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

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  • Hirai, A.H.
  • Hayes, D.K.
  • Taualii, M.M.
  • Singh, G.K.
  • Fuddy, L.J.

Abstract

Objectives. We identified potential determinants and cause-specific sources of excess infant mortality among Native Hawaiians. Methods. We compared infant mortality rates among Native Hawaiians and Whites by using data from the 2002 to 2009 Hawai'i State Linked Birth/Infant Death Cohort File. We evaluated the components of excess infant mortality by age and underlying cause of death as well as maternal sociodemographic, behavioral, and chronic condition disparities. Results. The Native Hawaiian infant mortality rate was more than twice that for Whites (7.9 vs 3.5/1000 live births). Excess Native Hawaiian infant mortality was equally apportioned to neonatal and postneonatal deaths. Preterm-related causes of death accounted for 43.9% of the infant mortality disparity, followed by sudden unexpected infant death (21.6%) and injury (5.6%). In multivariable models, maternal educational inequality accounted for the largest portion of the neonatal mortality disparity (20.9%); younger maternal age (12.2%) and smoking (9.5%) were the only significant contributors to the postneonatal mortality disparity. Conclusions. Addressing educational inequalities, promoting safe sleep practices, and reducing smoking among Native Hawaiian mothers would help to eliminate excess infant mortality. Copyright © 2013 by the American Public Health Association®.

Suggested Citation

  • Hirai, A.H. & Hayes, D.K. & Taualii, M.M. & Singh, G.K. & Fuddy, L.J., 2013. "Excess infant mortality among Native Hawaiians: Identifying determinants for preventive action," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 88-95.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301294_1
    DOI: 10.2105/AJPH.2013.301294
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    Cited by:

    1. Robert S Levine & Barbara A Kilbourne & George S Rust & Michael A Langston & Baqar A Husaini & Lisaann S Gittner & Maureen Sanderson & Charles H Hennekens, 2014. "Social Determinants and the Classification of Disease: Descriptive Epidemiology of Selected Socially Mediated Disease Constellations," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-6, November.
    2. Rachel Suss & Madison Mahoney & Kendall J Arslanian & Kate Nyhan & Nicola L Hawley, 2022. "Pregnancy health and perinatal outcomes among Pacific Islander women in the United States and US Affiliated Pacific Islands: Protocol for a scoping review," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-26, January.

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