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Young mothers are particularly likely to enter prenatal
care late in pregnancy, and the children of teenage
mothers are more likely to face economic, health,
and developmental challenges. Another area in which
we have seen progress, however, is in the rate of
births to adolescent women. According to preliminarydata
for 2001, the birth rate among adolescents was 46
births per 1,000 women aged 15-19, a record low. However,
again, teen birth rates are much higher within minority
groups: for African Americans, the adolescent birth
rate in 2001 was 73 births per 1,000 women 15-19,
and for Hispanics, the rate was 92 births per 1,000
women.
Another area in which the U.S. has shown consistent
progress is reducing the rate of infant mortality,
the death of children in the first year of life. In
2000, preliminary data show an infant mortality rate
of 6.9 deaths per thousand live births, the lowest
rate yet recorded in the United States. However, the
rate of death among black infants of 14 deaths per
thousand live births is still 2.5 times higher the
rate among white infants, and this disparity has not
decreased. The rate of neonatal mortality, the death
of infants during their first 28 days after birth,
is now 4.6 deaths per thousand live births, a decline
of 2.5 percent from the rate reported in 1999. The
leading causes of neonatal mortality, or death in
the first 28 days of life, are birth defects and disorders
related to short gestation (preterm delivery) and
low birth weight. The leading causes of postneonatal
mortality, or death between 28 days and 1 year of
age, are Sudden Infant Death Syndrome, or SIDS, and
birth defects. The rate of SIDS has dropped dramatically
in the past five years, as parents and caregivers
have learned about the importance of putting infants
down to sleep on their backs. Despite these significant
improvements, however, the United States still ranks
28th among developed nations in its rate of infant
mortality, reflecting the progress that remains to
be made.
The health and developmental prospects of infants
are also reflected in the rate of low and very low
birth weight. Babies born at low birth weight (less
than 2500 grams, or 5.5 pounds) are most susceptible
to physical disabilities, developmental delays, and
infant death. Despite improvements in the use of prenatal
care, the rate of low birth weight has actually risen
in recent years; the rate reported in 2000 was 7.6
percent of all live births, which is unchanged from
the rate in 1999 and is similar to rates reported
thirty years ago. However, the causes of these low
birth weight rates appear to be changing. The recent
increases in the low birth weight rates, at least
among white women, can be attributed in part to increases
in the rate of multiple births, as twins and triplets
are at particular risk for being small at birth.
Infant health and development can be greatly benefitted
by breastfeeding, and the rate of breastfeeding continues
to rise. Breast milk has a number of preventive health
benefits for both mother and child. The benefits of
breastfeeding include prevention of diarrhea and infections
in infants, as well as long-term preventive effects
for the mother, including earlier return to pre-pregnancy
weight and reduced risk of premenopausal breast cancer
and osteoporosis. In 2000, more than 68 percent of
mothers reported breastfeeding their babies right
after delivery, the highest rate yet reported. However,
rates of breastfeeding decline dramatically after
the initial months of life, and only 31 percent report
that they are still breastfeeding their infants at
6 months of age. These rates are even lower among
African American women; 51 percent of African American
women report breastfeeding in the hospital, and only
21 percent breastfed at 6 months.
Immunization is another critical preventive health
service. The percentage of children who receive a
full series of immunizations—including those
for measles, mumps, rubella (German measles), polio,
diphtheria, tetanus, pertussis (whooping cough), and
Haemophilus influenzae type b, the bacterium that
causes meningitis—was reported to be 74 percent
in 2001, a slight increase from the rate reported
in 2000. However, significant progress is still needed
to reach the goal of immunizing at least 90 percent
of children by their second birthday, and some states
are even farther from this goal than the nation as
a whole.
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