Indiana Highlights
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Between 1990 and 2003, the infant mortality rate (IMR) in
Indiana declined by 23.2 percent from 9.5 to 7.3 deaths per 1,000 live births.
(Table 1,
Figure 1)
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Among infants born to black mothers, the IMR has been
consistently higher than among infants born to white mothers, and the wide
racial gap persisted throughout the 1990-2003 period. In the 2001-2003 period,
the IMR among blacks (or non-Hispanic blacks) was 13.4 deaths per 1,000 live
births, double the rate of 6.7 among whites (or non-Hispanic whites). Among
Hispanics, however, the IMR followed a pattern similar to non-Hispanic whites.
(Table 7,
Figure 2)
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The majority of infant deaths occurred during the neonatal
period (<28 days). Both neonatal and postneonatal (28-364 days) mortality
rates declined during the period of 1990-2003, with a diminishing racial gap
in neonatal but not in postneonatal mortality rates.
(Table 7,
Figure 3,
Figure 4,
Figure 5)
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Between the two five-year periods of 1990-1994 and 1999-2003,
the neonatal mortality rates declined significantly among whites (by 9.7%) and
among blacks (by 23.1%) but not among Hispanics. In contrast, postneonatal
mortality rates declined significantly among Hispanics (by 52.8%) and among
whites (by 24.8%) but not significantly among blacks (by 14.8%).
(Table 13,
Figure 6,
Figure 7)
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The IMR declined among both female and male infants. The male
infants, however, had a consistently higher IMR than female infants among all
races combined, as well as among whites, blacks, and Hispanics.
(Table 8,
Table 9,
Table 10,
Table 11,
Table 12,
Figure 8,
Figure 9)
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For the three-year period 2001-2003, the IMR of multiple
births was 36.4 deaths per 1,000 live births, more than five times the rate of
6.4 among singleton births, with a downward trend since 1990-1992 for both
singleton and multiple births.
(Table 8,
Figure 10)
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The IMR of singleton and multiple births declined among both
whites and blacks, however there is more of a narrowing trend in racial
disparity among multiples than among singletons.
(Table 9,
Table 10,
Table 15,
Table 16,
Figure 11)
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For the five-year period 1999-2003, the IMR of Hispanic
singleton births was 5.2 deaths per 1,000 live births, 12 percent lower than
the rate among non-Hispanic white singletons, whereas the IMR of Hispanic
multiple births was 48.5 deaths per 1,000 live births, 53 percent higher than
the rate of 31.8 among non-Hispanic whites.
(Table 17,
Table 18,
Figure 12)
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In 2003, the IMR of low birth-weight (LBW) infants (<2,500
grams) was 57.4 deaths per 1,000 live births, more than 22 times the IMR of
2.6 among normal birth-weight (NBW) infants (≥2,500 grams). The IMR of very
low birth-weight (VLBW) infants (<1,500 grams) was 239.2 deaths per 1,000
births, more than 90 times the rate among NBW infants.
(Table 2,
Figure 13)
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There has been a downward trend in IMR among all birth-weight
categories for both whites and blacks. Infants born to black mothers had a
consistently higher IMR than infants born to white mothers for VLBW, LBW and
NBW infants, but the racial gap was wider among those with NBW than those with
LBW or VLBW.
(Table 9,
Table 10,
Table 12,
Figure 14,
Figure 15,
Figure 16)
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Between 1990-1994 and 1999-2003, the decline in IMR was
statistically significant for LBW, VLBW, and NBW infants born to white as well
as to black mothers. Among Hispanics, however, the decline in the IMR was
statistically significant only among NBW infants.
(Table 14,
Table 15,
Table 16,
Table 17,
Table 18,
Figure 17,
Figure 18,
Figure 19)
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Among VLBW infants, the IMR was similarly high among all races
and Hispanic origins, with slightly higher rates among blacks compared to
whites and Hispanics. In contrast, among NBW infants, there was a wide racial
and ethnic disparity in the IMR, with the lowest rate of 1.8 deaths per 1,000
live births for Hispanics followed by a rate of 2.5 for whites (2.6 for
non-Hispanic whites) and 4.6 for blacks.
(Table 15,
Table 16,
Table 17,
Table 18)
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During the three-year period 2001-2003, the IMR of preterm
infants (<37 weeks of gestation) was more than 12 times the IMR of term
infants (≥37 weeks of gestation) and the IMR of very preterm infants (<32
weeks of gestation) was more than 62 times the IMR of term infants. The
mortality rates of both preterm and term infants have declined since 1990
among whites, blacks, and Hispanics. However, the mortality rates were
consistently higher among blacks than among whites and Hispanics for both
preterm and term births.
