June 12, 2017
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Decline in SUIDs, sleep-related infant deaths differ by race, ethnicity

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Although the rate of sudden unexpected infant death has declined in the United States following the Back-to-Sleep campaign — which encouraged supine sleeping positions for infants and avoidance of soft bedding — significant disparities remain between racial and ethnic groups, with death rates highest among the American Indian/Alaska Native population.

“Together, sudden unexpected infant death (SUID) accounts for more than 35% of postneonatal deaths,” Sharyn E. Parks, PhD, MPH, from the division of reproductive health at the CDC, and colleagues wrote. “Although SUID rates decreased dramatically immediately after the 1994 Back-to-Sleep campaign, they have remained relatively stable — 93.4 per 100,000 live births — since 2000.”

To observe the current impact of SUIDS following the Back-to-Sleep campaign for different races, including non-Hispanic whites, non-Hispanic blacks, Hispanics, American Indian/Alaska Natives and Asian/Pacific Islanders, researchers analyzed birth-infant death data collected between 1995 and 2013.

Parks and colleagues determined SUID rates for every 100,000 live births, and used non-Hispanic whites as a referent group to examine racial differences in SUID. The researchers then compared SUID rates for 1995-1997 and 2011-2013, with an emphasis on birth characteristics and racial and/or ethnic status.

According to study results, American Indian/Alaska Natives demonstrated the highest rate of SUIDs between 1995 and 2013, with a 0.5% annual decrease, followed by non-Hispanic blacks (0.7% annual decrease).

Although non-Hispanic blacks experienced a significant decrease in annual rates of SUID (0.7, 95% CI 0.42 to 0.96), the researchers did not observe a corresponding decline in death rate among non-Hispanic whites.

Asian/Pacific Islanders and Hispanics both exhibited a lower death rate when compared with non-Hispanic whites; in 2013, the researchers observed that the SUID rate for non-Hispanic whites was twofold higher than that of Hispanics and threefold higher than that of Asian/Pacific Islanders.

“What remains to be explored are the reasons for the disparities and how best to eliminate them,” Parks and colleagues wrote. “Perhaps public health campaigns to reduce SUID are not reaching certain races/ethnicities, not addressing the most important risk factors for these groups or not being framed in the most effective way to ensure uptake among diverse populations.” — by Katherine Bortz

Disclosure: The researchers report no relevant disclosures.