Differences in Neonatal Mortality Among Whites and Asian American Subgroups: Evidence From California

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Objective: To obtain information about health outcomes in neonates in 9 subgroups of the Asian population in the United States.

Design: Cross-sectional comparison of outcomes for births to mothers of Cambodian, Chinese, Filipino, Indian, Japanese, Korean, Laotian, Thai, and Vietnamese origin and for births to non-Hispanic white mothers. Regression models were used to compare neonatal mortality across groups before and after controlling for various risk factors.

Setting: All California births between January 1,1991, and December 31, 2001.

Participants: More than 2.3 million newborn infants.

Main Exposure: Racial and ethnic groups.

Main Outcome Measure: Neonatal mortality (death within 28 days of birth).

Results: The unadjusted mortality rate for births to non-Hispanic white mothers was 2.0 per 1000. The unadjusted mortality rate for births to Chinese and Japanese mothers was significantly lower (Chinese: 1.2 per 1000, P<.001 japanese:="" per="" p=".004)," and="" for="" births="" to="" korean="" mothers="" the="" rate="" was="" significantly="" higher="" infants="" of="" chinese="" observed="" risk="" factors="" explain="" differences="" in="" unadjusted="" data.="" cambodian="" japanese="" thai="" persist="" or="" widen="" after="" are="" considered.="" adjustment="" have="" lower="" neonatal="" mortality="" rates="" compared="" with="" born="" non-hispanic="" white="" odds="" ratios="" all="" ratio="">

Conclusions: There are significant variations in neonatal mortality between subgroups of the Asian American population that are not entirely explained by differences in observable risk factors. Efforts to improve clinical care that treat Asian Americans as a homogeneous group may miss important opportunities for improving infant health in specific subgroups.

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