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Racial differentials in American Indian- White American Postneonatal Mortality in the United States: evidence from cohort linked birth/infant death records

Laurens Holmes Jr (Global Epigenomic Research Analytics, Wilmington, Delaware, USA and The Public Health (MPH/MSPH) Program, Delaware State University, Dover, Delaware, USA)
Elias Malachi Enguancho (College of Engineering, San Diego State University, San Diego, California, USA)
Rakinya Hinson (Department of Epidemiology and Biostatistics, Institute of Public Health, Florida A&M University, Tallahassee, Florida, USA)
Justin Williams (Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA)
Carlin Nelson (School of Health Sciences and Public Policy, Walden University, Minneapolis, Minnesota, USA)
Kayla Janae Whaley (Rollins School of Public Health, Emory University, Atlanta, Georgia, USA)
Kirk Dabney (Public Health (MPH/MSPH) Program, Delaware State University, Dover, Delaware, USA)
Johnette Williams (Earlham College, Richmond, Indiana, USA)
Emanuelle Medeiros Dias (Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA)

International Journal of Human Rights in Healthcare

ISSN: 2056-4902

Article publication date: 5 December 2022

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Abstract

Purpose

Postneonatal mortality (PNM), which differs from infant and perinatal mortality, has been observed in the past 25 years with respect to the health outcomes of children. While infant and perinatal mortality have been well-evaluated regarding racial differentials, there are no substantial data on PNM in this perspective. The purpose of this study was to assess whether or not social determinants of health adversely affect racial/ethnic PNM differentials in the USA.

Design/methodology/approach

A cross-sectional, nonexperimental epidemiologic study design was used to assess race as an exposure function of PNM using Cohort Linked Birth/Infant Death Data (2013). The outcome variable assessed PNM, while the main independent variables were race, social demographic variables (i.e. sex and age) and social determinants of health (i.e. marital status and maternal education). The chi-square statistic was used to assess the independence of variables by race, while the logistic regression model was used to assess the odds of PNM by race and other confounding variables.

Findings

During 2013, there were 4,451 children with PNM experience. The cumulative incidence of PNM was 23.6% (n = 2,795) among white infants, 24.3% (n = 1,298) among Black/African-Americans (AA) and 39.5% (n = 88) were American-Indian infants (AI), while 21.3% (n = 270) were multiracial, χ2 (3) = 35.7, p < 0.001. Racial differentials in PNM were observed. Relative to White infants, PNM was two times as likely among AI, odds ratio (OR) 2.11 (95% confidence interval [CI] 1.61, 2.78). After controlling for the confounding variables, the burden of PNM persisted among AI, although slightly marginalized, adjusted odds ratio (aOR) 1.70, (99% CI 1.10, 2.65).

Originality/value

In a representative sample of US children, there were racial disparities in PNM infants who are AI compared to their white counterparts, illustrating excess mortality. These findings suggest the need to allocate social and health resources in transforming health equity in this direction.

Keywords

Acknowledgements

Funding: Emanuelle Dias is supported by University of Texas Health Science Center at Houston School of Public Health Cancer Education and Career Development Program – National Cancer Institute/NIH Grant T32/CA057712. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.'

Citation

Holmes Jr, L., Enguancho, E.M., Hinson, R., Williams, J., Nelson, C., Whaley, K.J., Dabney, K., Williams, J. and Dias, E.M. (2022), "Racial differentials in American Indian- White American Postneonatal Mortality in the United States: evidence from cohort linked birth/infant death records", International Journal of Human Rights in Healthcare, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJHRH-03-2022-0017

Publisher

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Emerald Publishing Limited

Copyright © 2022, Emerald Publishing Limited.

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