Excess infant mortality in an American Indian population, 1940 to 1990
R. M. Nakamura, R. King, E. H. Kimball, R. K. Oye and S. D. Helgerson
Department of Medicine, Univeristy of California, Los Angeles.
OBJECTIVE.--To describe the infant mortality experience of an American
Indian community and to demonstrate the utility of examining
community-level mortality data. DESIGN.--Descriptive, population-based
historical review of infant death certificates. SETTING.--The Warm Springs
Indian Reservation, Oregon. PATIENTS OR OTHER PARTICIPANTS.--Infant tribal
members of the Confederated Tribes of Warm Springs, 1940 to 1990.
INTERVENTIONS.--None. MAIN OUTCOME MEASURES.--Categorization of causes of
infant deaths and calculations of mortality rates. RESULTS.--The infant
mortality rate, while lower in each decade since the 1940s, was still 2.6
times the national (all races) rate in the 1980s. Neonatal deaths did not
account for many of the excess deaths. The postneonatal mortality rate has
consistently been much greater than the national rate and was five times
greater in the 1980s. Almost all of the excess infant mortality since 1980
has been due to the sudden infant death syndrome. CONCLUSIONS.--While there
has been a dramatic decrease in infant mortality for this American Indian
population, it remains higher than the national rate. Examining the causes
of infant death has enabled this population to develop focused strategies
to reduce infant mortality.
