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

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Infant mortality remains a critical public health issue, with significant disparities observed among different ethnic groups.
• Native Hawaiians experience disproportionately higher rates of infant mortality compared to other populations in Hawaii.

Purpose of the Study:

• To identify the key determinants and specific causes contributing to the excess infant mortality among Native Hawaiians.
• To compare infant mortality rates and causes between Native Hawaiians and White infants in Hawaii.

Main Methods:

• Utilized the 2002-2009 Hawai'i State Linked Birth/Infant Death Cohort File for comparative analysis.
• Evaluated infant mortality by age, cause of death, and maternal sociodemographic, behavioral, and chronic condition factors.

Main Results:

• Native Hawaiian infant mortality rate (7.9/1000 live births) was more than double the White rate (3.5/1000).
• Preterm-related causes, sudden unexpected infant death, and injury were major contributors to the disparity.
• Maternal educational inequality significantly impacted neonatal mortality, while younger maternal age and smoking affected postneonatal mortality.

Conclusions:

• Reducing excess infant mortality requires addressing educational inequalities, promoting safe sleep practices, and decreasing smoking rates among Native Hawaiian mothers.
• Targeted interventions focusing on these factors can help eliminate health disparities in infant mortality.