Willis Earnestine, McManus Patricia, Magallanes Norma, Johnson Sheri, Majnik Amber
Department of Pediatrics, Center for the Advancement of Underserved Children, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, USA.
Black Health Coalition of Wisconsin, Inc., 3020 West Vliet Street, Milwaukee, WI 53208-2461, USA.
Clin Perinatol. 2014 Dec;41(4):847-75. doi: 10.1016/j.clp.2014.08.008. Epub 2014 Oct 7.
Infant mortality rate (IMR) is a reference indicator for societal health status. Trend analysis of IMR highlights 2 challenges to overcome in the United States: (1) US IMR is higher than most industrialized countries and (2) there are persistent racial/ethnic disparities in birth outcomes, especially for blacks. Racial/ethnic infant mortality disparities result from the complex interplay of adverse social, economic, and environmental exposures. In this article, racial/ethnic disparities are discussed, highlighting trends, the role of epigenetics in understanding mechanisms, key domains of community action planning, and programs and policies addressing the racial gaps in adverse birth outcomes.
婴儿死亡率（IMR）是社会健康状况的一项参考指标。对婴儿死亡率的趋势分析凸显了美国需要克服的两大挑战：（1）美国的婴儿死亡率高于大多数工业化国家；（2）出生结局存在持续的种族/民族差异，尤其是黑人。种族/民族婴儿死亡率差异是由不良社会、经济和环境暴露的复杂相互作用导致的。本文讨论了种族/民族差异，重点介绍了趋势、表观遗传学在理解机制中的作用、社区行动计划的关键领域以及解决不良出生结局种族差距的项目和政策。
