Sudden infant death syndrome as a socially determined cause of death

The background characteristics of infant deaths which have been certified by physicians as due to Sudden Infant Death Syndrome (SIDS) are examined. Two alternative models for explaining SIDS deaths are considered. The first views SIDS solely in medical/biological terms, while the second emphasizes the role played by social and cultural factors, either as contributing conditions or as factors in the misattribution of SIDS as the cause of death where other conditions are actually present. Data are based on linked birth and death certificates for the 1980-82 cohort of live births in Florida, which have been merged with NCHS reports of multiple cause of death. Analysis suggests a pattern of SIDS reporting which varies inversely with maternal education, prenatal care, and race/ethnicity. This pattern suggests either that social factors affect the etiology of the syndrome to a greater degree than would be expected from the medical/biological model or that deaths to infants of lower socioeconomic status are attributed to SIDS more often than warranted.