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Access to Health Care in America
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a Deaths before the age of one year.
b Provisional infant mortality rates based on a 10 percent sample. The 1897 provisional rate was 10 percent (versus a 10.1 percent final rate ). The 1988 provisional rate was 9.9 percent (versus a 10.0 percent final rate).
c Deaths at less that 28 days.
d Deaths from 28 days to one year of age.
SOURCES: For 1970–1988 data, National Center for Health Statistics (1990a); for 1989–1990 data, National Center for Health Statistics (1990b).
was less than 3 percent. The average rate of decline during the 1980s was well below the 4.7 percent experienced during the 1970s.
As the table shows, the past 20 years have also seen a dramatic decrease in the neonatal mortality rate, from 15.1 per 1,000 live births in 1970 to a provisional 5.7 per 1,000 in 1990. Over the same period, the decline in the postneonatal rate was less striking; it fell from 4.9 percent to a provisional 3.3 percent. During the 1980s, a 28 percent reduction occurred in the overall infant mortality rate, with the greatest decrease (33 percent) arising from improved neonatal mortality rates and the smallest (19 percent) stemming from improvements in postneonatal mortality. The comparable figures for the 1970s were 37 percent, 44 percent, and 16 percent for improvements in overall mortality, neonatal mortality, and postneonatal mortality, respectively.
A striking aspect of infant mortality data is the contrast between the white and black populations. As Table 3-5 shows, infant mortality rates for blacks are much higher than for whites. The absolute differences in rates between the races have narrowed, from approximately 15 more black deaths per 1,000 live births in 1970 to approximately 9 more deaths in 1988; however, the ratio of black to white infant deaths has increased substantially. In 1970 blacks were 85 percent more likely than whites to die during the first year after birth. By 1988 black infants were more than twice as likely as whites to die during their first year. In 1970 blacks were 65 percent more likely than whites to die during the first month after birth; by 1988 they were more than twice as likely to die. In 1975 blacks were twice as likely as whites to die during the postneonatal period, a difference that remained largely unchanged through 1988.
Table 3-6 provides data on infant mortality according to the race or ethnicity of the mother. The data are derived from the linked birth and death records for 1983–1985. Using linked birth and death records addresses the inconsistencies between the information on the two records. Although this information is quite constant for blacks and whites, it can vary