Posted on October 17, 2011

Racial Gap in Infant Mortality Baffles Health Experts

Stl Today, October 16, 2011

Amanda Ralph is the kind of woman whose babies are prone to die. She is young, poor and dropped out of school after the ninth grade.

But there is also an undeniable link between Ralph’s race–she is black–and whether her baby will survive: Nationally, black babies are more than twice as likely as white babies to die before the age of 1. In Pittsburgh, the rate is five times.

So, seven months into her first pregnancy, Ralph, 20, is lying on a couch at home as a nurse from a federally financed program listens to the heartbeat of her fetus.

The unusual attention Ralph is receiving is one of myriad efforts being made nationwide to reduce the tens of thousands of deaths each year of infants before age 1. {snip}


The infant mortality rate in the United States has long been near the bottom of the world’s industrialized countries. The nation’s current mark–6.7 deaths per 1,000 live births–places the U.S. 46th in the world, according to a ranking by the CIA. African-Americans fare far worse: Their rate of 13.3 deaths per 1,000 is almost double the national average and higher than Sri Lanka’s.

Precisely why the black infant mortality rate is so high is a mystery that has eluded researchers even as the racial disparity continues to grow in cities such as Pittsburgh, Los Angeles and Boston.


Recent studies have shown that poverty, little education, low access to prenatal care, smoking and even low birth weight do not alone explain the racial gap in infant mortality, and that even black women with graduate degrees are more likely to lose a child in its first year than are white women who did not finish high school. Research is now focusing on stress as a factor and whether black women have shorter birth canals.

“It is truly one of the most challenging issues, because it is multifactorial,” said Dr. Garth Graham, a deputy assistant secretary in the Office of Minority Health at the Department of Health and Human Services. “And nationally, the disparity has remained despite our best efforts.”