SIDS and postneonatal mortality rates in the 27 most populous states for 1987-1995 were collected from state Departments of Health. These states represent a mean of 75% of all yearly births in the United States. SIDS and postneonatal mortality (PNM) have been steadily decreasing since 1989. After the inception of Back to Sleep, the rate of decline in SIDS / 1000 births has increased. Table

Table 1
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There has been a 31% decline in SIDS rate since the AAP 1992 sleep position recommendation, and a 15% decline since the initiation of the back to sleep campaign. SIDS as a% PNM has also decreased, although not as much as the SIDS rate. This slight disparity may be evidence of a diagnostic shift away from the term SIDS. The decline in SIDS has been steeper in the Caucasian (C), and Asian & Hispanic (NW) groups than in African Americans (AA). There is evidence that the rate of supine sleep may be lower in the AA group. SIDS rates by race are: Table

Table 2
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The overall decline in SIDS (C) has been 36%, SIDS (AA) is 16%, and SIDS(NW) is 42%. The ratio of SIDS (AA) to SIDS (C) has increased from 2.14 to 2.84. Despite a dramatic overall decline in SIDS in the past four years, the AA population has not fully realized the gains of other population groups.