.H. Hirai, D.K. Hayes, M.M. Taualii, G.K. Singh and L.J. Fuddy

American Journal of Public Health, 2013, vol. 103, issue 11, e88-e95

Abstract: Objectives. We identified potential determinants and cause-specific sources of excess infant mortality among Native Hawaiians. Methods. We compared infant mortality rates among Native Hawaiians and Whites by using data from the 2002 to 2009 Hawai'i State Linked Birth/Infant Death Cohort File. We evaluated the components of excess infant mortality by age and underlying cause of death as well as maternal sociodemographic, behavioral, and chronic condition disparities. Results. The Native Hawaiian infant mortality rate was more than twice that for Whites (7.9 vs 3.5/1000 live births). Excess Native Hawaiian infant mortality was equally apportioned to neonatal and postneonatal deaths. Preterm-related causes of death accounted for 43.9% of the infant mortality disparity, followed by sudden unexpected infant death (21.6%) and injury (5.6%). In multivariable models, maternal educational inequality accounted for the largest portion of the neonatal mortality disparity (20.9%); younger maternal age (12.2%) and smoking (9.5%) were the only significant contributors to the postneonatal mortality disparity. Conclusions. Addressing educational inequalities, promoting safe sleep practices, and reducing smoking among Native Hawaiian mothers would help to eliminate excess infant mortality. Copyright © 2013 by the American Public Health Association®.

Keywords: Aborigine; article; birth certificate; Caucasian; cause of death; cohort analysis; comparative study; educational status; ethnology; health disparity; human; infant; infant mortality; low birth weight; newborn; prematurity; risk factor; socioeconomics; statistics; United States; Caucasian; epidemiology; ethnology; infant mortality; Oceanic ancestry group; statistics and numerical data; United States, Birth Certificates; Cause of Death; Cohort Studies; Educational Status; European Continental Ancestry Group; Hawaii; Health Status Disparities; Humans; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Oceanic Ancestry Group; Premature Birth; Risk Factors; Socioeconomic Factors, Birth Certificates; Cause of Death; Cohort Studies; Educational Status; European Continental Ancestry Group; Hawaii; Health Status Disparities; Humans; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Oceanic Ancestry Group; Premature Birth; Risk Factors; Socioeconomic Factors (search for similar items in EconPapers)
Date: 2013
References: Add references at CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2013.301294

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301294_1

DOI: 10.2105/AJPH.2013.301294

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().