Infant Mortality

Infant Mortality in the United States

Major causes of U.S. infant mortality include congenital abnormalities, preterm/low birth weight, pregnancy-related problems, respiratory distress syndrome, and sudden infant death syndrome (SIDS). The dramatic decrease in the U.S. IMR during the 20th century primarily reflected fewer babies dying from pneumonia and influenza, prematurity, and low birth weight as a result of better, more available technology and medicine. However, among developed countries, the United States has the second worst newborn mortality rate. The poor IMR in the United States is due to substantial disparities in race/ethnicity, education, income, and health within the population. Overall, not all U.S. racial and ethnic groups have benefited equally from the long-term downward trend in infant mortality.

In the United States, prematurity/low birth weight (less than 5.5 pounds at birth) is one of the major determinants of infant mortality and has been the leading cause of death for black infants for more than a decade. In New York City, for example, infants born to black non-Hispanic mothers have an IMR more than twice the rate of those born to white non-Hispanic mothers. This difference is especially stark in communities with a high percentage of black residents. The factors that contribute to these disparities are difficult to isolate as they interact with each other, but some areas studied include the overall health of the mother, socioeconomic status, and social stressors. The stress of marginalization associated with racism has been investigated as a cause of poorer health among minorities. It is probable that these stressors can have an effect on women before conception as well as during pregnancy, which may contribute to poor birth outcomes. There are also disparities between whites and other ethnic groups. For example, compared with non-Hispanic whites, SIDS deaths among American Indian and Alaska Natives are 2.3 times greater. U.S. efforts to decrease infant mortality across ethnic groups focus not only on the individual behaviors of women but also on the communities in which they live, their economic standing, and their social status, since many factors can affect pregnant women and the health of their babies.

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