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June, 2007

Highlights in Minority Health
& Health Disparities
October, 2006


     SIDS Awareness Month

SIDS is the sudden death of an infant less than one year of age that cannot be explained by information collected during a thorough investigation*.1  In 2003, the rate of SIDS for all races was 52.9 per 100,000 live births.2  SIDS is the third leading cause of infant mortality in the United States1 (accounting for 7.7% of all infant deaths)2 and the leading cause of death among infants 28Ė364 days.1
The cause of SIDS is currently unknown.3  Most SIDS deaths occur when a baby is between two and four months of age.4

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Although the overall rate of SIDS in the United States has declined by more than 50% since 1990, rates have declined less among non-Hispanic black and American Indian/Alaska Native (AI/AN) infants.1

Sudden Infant Death Syndrome (SIDS) Incidence
by Race and Hispanic Origin of the mother: U.S., 2003
(Rates per 100,000 live births)

All Populations 52.9
Non-Hispanic white 50.5
Non-Hispanic black 108.8
American Indian / Alaska Native (AI/AN) 124.0
Asian American or Pacific Islander (AAPI) 27.7
Total Hispanic / Latino 25.6
Total Hispanic / Latino 25.6
        Mexican 24.8
        Puerto Rican 53.1
        Central and South American 19.9

Source: National Vi25.6tal Statistics Report 54(16) May 3, 2006

  IN 2003
purple square SIDS rates were highest for AI/AN (124.0 per 100,000 live births) and non-Hispanic black mothers (108.8) Ė 2.5 and 2.2 times those for non-Hispanic white mothers (50.5), respectively.  SIDS rates for AI/AN and non-Hispanic black mothers were 2.3 and 2.1 times higher than for all mothers (52.9), respectively.2
purple square Among Hispanics/Latinos, the Puerto Rican SIDS rate (53.1 per 1,000) was 2.7 times higher than for Central and South Americans (19.9) and 2.1 times higher than for Mexicans (24.8).2

The SIDS rate for Mexican mothers was 51% lower, and for Central and South American mothers, 61% lower than the rate for non-Hispanic white mothers.2
purple square SIDS rates for Asian or Pacific Islander mothers (27.7) were almost one-half those for non-Hispanic white mothers (50.5).2   Among Asian/Pacific Islanders, the infant mortality rate was 2.8 times greater for mothers under 20 years old (10.8) than for mothers, ages 25-29 years old (3.9).5
  IN 2001
purple square In 2001, boys were about 1.3 to 1.4 times more likely to die from SIDS than girls in all race and ethnic groups (All races males: 64.0 per 100,000, females: 46.6; non-Hispanic white males: 59.3 females: 41.1; black males: 137.1 females: 108.3).6

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Several factors have been identified that increase an infantís risk for SIDS.
1. Tummy (prone) or side sleeping
Infants who are put to sleep on their tummy or side are more likely to die from SIDS than infants who sleep on their backs.
2. Soft sleep surfaces
Sleeping on a waterbed, couch, sofa, or pillows, or sleeping with stuffed toys has been associated with an increased risk for SIDS.
3. Loose bedding
Sleeping with pillows or loose bedding such as comforters, quilts, and blankets increases an infants risk for SIDS.
4. Overheating
Infants who overheat because they are overdressed, have too many blankets on, or are in a room that is too hot are at a higher risk of SIDS.
5. Smoking
Infants born to mothers who smoke during pregnancy are at increased of SIDS. Also, infants exposed to smoke at home or at daycare are more likely to die from SIDS.
6. Bed sharing
Sharing a bed with anyone other than the parents or caregivers and with people who smoke or are under the influence of alcohol or drugs, increases an infantís risk for SIDS. The safest place for an infant to sleep is in their own crib or other separate safe sleep surface next to the parent or caregiverís bed.
7. Preterm and low birth weight infants
Infants born premature or low birth weight are more likely to die from SIDS.3

