Cathy: Thanks for that well written thoughtful explanation of your
interpretation of Rogan's study. I must politely say that I disagree. For
one, the infant mortality rate that you quote is not correct. In 1989, the
National Center for Health Statistics say the US infant mortality rate was
9.4/1000. Even in 1983, the infant mortality rate was already down to 10.9
in the US (according to NCHS). Where did you get the 15/1000 infant
mortality rate? In 1989 I was working for NCHS as a UCLA on site
post-doctoral research collaborator for the National Health Interview
Survey). I don't have time at the moment to go into great detail as to why,
but I will tell you that the models are not as linear as you are implying.
The fractiled mortality is much more compounded than can be explained in a
few paragraphs.
I do understand the danger of possibly misrepresenting the power of
breastmilk, but as long as ILCA continues to publish M. Walker's HAZARDS OF
INFANT FORMULA, I will use it because taken altogether, it is a very
powerful piece. If you feel strongly about this, why have you not suggested
to ILCA that they pull it from Marsha Walker's HAZARDS OF INFANT FORMULA
piece?
From the USDHHS Information about the National Vital Statistics System is
available online at http://www.cdc.gov/nchs/nvss.htm
"Due in part to long-standing medical research and social services supported
by HHS, infant mortality has declined considerably in recent decades. Over
the past twenty-five years alone, the infant mortality rate has dropped from
20 deaths per 1,000 live births in 1970 to less than 8 deaths per 1,000 live
births in 1996.
* Infant mortality dropped to 7.2 deaths per 1,000 live births in 1996,
down 4 percent since 1995 and nearly 22 percent since 1990. Declines
occurred among both neonates (infants under 28 days of age) and postneonates
(infants aged 28 days to 12 months)."
Infant Mortality Rates
The U.S. infant mortality rate was 7.2 per 1,000 live births, tying 1997's
record low. However, that statistic represents 28,486 infant deaths and
compares unfavorably with the rate in other developed nations. Sweden, for
example had a rate of 3.6, Japan had a rate of 3.7, and Germany had a rate
of 4.9. Even so, the U.S. mortality rate has declined by more than 40
percent since 1980. New Hampshire had the lowest rate at 4.3 deaths per
1,000 live births. The District of Columbia had the highest at 13.2, and
Mississippi was the next highest at 10.6. "
National Health Interview Survey
The National Health Interview Survey (NHIS) is a continuing nationwide
sample survey of the civilian noninstitutionalized population in which data
are collected by personal household interviews. Interviewers obtain
information on personal and demographic characteristics, including race and
ethnicity, by self-reporting or as reported by an informant. Investigators
also collect data about illnesses, injuries, impairments, chronic
conditions, activity limitation caused by chronic conditions, utilization of
health services, and other health topics. Each year the survey is reviewed
and special topics are added or deleted. For most health topics, the survey
collects data over an entire year.
The NHIS sample includes an oversample of black and Hispanic persons and is
designed to allow the development of national estimates of health
conditions, health service utilization, and health problems of the U.S.
civilian noninstitutionalized population. The response rate for the ongoing
part of the survey has been between 94 and 98 percent over the years. In
1997, the NHIS was redesigned, so some estimates are likely to vary slightly
from previous years. Interviewers collected information for the basic
questionnaire on 103,477 persons in 1997, including 29,792 children.
Descriptions of the survey design, the methods used in estimation, and the
general qualifications of the data are presented in:
Massey, J.T., Moore, T.F., Parsons, V.L., and Tadros, W. (1989). Design and
estimation for the National Health Interview Survey, 1985-1994. Vital and
Health Statistics, 2 (110). Hyattsville, MD: National Center for Health
Statistics.
Adams, P.F., Hendershot, G.E., and Marano, M.A. (1999). Current estimates
from the National Health Interview Survey, 1996. Vital and Health
Statistics, 10 (200). Hyattsville, MD: National Center for Health
Statistics.
