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Native American postneonatal mortality
1Division of Pediatric Practice, American Academy of Pediatrics, Elk Grove Village, IL 60009-0927.
Insights
Native American infant postneonatal mortality remains high due to unsafe environments and socioeconomic factors, despite lower neonatal death rates. Interventions must address both health access and socioeconomic disparities for improved infant survival.
Area of Science:
- Public Health
- Pediatrics
- Sociology
Background:
- Native American infant mortality rates show disparities, with postneonatal deaths twice as high as in the white population.
- While neonatal deaths have decreased, postneonatal deaths remain a significant concern for Native American infants.
Purpose of the Study:
- To investigate the causes of high postneonatal mortality among Native American infants.
- To identify factors contributing to the elevated postneonatal death rates in this population.
Main Methods:
- Analysis of available data on postneonatal deaths among Native American infants.
- Examination of contributing factors including medical conditions, accidents, and socioeconomic determinants.
Main Results:
- Postneonatal deaths are primarily linked to preventable accidents and treatable conditions like pneumonia and gastroenteritis.
- Socioeconomic factors such as poverty, alcoholism, unemployment, and family disorganization significantly contribute to mortality.
Conclusions:
- Native American infants often face unsafe environments post-discharge, increasing mortality risk.
- Effective interventions require addressing both healthcare access for treatable conditions and prevention of accidents, alongside socioeconomic improvements in Native American communities.
Abstract:
Although dramatic gains have been realized in lowering the incidence of neonatal deaths among native American infants to a level lower than the white race, postneonatal death rates for this population remain twice as high as in the white race. The limited data available reveal that excessive postneonatal deaths among native American infants largely result from preventable accidents and treatable acute medical conditions, such as pneumonia and gastroenteritis. This suggests that native American infants leave the hospital healthy but go to unsafe environments, which decrease their chances of survival past 1 year. In particular, the poorer socioeconomic conditions that native American families experience and the related problems of alcoholism, unemployment, and family disorganization contribute to the high rate of postneonatal mortality. Intervention programs to lower native American postneonatal mortality should focus on promoting prompt recognition of and health seeking for treatable medical conditions and prevention of accidents and other postneonatal health problems. The roots of the problem of native American postneonatal mortality lie in the socioeconomic conditions of many Indian communities and cannot be addressed without recognition of how these factors combine with the health care delivery system to diminish life expectancy for native American infants.