This report describes changes in Washington State infant mortality and SIDS in particular in the 1990s. In Washington State, the overall rate of infant death has decreased by 44% from 9.1 per 1,000 (1988-89) to 5.1 per 1,000 (1999-2000). While infant mortality declined rapidly from 1900 to 1950, improvements have been gradual since 1950, and infant mortality rates for African Americans and American Indians have remained substantially higher than those for other races. A number of factors have contributed to the recent decline in infant mortality. The First Steps program, Washington's Medicaid expansion for low income pregnant women that started in August 1989, increased access to prenatal care and provided enhanced prenatal care. Surfactant therapy for respiratory disease has reduced mortality among very low birth weight infants. In 1992-94, pediatric providers and the Back to sleep media campaign began to tell mothers to place their babies on their backs for sleep. SIDS rates have fallen dramatically for some groups since Back to Sleep has become a standard message for parents of newborns.
