Infant Mortality Among Non-Hispanic Asian Subgroups in the United States, 2018–2020

Infant mortality is an indicator of overall national health (1,2). Infants of non-Hispanic Asian women have among the lowest infant mortality rates (IMRs) of all race and Hispanic-origin groups (3–5). However, few recent studies address infant mortality across Asian subgroups. This report compares infant, neonatal, and postneonatal mortality rates for infants of all U.S. women, all non-Hispanic Asian women, and women in the five largest Asian subgroups for 2018–2020.

The IMR for infants of non-Hispanic Asian women (3.39) was lower than the U.S. rate (5.56) (Figure 1 and Table). IMRs for infants of Filipino (4.52), Vietnamese (3.62), and Asian Indian (3.57) women were higher than those for infants of Korean (2.43) and Chinese (1.96) women. The IMR for infants of Filipino women was higher than the rates for other subgroups but lower than the overall U.S. rate.

The neonatal mortality rate for infants of non-Hispanic Asian women (2.50) was lower than the overall U.S. rate (3.68) (Figure 2 and Table). The neonatal mortality rate for infants of Filipino women (3.35) was higher than rates for all other subgroups. Rates for infants of Asian Indian (2.75) and Vietnamese (2.54) women were higher than that for infants of Chinese women (1.46). The rate for infants of Asian Indian women was higher than that for infants of Korean women (1.56).

The postneonatal mortality rate for infants of non-Hispanic Asian women (0.89) was less than one-half of the overall U.S. rate (1.88) (Figure 2 and Table). The postneonatal mortality rate for infants of Filipino women (1.17) was higher than those for infants of Asian Indian (0.82) and Chinese (0.50) women. Infants of Asian Indian and Vietnamese (1.08) women had higher postneonatal mortality rates than infants of Chinese women.

Data source and methods

This report uses data from the linked birth/infant death data file from the National Vital Statistics System (3), which includes all infant deaths under age 1 year reported on death certificates and all births reported from birth certificates. It is the only source for examining infant mortality by maternal race and Hispanic origin and factors related to birth (3,6). IMRs are the number of deaths to infants under 365 days per 1,000 live births. Neonatal mortality rates are the number of deaths to infants aged 0–27 days per 1,000 live births. Postneonatal mortality rates are the number of deaths to infants aged 28–364 days per 1,000 live births.

Race and Hispanic origin are self-reported by the mother on the birth certificate (7). The race and Hispanic-origin groups shown in this report follow the 1997 Office of Management and Budget standards (8). Due to small counts of infant deaths, infants of other Asian subgroups are not shown. References to differences indicate statistically significant differences at the 0.05 level using a two-tailed z test.

The text, table, and figures show the total U.S. rate. Statistical testing between non-Hispanic Asian rates and the U.S. rate excludes the non-Hispanic Asian contribution to the U.S. rate.

References

1. Jacob JA. US infant mortality rate declines but still exceeds other developed countries. JAMA 315(5):451–2. 2016.
2. MacDorman MF, Mathews TJ, Mohangoo AD, Zeitlin J. International comparisons of infant mortality and related factors: United States and Europe, 2010. National Vital Statistics Reports; vol 63 no 5. Hyattsville, MD: National Center for Health Statistics. 2014.
3. Ely DM, Driscoll AK. Infant mortality in the United States, 2020: Data from the period linked birth/infant death file. National Vital Statistics Reports; vol 71 no 5. Hyattsville, MD: National Center for Health Statistics. 2022.
4. Baker LC, Afendulis CC, Chandra A, McConville S, Phibbs CS, Fuentes-Afflick E. Differences in neonatal mortality among whites and Asian American subgroups: Evidence from California. Arch Pediatr Adolesc Med 161(1):69–76. 2007.
5. Morrow HW, Chavez GF, Giannoni PP, Shah RS. Infant mortality and related risk factors among Asian Americans. Am J Public Health 84(9):1497–500. 1994.
6. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2020. National Vital Statistics Reports. Hyattsville, MD: National Center for Health Statistics. 2023. [Forthcoming].
7. National Center for Health Statistics. User guide to the 2020 natality public use file. 2021.
8. Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Fed Regist 62(210):58782–90. 1997.

Suggested citation

Ely DM, Driscoll AK. Infant mortality among non-Hispanic Asian subgroups in the United States, 2018–2020. NCHS Health E-Stats. 2022. DOI: https://dx.doi.org/10.15620/cdc:122451.

Figures

Figure 1. Mortality rates among infants of all women and non-Hispanic Asian women: United States, 2018–2020

¹Significantly higher than rates for all other groups (p < 0.05).
²Significantly higher than rates for all other subgroups (p < 0.05).
³Significantly higher than rates for Korean and Chinese groups (p < 0.05).

SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file.

Figure 2. Neonatal and postneonatal mortality rates among infants of all women and non-Hispanic Asian women: United States, 2018–2020

¹Significantly lower than rate for total United States (p < 0.05).
²Significantly higher than rate for Asian Indian group (p < 0.05).
³Significantly higher than rate for Chinese group (p < 0.05).
⁴Significantly higher than rates for all other subgroups (p < 0.05).
⁵Significantly higher than rate for Korean group (p < 0.05).

SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file.

Table

Table. Infant, neonatal, and postneonatal mortality rates for infants of all women and non-Hispanic Asian women: United States, 2018–2020