SIDS Program Manual SIDS & Infant Death Program Manual and Trainer's Guide Trainer's Guide

What is SIDS?

SIDS Racial Disparities


Native Americans

SUID/SIDS Rates. The decline in SIDS has also not been as significant for Native Americans in certain areas of the United States. The leading cause of infant mortality among Native American infants is SIDS.30 The Indian Health Service (IHS) reports that in IHS service areas, the SIDS rate averages 2.3 times the U.S. rate for all races and three times the rate for Whites. SIDS is responsible for 21.9 percent of all infant deaths reported by IHS. However, in some IHS service areas, the percentage of SIDS deaths is much higher, ranging from 24.1 percent to 35.2 percent.31 It is well-documented that overall, Native Americans have one of the highest rates of infant mortality among any racial or ethnic group in this country.

Prevalence of Risk Factors. Several studies have found that there was no evidence of significant interaction between risk variables and ethnicity. It appears that the high rate of SIDS deaths among Native Americans is due to the high prevalence of risk factors in the population and not an intrinsic risk based on Native American race. These risk factors include unsafe sleep practices, smoking, late or no prenatal care, maternal alcohol use and binge drinking during pregnancy. Native American women have the highest rates of smoking compared to any other race/ethnic group.32,33

Within Native American populations, certain nationalities/tribes are also more likely to place infants to sleep on their stomachs than other nationalities/tribes.34

In December 1992, the Aberdeen Area Infant Mortality Study35 was created to examine why Northern Plains Indian infants were at a greater risk for SIDS. The study was funded by NICHD, IHS and the CDC. The results of the study highlighted areas of Native American family health that could be improved.

The study revealed the positive impact of public health nurses’ visits to Northern Plains Indian women before and after they gave birth in reducing the risk of infants’ death. Infants who lived in homes where a public health nurse visited, before or after birth, were 80 percent less likely to die from SIDS than infants in homes not visited.

The study also found that:

  • Binge drinking (five or more drinks at a time) during a mother’s first trimester of pregnancy made it eight times more likely that her infant would die from SIDS.
  • Any maternal alcohol use during the periconceptional period (three months before pregnancy or during the first trimester) was associated with a six-fold increased risk of SIDS.
  • Infants wearing more than two layers of clothing had more than a six-fold increased risk of dying from SIDS.