Racial and Ethnic Disparities in Sudden Unexpected Infant Death and Sudden Infant Death Syndrome Rates in the USA: a Com
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SLEEP AND HEALTH DISPARITIES (A SHELTON, SECTION EDITOR)
Racial and Ethnic Disparities in Sudden Unexpected Infant Death and Sudden Infant Death Syndrome Rates in the USA: a Complex Problem Mired in a Deeply Entangled Web Roberta Leu 1,2
&
Nikhila Raol 2,3 & Kelli-Lee Harford 1,2
Accepted: 27 October 2020 / Published online: 25 November 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose of This Review In this review, we examine the slow decline in the US infant mortality rate by evaluating disparate racial and ethnic improvements in sudden unexpected infant death/sudden infant death syndrome rates. Recent Findings The US infant mortality rate continues to be higher in minority groups. Limited data associates specific genetic variations with increased risk of SIDS in African Americans. Public health campaigns to reduce SIDS risks have focused on vulnerable groups and used messaging that can be perceived as guilt/blame based. Qualitative studies have found that many Black mothers view SUIDS/SIDS as a random, unpreventable event. Consequently, cultural beliefs and traditions may override healthcare advice for safe infant sleeping. Analysis of SIDS rates in other countries shows that some behaviors considered SIDS risks are common in countries with low SIDS rates. Studies show that social forces perpetuating racial inequity contribute to disparate racial/ethnic improvements in mortality rates. Summary Approaching healthcare campaigns for safe infant sleeping from a culturally sensitive perspective may improve individual risks, but large impacts on infant mortality and SUID/SIDS rates will require changes that decrease racial inequities in the US society. Keywords Racial disparities . SUIDS . SIDS . Infant mortality . Culture . Ethnic disparities
Introduction Infant Mortality Infant mortality is defined as an infant dying before 12 months of age [1]. Infant mortality rates (IMR) are described as the number of infant deaths per 1000 live births in a given year [1, 2]. 2018 data from the Period Linked Birth-Infant Death Data This article is part of the Topical Collection on Sleep and Health Disparities * Roberta Leu [email protected] 1
Department of Pediatrics – Pulmonary, Allergy/Immunology, Cystic Fibrosis, and Sleep Division, Emory University School of Medicine, Atlanta, Georgia
2
Children’s Healthcare of Atlanta, Atlanta, Georgia
3
Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia
Files showed a US IMR of 5.67 deaths per 1000 live births [2]. The US IMR has had only minor improvement in the last decade, dropping only 14% from a rate of 6.7 deaths per 1000 live births in 2007 [3]. Held against 20 other comparable Organization for Economic Cooperation and Development (OECD) countries, the US infant mortality rate averages 75% worse [4]. Among the 36 countries that are OECD members, the US infant mortality rate ranks 4th from the bottom followed by Chile, Turkey, and then Mexico ranking the worst with 12.1 deaths per 1000 live births [4]. Wi
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