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Wednesday, July 5, 2017

Infant Mortality

From 2005 to 2012, the infant mortality rate for non-Hispanic black infants decreased from 14.3 to 11.6 per 1000 births (Figure 1A). Thereafter, the infant mortality rate in black infants plateaued and then increased from 11.4 to 11.7 from 2014 to 2015. For non-Hispanic white infants, the rate decreased monotonically from 5.7 to 4.8 per 1000 from 2005 to 2015. Because the black infant mortality rate declined faster than the white infant mortality rate, excess events in black infants fell from 8.6 deaths per 1000 infants in 2005 to 6.6 deaths in 2012 but rose to 6.9 in 2015 (Figure 1B). These excess events imply nearly 4000 additional infant deaths among the 589 047 black infants compared with the number of expected deaths if they had experienced the same mortality rate as white infants.

No single cause appears solely responsible for the recent increase in black infant mortality, and in many instances, some arbitrariness exists in the single cause that is assigned. The preterm birth rate is nearly 50% higher for black compared with white infants.5 Furthermore, black infants experience nearly 4-fold as many deaths related to short gestation and low birthweight, making it the leading cause of infant death among black infants.
The sustained progress in reducing infant mortality among black infants since 2005 has stalled in the past few years. This has led to increases in the absolute inequality in infant mortality between black and white infants during the past 3 years. Interventions to further reduce the rate of preterm birth among black infants appear the most promising option for reducing black infant mortality and the absolute inequality between black and white infants.