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The infant mortality among Indian people living on the Northern Plains reservations (18.4per 1,000) is nearly double that of the U.S. infant mortality rate (9.8per 1,000). Data were collected for 19 reservations through the Healthy Start Program established to combat this problem, using the reservation as the unit of analysis. Relationships were hypothesized between reservations with high infant mortality rates and high alcohol consumption, tobacco use, poverty levels, and low availability of certain social services. The analysis substantiated only one major variable—poverty. Further analysis suggested that mortality rates were higher on reservations that did not provide social support programs such as smoking cessation, child care, substance abuse, or family planning. The authors contend that the causes of high infant mortality in this area are more social than medical in nature.



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