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Excess Infant Mortality Among Native Hawaiians: Identifying Determinants for Preventive Action.
MedLine Citation:
PMID:  24028241     Owner:  NLM     Status:  Publisher    
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. (Am J Public Health. Published online ahead of print September 12, 2013: e1-e8. doi:10.2105/AJPH.2013.301294).
Ashley H Hirai; Donald K Hayes; Maile M Taualii; Gopal K Singh; Loretta J Fuddy Acsw
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-12
Journal Detail:
Title:  American journal of public health     Volume:  -     ISSN:  1541-0048     ISO Abbreviation:  Am J Public Health     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1254074     Medline TA:  Am J Public Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Ashley H. Hirai and Gopal K. Singh are with the Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD. Donald K. Hayes and Loretta J. Fuddy are with the Hawai'i Department of Health, Honolulu. Maile M. Taualii is with the Office of Public Health Studies, Native Hawaiian and Indigenous Health, University of Hawai'i and Papa Ola Lokahi, Honolulu.
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