The U.S. Is Failing in Infant Mortality, Starting at One Month Old

Aaron E. Carroll, New York Times, June 6, 2016

Many more babies die in the United States than you might think. In 2014, more than 23,000 infants died in their first year of life, or about six for every 1,000 born. According to the Centers for Disease Control and Prevention, 25 other industrialized nations do better than the United States at keeping babies alive.

This fact is hard for some to comprehend. Some try to argue that the disparity isn’t real. They assert that the United States counts very premature births as infants because we have better technology and work harder to save young lives. Therefore, our increased rate of infant death isn’t due to deficiencies, but differences in classification. These differences are not as common, nor as great, as many people think. Even when you exclude very premature births from analyses, the United States ranks pretty poorly.

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Infant mortality is not distributed equally in the United States. In 2013, the infant mortality rate among non-Hispanic whites was 5 per 1,000 births, as was the infant mortality rate among Hispanics. The rate among non-Hispanic blacks, however, was more than 11 per 1,000 births.

A number of other factors seem to play a role. Mothers younger than 20 years or older than 40 have children with a higher infant mortality. First babies have a higher chance of death than later siblings. Unmarried mothers also have a higher rate of death in their children, more than 70 percent higher than that of married mothers.

The No. 1 cause of infant mortality among newborns is premature birth, which has traditionally been linked with inferior prenatal care. That may not be the case in the United States. A 2006 study published in Epidemiology looked at how preterm delivery occurred among women in active-duty military installations.

Such women receive the same prenatal care regardless of race, or even socio-economic status. Because they were guaranteed care, their overall risk of premature delivery was low, just over 8 percent. But even among these women, black women were more than two times as likely as white women to deliver prematurely, regardless of military rank.

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[Editor’s Note: This is a table of infant mortality rates by race and state. There is as much variation by state as by race.]

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