Authors: Imari Z. Smith, Keisha L. Bentley-Edwards, Salimah El-Amin and William Darity, Jr
Introduction: The infant mortality rate is a key national indicator of population health. Despite technological advances in medicine and other health-related resources available to the average American, the infant mortality rate (IMR) in the United States is exceptionally high relative to other developed countries. For black infants, the numbers are devastatingly high. In 2013, the white IMR in the United States was five per 1000 live births —resembling economically advanced nations like New Zealand. In contrast, the black IMR was 11.2 per 1000 live births — a rate closer to that of lower income nations like Thailand, Romania, and Grenada.
In fact, black women experience the highest infant mortality rates among any racial or ethnic group in the United States. The black IMR has been roughly twice that of the white IMR for over 35 years. In order to decrease the national infant mortality rate, factors that maintain these disparities must be addressed directly.
There is a common perception that racial disparities in IMR are driven primarily by risky behaviors. However, the best available evidence does not support this assertion and indicates that systemic barriers to positive birth outcomes merit further investigation. This research brief will provide an overview of the social determinants that contribute to racial disparities in IMR. It will also provide policy and research recommendations to improve outcomes for black babies and their mothers.
Key Findings
- In 2015, more than 23,000 Americans died before their first birthday; 28.2 percent of these deaths were black infants.
- While income, age, and educational attainment are all correlated with birth outcomes, these “protective factors” are not as protective for black women as for other groups. Notably, black women have a higher risk of infant mortality at every age during their childbearing years, and black women with doctorates and professional degrees have a higher IMR than white women who never finished high school.
- Similarly, risk factors (obesity) and risky behaviors (alcohol and drug use) do not explain the IMR disparities. Infants born to obese black women were admitted to the NICU at higher rates (with lower birth weight) than those born to obese white women. And pregnant black women consume alcohol at equivalent rates to pregnant white women and smoke cigarettes at significantly lower rates.
