Racial and ethnic disparities of sudden unexpected infant death in large US cities: a descriptive epidemiological study

Abstract

Background Sudden unexpected infant death (SUID) accounts for ~ 3400 deaths per year in the USA, and minimal progress has been made in reducing SUID over the past two decades. SUID is the sudden death of an infant that has occurred as a result of accidental suffocation in a sleeping environment, SIDS (sudden infant death syndrome), or from an unknown cause of death. Nationally, non-Hispanic Black (NHB) infants have twice the risk of SUID compared to non-Hispanic White (NHW) infants. In Chicago, this disparity is greatly magnified. To explore whether this disparity is similarly seen in other large cities, we analyzed SUIDs by race and ethnicity for a seven-year period from the 10 most populous US cities. SUID case counts by race and ethnicity were obtained for 2011–2017 from the 10 most populous US cities based on 2010 census data. For each city, we calculated average annual SUID rates (per 1000 live births) by race and ethnicity, allowing calculation of disparity rate ratios. Findings Nationally, from 2011 through 2017, there were 0.891 SUIDs per 1000 live births, with a rate of 0.847 for NHWs, 1.795 for NHBs, and 0.522 for Hispanics. In most study cities, the NHB and Hispanic SUID rates were higher than the corresponding national rate. Hispanic SUID rates were higher than NHW rates in 9 of the 10 largest cities. In every study city, the NHW SUID rate was lower than the national NHW rate. In Chicago, NHB infants had a SUID rate 12.735 times that of NHW infants. Conclusion With few exceptions, the 10 largest US cities had higher NHB and Hispanic SUID rates, but lower NHW SUID rates, compared to the corresponding rates at the national level. Unlike the national pattern, Hispanic SUID rates were higher than NHW rates in 9 of the 10 largest cities. Prevention is currently hampered by the lack of detailed, accurate, and timely information regarding the circumstances of these tragic deaths. A national SUID surveillance system would allow greater understanding of the factors that lead to this disproportionately distributed and enduring cause of infant death.

Pre- and postnatal safe sleep knowledge and planned as compared to actual infant sleep practices

“…For example, a meta-analysis found bed sharing to have a nearly three times greater risk of SIDS (Vennemann et al 2012 ) and adults sharing beds with infants is more common among African American families (Bombard et al 2018 ). Hispanic families also have higher proportions of bed sharing with infants (Parks et al 2017 ), and although the national rate of SUID for Hispanic infants is almost half that of non-Hispanic Whites (Parks et al 2017 ), a recent study showed that they had SUID rates higher than non-Hispanic White infants in 9 of the 10 largest US cities (Boyer et al 2022 ).…”

Multiomic Analysis of Neuroinflammation and Occult Infection in Sudden Infant Death Syndrome

“…Specimens were identified in the database as belonging to the following race and ethnicity categories: Asian, Black, Hispanic, multiracial, White, and unknown. Race and ethnicity information was obtained from autopsy reports because certain races and ethnicities (eg, African American, American Indian) are known risk factors for SIDS . The research was performed in accordance with Boston Children’s Hospital institutional review board.…”

“…Race and ethnicity information was obtained from autopsy reports because certain races and ethnicities (eg, African American, American Indian) are known risk factors for SIDS. 5,6 The research was performed in accordance with Boston Children's Hospital institutional review board. A case report Health Insurance Portability and Accountability Act waiver was obtained owing to the use of deidentified patient information.…”

Unexplained and Unexpected Pediatric Deaths: Forensic Review and New Perspectives

“…In 2020, the infant mortality rate in the United States was calculated at 541.9 deaths per 100,000 births [1]. Sudden unexpected infant death (SUID) deaths amount to approximately 3400 per year in the United States alone [2]. A variable rate has been described from country to country in the world.…”