Racial differences in birthweight-specific neonatal mortality in Alaska: 1987-1996.

OBJECTIVES: This study compared the neonatal mortality in the Alaska Native and non-native (primarily white) population in Alaska for a 10-year period (1987-1996).
METHODS: Natality, mortality, and cause of death data were obtained from the State of Alaska's Bureau of Vital Statistics (BVS). Birthweight-specific and preventable birthweight-specific mortality were analyzed for babies < 1500 grams, 1500-2499 grams, and > or = 2500 grams birthweight.
RESULTS: The low birthweight (LBW) and very low birthweight (VLBW) rates were similar for the Alaska Native and non-native populations. The neonatal mortality rate for the Alaska Native population was higher than for the non-native population (6.4 per 1,000 live births for Alaska Native vs. 4.1 for non-native for 1987-1991; 5.5 for Alaska Native vs. 3.5 for non-native for 1992-1996). Birthweight-specific mortality was higher in the Alaska Native population for all birthweight groups. The exclusion of non-preventable conditions accentuated the differences in mortality rates between the Alaska Native and non-native population for infants < 2500 grams birthweight.
CONCLUSION: The higher neonatal mortality in the Alaska Native population is associated with a higher overall and preventable birthweight-specific neonatal mortality. The differences are therefore likely to reflect differences in access to and quality of perinatal care.