Perinatal & Pediatric
Spatial Variation in Sudden Infant Death Syndrome Across California’s San Joaquin Valley, 2019–2022 Elizabeth Amankwah* Elizabeth Amankwah Amankwah Amankwah Amankwah Department of Public Health, University of California, Merced, CA, USA
Sudden Infant Death Syndrome (SIDS) remains a leading cause of post-neonatal mortality in the United States and accounts for a large proportion of Sudden Unexpected Infant Deaths (SUID). SIDS is defined as the sudden, unexplained death of an apparently healthy infant under one year of age following a complete investigation. SIDS continues to present persistent regional and sociodemographic disparities. Nationally, SIDS rates increased from 39.8 to 41.7 deaths per 100,000 live births between 2019 and 2022. Although California’s overall infant mortality rate is lower than the national average, sudden unexpected infant death (SUID), including SIDS, remains the second leading cause of infant death statewide, with a rate of about 53.4 deaths per 100,000 live births (CDPH, 2023). Within California, parts of the San Joaquin Valley (SJV) exhibit higher SIDS rates, yet fine-scale spatial variation in SIDS risk within this region has not been well characterized.
We conducted a retrospective ecological analysis using California Vital Statistics Birth and Death certificate data from the California Department of Public Health for 2019–2022. The analytic dataset included all live births and infant deaths occurring within the first year of life. SIDS cases were identified using the ICD-10 code R95. ZIP-code–level SIDS rates were calculated per 1,000 live births. Spatial autocorrelation and clustering were assessed using Global Moran’s I and Geary’s C to evaluate geographic heterogeneity and temporal variability in SIDS risk.
SIDS rates varied across ZIP codes in the SJV, with evidence of spatial clustering and persistent areas of elevated risk over time. These findings highlight meaningful small-area heterogeneity in SIDS risk, which can help identify communities that may benefit from targeted prevention and enhanced surveillance efforts.