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U.S. Posts Lowest-Ever Infant Mortality Rate : Health: Officials caution that the rate of improvement has slowed. Black infants still have a death rate twice that of white babies.

TIMES STAFF WRITER

The 1989 infant mortality rate in the United States was the lowest in its history, Health and Human Services Secretary Louis W. Sullivan announced Thursday, but he warned that “we must do better.”

The rate was 9.7 per 1,000 live births, 2% lower than the previous year, the department said. However, federal health officials and other analysts emphasized that the rate of decline in recent years has slowed, particularly for black infants, who have a mortality rate twice that of white babies.

For a number of years, global studies have shown the United States to be falling behind the pace other nations are setting in reducing infant mortality. In March, the National Commission to Prevent Infant Mortality found that the United States had fallen to 20th place among developed countries, while Japan had moved into first place with 5.0 deaths per 1,000 live births, a rate nearly half that in this country.

“Although we’ve made progress in reducing this nation’s infant mortality, we must do better,” Sullivan said in a statement. “In particular, we must continue to direct prevention, education and health care opportunities to our minority and poor citizens, where infant mortality strikes hardest.”

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The 1989 preliminary data, released by the National Center for Health Statistics, showed also that life expectancy at birth reached a record high of 75.2 years.

Dr. Diane Rowley, a pediatrician/epidemiologist with the federal Centers for Disease Control, who specializes in infant health, cautioned that the infant mortality numbers--although the lowest ever recorded--fell short of expectations.

“It’s hard to look at one year and say we think we’ve turned things around,” she said. “Most of us would want to have at least two or three years of very good numbers to feel confident that we’re seeing a real improvement.”

The overall target rate for 1990 had been 9 deaths per 1,000 live births, which the latest figures now suggest is unlikely, she said.

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“I suppose it’s possible to achieve that, but I don’t think the majority of states in the United States will be at 9 by next year,” she said.

Further, she added, “one of the other measures we look at is low birth weight--because at least 40% of infants who die weigh less than 5 pounds, 8 ounces. And the trend for low birth weight has not gotten better. For black infants, the low birth weight trend has gone up. So that makes it somewhat unlikely we will achieve major improvements over the next year or two.”

Rae K. Grad, executive director of the National Commission to Prevent Infant Mortality, agreed.

“I’m always happy when fewer babies die, and clearly that’s what’s happened,” she said. “Fewer babies died last year in the United States--this is good news. But at what price? The babies who are being saved now are being saved through high technology rescue methods, as opposed to investing in prevention--prenatal care--which is low cost, and it works. And it works better if it’s applied across the board, (rather) than an episodic, high-tech rescue.

“We’d like to see the emphasis change from an after-the-fact strategy to a before-the-fact strategy so we can save money and save lives,” Grad added. “And that is what will truly turn these numbers around.”

The health service said also that its findings indicated a continuing reduction in death rates for certain diseases, including heart disease and stroke. Deaths from AIDS, however, rose to become the 11th leading cause of death, up from 15th place, the report said.

Diabetes continued to rank as the seventh leading cause of death in 1989, with about 47,000 deaths for that year, the health service said. Deaths from that disease were up “markedly” from the previous year, in contrast to the relatively stable rates for diabetes during the rest of the 1980s, it said said.

Heart disease, cancer, stroke and accidents, the four leading causes of death in the United States, accounted for almost 70% of the estimated 2,155,000 deaths in 1989, the department said.

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