Information about the NHIS is available online at
http://www.cdc.gov/nchs/nhis.htm
Agency Contacts:
For information on activity limitations and general health status:
Laura Montgomery
National Center for Health Statistics
Phone: (301) 458-4381
For information on usual source of health care:
Robin Cohen
National Center for Health Statistics
Phone: (301) 458-4152
National Linked File of Live Births and Infant Deaths
The National Linked File of Live Births and Infant Deaths is a data file for
research on infant mortality. Beginning with the 1995 data, this file is
produced in two formats. The file is first released as a period data file
and then later released as a cohort file. In the birth cohort format, it
comprises linked vital records for infants born in a given year who died in
that calendar year or the next year before their first birthday. In the
period format, the numerator consists of all infant deaths occurring in one
year, with deaths linked to the corresponding birth certificates from that
year or the previous year. The linked file includes all the variables on the
national natality file, as well as medical information reported for the same
infant on the death record and the age of the infant at death. The use of
linked files avoids discrepancies in the reporting of race between the birth
and infant death certificates. Although discrepancies are rare for white and
black infants, they can be substantial for other races. National linked
files are available starting with the birth cohort of 1983. No linked file
was produced for 1992 through 1994 data years. Match completeness for each
of the birth cohort files is about 98 percent.
For more information, see:
Prager, K. (1994). Infant mortality by birthweight and other
characteristics: United States, 1985 birth cohort. Vital and Health
Statistics, 20 (24). Hyattsville, MD: National Center for Health Statistics.
MacDorman, M.F. and Atkinson, J.O. (1999). Infant mortality statistics from
the 1997 period linked birth/infant death data set. Monthly Vital Statistics
Report, 47 (23). Hyattsville, MD: National Center for Health Statistics.
Information about the National Linked File of Live Births and Infant Deaths
is available online at http://www.cdc.gov/nchs/about/major/lbid/linked.htm
Agency Contact:
For information on infant mortality:
Marian MacDorman
National Center for Health Statistics
Phone: (301) 458-4356
National Vital Statistics System
Through the National Vital Statistics System, the National Center for Health
Statistics (NCHS) collects and publishes data on births and deaths in the
United States. NCHS obtains information on births and deaths from the
registration offices of all States, New York City, and the District of
Columbia.
Demographic information on birth certificates, such as race and ethnicity,
is provided by the mother at the time of birth. Hospital records provide the
base for information on prenatal care, while funeral directors provide
demographic information on death certificates. Medical certification of
cause of death is provided by a physician, medical examiner, or coroner.
Information on Hispanic Origin. The number of States gathering information
on births to parents of Hispanic origin has increased gradually since
1980-81, when 22 States included this information on birth certificates. By
1993, the Hispanic origin of the mother was reported on birth certificates
in all 50 States and the District of Columbia. Similarly, mortality data by
Hispanic origin of decedent have become more complete over time. Based on
data from the U.S. Census Bureau, 99.6 percent of the U.S. Hispanic
population resides in areas that report deaths by Hispanic origin.
Preliminary Data. A continuous receipt of statistical records by NCHS from
the States' vital registration systems supplies preliminary data.
Investigators weight individual records of births and deaths to independent
counts of vital events registered in each State and reported to NCHS. These
independent counts, aggregated for a 12-month period, serve as control
totals, and are the basis for the individual unit record weights in the
preliminary file. For selected variables, unknown or not-stated values are
imputed. The percentage not stated is generally 1 percent or less, except
for prenatal care, which is 2.2 percent.
For more information on national natality and mortality data, see National
Center for Health Statistics. Technical Appendix. Vital Statistics of the
United States, I (Natality) (1992), (DHHS Publication No. (PHS) 96-1100),
and II (Mortality), Part A (1996) (DHHS Publication No. (PHS) 96-1101).
Washington, DC: Public Health Service.
Information about the National Vital Statistics System is available online
at http://www.cdc.gov/nchs/nvss.htm
Respectfully,
Chris
--Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
€€€INFANT CUISINE AND MOTHER CARE: LACTATION CONSULTING & PERINATAL CARE€€€
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