Honigfeld L S, Kaplan D W
Division of Pediatric Practice, American Academy of Pediatrics, Elk Grove Village, IL 60009-0927.
Pediatrics. 1987 Oct;80(4):575-8.
Although dramatic gains have been realized in lowering the incidence of neonatal deaths among native American infants to a level lower than the white race, postneonatal death rates for this population remain twice as high as in the white race. The limited data available reveal that excessive postneonatal deaths among native American infants largely result from preventable accidents and treatable acute medical conditions, such as pneumonia and gastroenteritis. This suggests that native American infants leave the hospital healthy but go to unsafe environments, which decrease their chances of survival past 1 year. In particular, the poorer socioeconomic conditions that native American families experience and the related problems of alcoholism, unemployment, and family disorganization contribute to the high rate of postneonatal mortality. Intervention programs to lower native American postneonatal mortality should focus on promoting prompt recognition of and health seeking for treatable medical conditions and prevention of accidents and other postneonatal health problems. The roots of the problem of native American postneonatal mortality lie in the socioeconomic conditions of many Indian communities and cannot be addressed without recognition of how these factors combine with the health care delivery system to diminish life expectancy for native American infants.
尽管在将美国原住民婴儿的新生儿死亡率降低到低于白人种族的水平方面已经取得了显著进展，但该人群的新生儿后期死亡率仍然是白人种族的两倍。现有的有限数据显示，美国原住民婴儿过多的新生儿后期死亡主要是由可预防的事故和可治疗的急性疾病导致的，如肺炎和肠胃炎。这表明美国原住民婴儿出院时是健康的，但却进入了不安全的环境，这降低了他们一岁后存活的几率。特别是，美国原住民家庭所经历的较差社会经济状况以及与之相关的酗酒、失业和家庭解体问题，导致了较高的新生儿后期死亡率。降低美国原住民新生儿后期死亡率的干预项目应侧重于促进对可治疗疾病的及时识别和寻求医疗帮助，以及预防事故和其他新生儿后期健康问题。美国原住民新生儿后期死亡率问题的根源在于许多印第安社区的社会经济状况，如果不认识到这些因素如何与医疗保健系统相结合，从而缩短美国原住民婴儿的预期寿命，就无法解决这一问题。