(Table 8,
Table 9,
Table 10,
Table 11,
Table 12,
Figure 20,
Figure 21,
Figure
22)
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Despite the decline in the IMR of LBW and preterm infants
between 1990 and 2003, the prevalence of birth of these high-risk infants has
not improved during this period. Between 1990 and 2003, the prevalence of
preterm births increased by 38 percent among whites, remained at the same high
level among blacks, and increased slightly among Hispanics.
(Data extrapolated from Table A-3,
Table A-4, and
Table A-6,
Figure 23)
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Although the IMR has declined among both age groups,
throughout the 1990-2003 period, infants born to teenage mothers (<20 years of
age) had a higher IMR than infants born to adult mothers (≥20 years of age).
The gap between the IMR of these two age groups, however, is more distinct
among whites than among blacks.
(Table 8,
Table 9,
Table 10,
Figure 24)
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Among infants born to white mothers in the age groups 18-19,
20-24, 25-29, and 30-34 years, the IMR decreased as mother’s age increased;
whereas among infants born to black mothers in the same age categories, the
IMR did not follow a specific pattern. For both races, the IMR was higher
among infants born to mothers aged 35 years and older than among infants born
to mothers in their late 20s.
(Table 15,
Table 16,
Figure 25)
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During the five-year period 1999-2003, the IMR among infants
born to non-Hispanic white teenage mothers was higher than the IMR among
infants born to mothers aged 35 years and older. In contrast, for Hispanics
and blacks, the IMR was higher among infants born to mothers aged 35 years and
older than among infants born to teenage mothers.
(Table 16,
Table 17,
Table 18,
Figure 26)
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In general, the IMR decreased as the maternal educational
level increased, but this pattern is more noticeable among whites than among
blacks.
(Table 8,
Table 9,
Table 10,
Figure 27,
Figure 28)
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The IMR among infants born to mothers with more than high
school education was lower than the IMR among infants born to less educated
mothers, regardless of race and Hispanic origin.
(Table 10,
Table 11,
Table 12,
Figure 29)
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In the three-year period 1990-1992, the IMR among infants born
to mothers with less than 12 years of education (ages ≥20 years) was 20.3 per
1,000 live births among blacks, 93 percent higher than the rate among their
non-Hispanic white counterparts (10.5), whereas in 2001-2003, the IMR of
blacks in the same category (13.4) was 41 percent higher than the rate among
non-Hispanic whites (9.5). This indicates that, although racial disparity in
IMR continues to exist, its magnitude has diminished with time among this
category of infants.
(Table 10,
Table 11,
Table 12,
Figure 30)
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Throughout the 1990-2003 period, the IMR rate was higher among
infants born to unmarried mothers than among infants born to married mothers,
and the rates declined among both groups. The higher IMR among infants born to
unmarried compared to married mothers, however, was more noticeable among
non-Hispanic whites than among blacks and Hispanics.
(Table 10,
Table 11,
Table 12,
Figure 31,
Figure 32)
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The infant mortality rates were higher among infants born to
women who received adequate plus or intensive care than among infants born to
women who received adequate or less than adequate care. In 1999-2003, the IMR
among infants born to mothers who received inadequate prenatal care was higher
than the IMR among infants corn to mothers who had adequate care by 103
percent among non-Hispanic whites (7.1 vs. 3.5), by 46 percent among blacks
(10.1 vs. 6.9), and by 24 percent among Hispanics (4.1 vs. 3.3).
(Table 16,
Table 17,
Table 19,
Figure 33)
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In 2003, the IMR among infants born to mothers who smoked
during pregnancy was 10.7 per 1,000 live births, 65 percent higher than the
rate of 6.5 among infants born to non-smokers. Between 1990-1994 and
1999-2003, the IMR among infants born to non-smokers declined significantly
among both whites and blacks, whereas the IMR among infants born to smokers
did not change significantly. The racial gap in IMR persisted regardless of
the smoking status of mother.
(Table 2,
Table 15,
Table 16,
Figure 34)
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In general, the racial disparity in IMR was present regardless
of the characteristics of the mother and infant. The gap, however, was wider
among those who were in a lower risk category compared to those in a higher
risk category, e.g., singletons compared to multiple births, normal birth
weights compared to low birth weights, mothers in their late 20s compared to
teenagers, more educated compared to less educated mothers, or married mothers
compared to those who were unmarried.
(Figure 35,
Figure 36,
Figure 37,
Figure 38)
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The overall IMR of Hispanics was similar to non-Hispanic
whites. However, for those with one or more potential demographic risk factors
(mother being a teenager, without a high school diploma, or unmarried),
Hispanics had a lower IMR than their non-Hispanic white counterparts. In
contrast, among those with a higher risk birth, e.g., multiple births compared
to singleton births, the IMR of Hispanics was higher than the IMR of
non-Hispanic whites.
(Figure 35,
Figure 36,
Figure 37,
Figure 38)
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