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Infant-Mortality Rate Hits New Low, C.D.C. Reports

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The infant-mortality rate for babies born in the United States dropped to a new low in 1989, 9.8 deaths per 1,000 live births, the U.S. Centers for Disease Control reported this month.

Although that figure is an improvement over the previous low of 10 deaths per 1,000 live births recorded in 1988, black babies are still far more likely to die before their first birthday than are white babies, the statistics show.

For white infants, the infant mortality rate in 1989 was 8.2 deaths for every 1,000 live births, an improvement over the 1988 rate of 8.5 per 1,000 births. For black babies, the outlook declined between 1988 and 1989, the study found. In 1988, 17.6 black infants died for every 1,000 births, rising to 17.7 deaths per 1,000 births in 1989.

White and black babies died due to different causes, the C.D.C. found. For white babies, the leading cause of death was birth defects, accounting for about 25 percent of all deaths.

In contrast, only about 12 percent of black babies died due to birth defects. Instead, the leading causes of death for black infants--accounting for about 15 percent of the deaths-were related to premature birth or low birthweight, generally defined as being less than 5 pounds, 5 ounces at birth.

In 1989, the risk of dying within the first year of life was 2.3 times greater for black infants than for white infants, the C.D.C. said.

The infant-mortality rate is one of the widest used indices of health in the United States.

While the rate declined rapidly during the 1970's, the rate of decline slowed markedly during the 1980's. In 1987, the latest year for which comparative data are available, the United States ranked 24th in the world in infant mortality, compared with 20th in 1980.

The C.D.C. said that current efforts to prevent infant mortality have focused on expanding access to prenatal care for poor women, mostly through expanding state Medicaid programs. Better prenatal care, the federal agency noted, is likely to have its greatest impact on preventing deaths not caused by birth defects.

The C.D.C. reported that pneumonia, influenza, and accidents are major causes of death for all children between the ages of 1 month and 11 months, and that all of them are largely preventable through programs that emphasize well-baby care and parenting skills.

In contrast, sudden-infant-death syndrome, the leading cause of death for babies more than a month old but less than a year old, needs to be the subject of additional research before more prevention strategies can be developed, the C.D.C. concluded.

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