Abstract 12154: Exploring Differences in Race and Ethnicity in Sudden Death in the Young, 2015-2019

Background: In 2015, the National Institutes of Health and Centers for Disease Control and Prevention collaborated to create the Sudden Death in the Young (SDY) Case Registry, a population-based surveillance and research initiative. The Registry monitors SDY incidence and identifies characteristics to inform data-driven prevention efforts. Previous analyses using 2015-2017 data identified differences in SDY by race/ethnicity. Further investigation into SDY demographics and the circumstances at death by race/ethnicity may help identify reasons for disparities and priority areas for future research. Objective: To explore racial/ethnic differences in SDY by demographic and circumstantial characteristics. Methods: We analyzed sudden and unexpected deaths that occurred during 2015-2019 among infants (<1 year old) and children (1-18 years old) in the 13 states/jurisdictions participating in the Registry. We excluded cases with explained causes including explained suffocation, motor vehicle accidents and drownings, and those missing race/ethnicity (n=15). We reported percentages and performed χ 2 tests to assess differences in demographic and circumstantial characteristics by race/ethnicity. Results: Among 1,370 SDY cases included, 46% were non-Hispanic White (NHW), 35% non-Hispanic Black (NHB), 10% Hispanic, and 9% non-Hispanic other (NHO). Most occurred among infants (68%), and most infants (92%) were sleeping at the time of the incident. Among children, sleeping at the time of the incident ranged from 45% for NHW to 29% for Hispanic (P<0.0073). More NHW infants/children had metabolic and genetic testing than infants/children of other race/ethnicities. Metabolic testing ranged from 52% for NHW to 36% for NHB (p<0.0001). Genetic testing ranged from 11% for NHW to 5% for NHB (p<0.0056). Conclusion: Our findings show that among SDY, there are key demographic and circumstantial differences by race/ethnicity: NHW children were more likely to be sleeping at the time of the incident, and NHW infants/children more commonly had metabolic and genetic testing. This analysis contextualizes the racial/ethnic differences in SDY, offering focus for further research and prevention efforts.