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Health care providers don't know exactly what causes SIDS, but they do know certain things can help reduce the risk of SIDS:
1. Always place babies on their backs to sleep
Babies who sleep on their backs are less likely to die of SIDS than babies who sleep on their stomachs or sides.  Placing your baby on his or her back to sleep is the number one way to reduce the risk of SIDS.
2. Use the back sleep position every time 
Babies who usually sleep on their backs but who are then placed on their stomachs, like for a nap, are at very high risk for SIDS.  So it is important for babies to sleep on their backs every time, for naps and at night.
3. Place your baby on a firm sleep surface, such as a safety-approved* crib mattress covered with a fitted sheet
Never place a baby to sleep on a pillow, quilt, sheepskin, or other soft surface.
4. Keep soft objects, toys, and loose bedding out of your babyís sleep area
Donít use pillows, blankets, quilts, sheepskins, or pillow-like bumpers in your babyís sleep area.  Keep all items away from the babyís face.
5. Avoid letting your baby overheat during sleep
Dress your baby in light sleep clothing and keep the room as a temperature that is comfortable for an adult.
6. Think about using a clean, dry pacifier when placing your baby down to sleep
but donít force the baby to take it.  (If youíre breastfeeding, wait until your child is 1 month old, or is used to breastfeeding before using a pacifier.)


For more information on crib safety, visit

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CDC National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Reproductive Health (DRH) engages in the following activities to reduce SIDS:
purple square Revising the 1996 Guidelines for the Death Scene Investigation of Sudden, Unexplained Infant Deaths (SUID) and the Investigation Reporting Form (SUIDRF)
Accurate, consistent cause-of-death data is needed to monitor national trends in infant deaths, evaluate prevention programs, and conduct research that will ultimately lead to a reduction in these deaths. In order to achieve this aim, CDC is working to improve the quality of data collected at infant death scene investigations and of data recorded on death certificates.
purple square Developing Infant death scene investigation training materials
Of equal importance to revising the SUIDIRF is the need for training investigators and death certifiers in how to consistently collect data at the death scene and translate the investigation findings into a cause-of-death on the death certificate.
purple square SIDS Research
CDC is investigating reasons for the disparities in SIDS rates between minorities and white infants. Additionally, CDC is examining the trends in SIDS and other SUID to determine the extent to which changes in reporting cause-of-death explain the continued decline in SIDS rates.7

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Centers for Disease Control and Prevention (CDC)
  CDC's Office of Minority Health (OMH)
    Eliminate Disparities in Infant Mortality
  CDC's Sudden Infant Death Syndrome (SIDS) Home
  CDC's Reproductive Health Home
  National Immunization Program (NIP)
    SIDS and Vaccination
U.S. Department of Health and Human Service (HHS)
Office of Minority Health Resource Center (OMHRC)
    Infant Mortality/SIDS
Indian Health Service (IHS)
  SIDS Among American Indians and Alaska Natives
National Institutes of Health (NIH)
  Study Identifies SIDS Risk Factors Among American Indian Infants
  National Institute of Child Health and Human Development (NICHHD)
    SIDS "Back to Sleep" Campaign
    Babies Sleep Safest on Their Backs: Reduce the Risk of Sudden Infant Death Syndrome (SIDS)
    Targeting Sudden Infant Death Syndrome (SIDS): A Strategic Plan
    SIDS Fact Sheet
Medline Plus: SIDS
American Academy of Pediatrics

The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleep Environment, and New Variables to Consider in Reducing Risk

First Candle/SIDS Alliance

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  1. Centers for Disease Control and Prevention (CDC), Sudden Infant Death Syndrome (SIDS), SIDS: Home, 2006.
  2. CDC, National Center for Health Statistics (NCHS), National Vital Statistics Report (NVSR) 54(16) May 3, 2006.
  3. CDC, Sudden Infant Death Syndrome (SIDS), SIDS: Risk Factors, 2006.
  4. National Institutes of health (NIH), National Institute of Child Health and Human Development (NICHD), Fact Sheet: Sudden Infant Death Syndrome, 1997.
  5. U.S. Department of Health and Human Services (HHS), Office of Minority Health (OMH), Infant Mortality and Asians and Pacific Islanders, 2006  
  6. CDC, NCHS, NVSR,  Deaths: Leading Causes for 2001, 52(9), Nov. 7 2003.
  7. CDC, Sudden Infant Death Syndrome (SIDS), CDCís SIDS Activities, 2006.
  *. An investigation should include a complete autopsy, examination of the death scene, and a review of the clinical history.1

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