Reductions in Sudden Unexpected Infant Death Rates Differ by Race/Ethnicity

Summary and Comment |
May 15, 2017

Reductions in Sudden Unexpected Infant Death Rates Differ by Race/Ethnicity

  1. John D. Cowden, MD, MPH

The relative ranking of SUID rates by racial and ethnic group did not change between 1995 and 2013, but some groups had significantly larger reductions than others.

  1. John D. Cowden, MD, MPH

Although sudden unexpected infant death (SUID) rates fell sharply after the introduction of the Back to Sleep campaign, there continue to be racial/ethnic disparities. Researchers used national infant death data from 1995 to 2013 to evaluate annual SUID rates and secular trends by race/ethnicity. SUID cases included those coded as sudden infant death syndrome (SIDS), accidental suffocation or strangulation in bed, or other ill-defined or unspecified causes of death.

Between 1995 and 2013, SUID rates fell for all racial/ethnic groups, although reductions were statistically significant only in non-Hispanic blacks, Hispanics, and Asian/Pacific Islanders. Rates were highest for American Indian/Alaska Natives and non-Hispanic blacks throughout, but the gap between these groups and non-Hispanic whites shrank, as the reduction in non-Hispanic whites was relatively small. Hispanics and Asian/Pacific Islanders had the lowest rates, with an increasing advantage over non-Hispanic whites. In 2013, rates for American Indian/Alaska Natives and non-Hispanic blacks were over double the rate for non-Hispanic whites, whose rate was, in turn, almost double that of Hispanics and almost triple that of Asian/Pacific Islanders.

Comment

Safe sleep promotion in the newborn and infant period addresses SIDS risks associated with environmental factors and developmental vulnerability and might be tailored to specific racial/ethnic groups to continue closing gaps in SUID rates. Less understood is the possible biological variation among what we call races and ethnicities that also may underlie differences in SUID risk. As editorialists note, non-Hispanic blacks, the group that has been least likely to adopt safe sleep practices, had the largest reduction in SUID rate. We should take heart that rates are falling, but be attentive to new developments in SUID science (e.g., genetic vulnerability) that may alter our clinical approach in the future.

Editor Disclosures at Time of Publication

  • Disclosures for John D. Cowden, MD, MPH at time of publication Leadership positions in professional societies Academic Pediatric Association (Co-Chair, Culture, Ethnicity, and Health Care Special Interest Group)

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