Disparities in Birth Outcomes
The U.S. ranked behind 29 other nations in infant mortality in 2005. Experts believe the poor U.S. ranking is due in large part to disparities that continue to exist among various racial and ethnic groups, especially African-Americans. African-American babies are more than twice as likely to die in their first year as white babies. Low birth-weight and pre-term births are risk factors for infant mortality, but there is little consensus about why babies are born too soon or too small, or why racial and ethnic disparities persist.
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Infant mortality generally indicates the health of a population. Infant mortality measures how many infants die before their first birthday and is reported as a rate per 1,000 live births. Rates have been steadily declining in the states since the early 1900s.
As a nation, the U.S. ranked behind 29 other nations in infant mortality in 2005, with a rate worse than many European nations, but also behind Singapore, Japan, Israel, New Zealand, Australia and Cuba.1
Experts believe the U.S. ranking is due in large part to disparities that continue to exist among various racial and ethnic groups, especially African-Americans.2
The infant mortality rate for African-American infants in the U.S. is more than twice the rate for white infants—13.5 per 1,000 black births from 2004 to 2006, compared to 5.7 infant deaths per 1,000 white births.
This same disparity exists in every state and is even greater than the national disparity in 12 states and the District of Columbia. In fact, the mortality rate for African-American infants is three times higher than for white infants in Connecticut, the District of Columbia, Hawaii, New Jersy and Wisconsin.
Leading causes of infant deaths include preterm and low–weight births and Sudden Infant Death Syndrome, or SIDS.3
Premature births are increasing in the U.S. In 2006, one in eight infants was born early. Even infants born between 34 and 36 weeks of gestation have increased health risks and higher health care costs in the first year of life.4
Over the last three decades, Medicaid eligibility has expanded dramatically for pregnant women; however, access barriers remain for many women.
About eight out of ten U.S. women reported receiving prenatal care during the first trimester of their pregnancy in 2006, according to the National Center for Health Statistics at the CDC.
In 2006, 1.2 million babies were born in the U.S. and 200,000 of them did not receive early prenatal care, a key preventive health service.
White women are more likely to receive early prenatal care than either African-American or Hispanic women. According to 2006 data from the National Center for Health Statistics at the CDC, 88 percent of white mothers had early prenatal care, while only 76 percent of African-American and 77 percent of Hispanic mothers did.
Despite the fact that low birth-weight and preterm births are risk factors for infant mortality, there is little consensus about why babies are born too soon or too small, or why racial and ethnic disparities persist.5
African-American babies are much more likely than white or Hispanic babies to be born too soon or too small.
Babies born into households at or near the poverty line face greater health risks than infants in more affluent homes.6
African-American mothers are more than twice as likely as white mothers to lose their babies before they turn one, regardless of the mother’s age, income, education or socioeconomic level.
1 Marian F. MacDorman and T.J. Mathews. “Behind International Rankings of Infant Mortality: How the United States Compares with Europe.” NCHS Data Brief, No. 23, November 2009.
2 Centers for Disease Control and Prevention. “Eliminate Disparities in Infant Mortality.”
4 "Collaborating for Preemies: Challenges & Changes: Meeting Summary Report." Medimmune, LLC. 2010.
5 Rima Shore and Barbara Shore. "Kids Count Indicator Brief: Reducing Infant Mortality." The Annie E. Casey Foundation, July 2009.