Government and Regulations

A Deadly Problem Among American Indians

Due to “a shift in the cultural and spiritual ways,” American Indian infant mortality rates increase while overall rates decrease.


Despite efforts to change the results, the American Indian infant mortality rate is still nearly twice that of the nation. The Great Plains area—South Dakota, North Dakota, Iowa, and Nebraska—is particularly hard-hit. There, babies are 2 to 3 times more likely than white babies to die within their first year. A recent article in Native Health News Alliance (NHNA)provides some background.

In South Dakota, American Indian babies accounted for 23 of 73 infant deaths reported in 2014, according to the South Dakota Department of Health, quoted in NHNA. In fact, between 2013 and 2014, although the number dropped of white babies dying, the number rose slightly for American Indians. Usually the postneonatal period (starting on day 28) marks the end of the “danger zone,” when the risk of infant death tends to go down. But for American Indian babies in South Dakota, the rate jumps from 4.2 per 1,000 births to 7.9.

In the NHNA article, Carol Iron Rope Herrera, who teaches parents about Lakota birthing and child-rearing traditions, says the Lakota tradition considers all babies sacred. She believes infant death in American Indian communities reflects lifestyle changes: “a shift in the cultural and spiritual ways of Native people.”

Linda Littlefield, manager of the Northern Plains Healthy Start program, agrees about lifestyle issues, specifically citing smoking. The NHNA article cites a report by the Northern Plains Tribal Epidemiology Center that found that between 2008 and 2012, > 30% of American Indian women in the Great Plains reported using tobacco during pregnancy.

Many American Indian traditions and beliefs support infant health and well-being, according to Christy Hacker, director of Maternal and Child Health programs for the Great Plains Tribal Chairmen’s Health Board, quoted in the NHNA article. Healthy Start communities often incorporate Lakota traditions about life and the sacredness of babies at powwows and other ceremonies.

But Hacker believes it is also important to encourage and support good care for women. According to research by the CDC and Northern Plains Tribal Epidemiology Center, only half of American Indian mothers in the Great Plains began prenatal care within the first trimester. “If mothers can take care of themselves,” Hacker says, “they can take care of the baby when it’s born.”

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