Among developed nations, the United States maintains 1 of the highest rates of infant death in the world. Infant health and care is improving, and mortality rates have steadily dropped – but more than 23,000 of these untimely deaths still occur every year. Why?
Since the genetic abnormalities and medical errors that lead to infant death could happen to anyone at any time, it might seem a stretch to assume certain demographics and geographic areas are more susceptible than others. But according to new data from the U.S. Centers for Disease Control and Prevention (CDC), this assumption may not be far from the truth.
To get a sense of the country’s overall health, which is influenced by similar factors, the CDC takes a look at infant mortality datasets from the National Vital Statistics System each year. This month, the CDC released data from 2014 examining this rate, calculated by the number of infant (age 1 or younger) mortalities per 1,000 live births. Across locations, but much more so among different ethnic groups, the inequities are much too pronounced to ignore.
The Numbers Alone Tell an Unpleasant Story
According to the CDC, infant mortality in the United States has been on a 15 percent decline in the last decade and decreased more than 70 percent since 1962. However, there remains some disparity in the death toll based on factors such as the urbanization level of a county, and maternal or infant characteristics such as age, race, and Hispanic origin.
Overall, urbanization was the most telling factor in this study. Infant mortality rates were lowest in highly populated urban areas at 5.44 deaths per 1,000 births and 20 percent higher in rural areas at 6.55, for most demographics. This isn’t surprising, as people who live in rural areas are more likely to have limited access to doctors.
Neonatal mortality rates are also highest in rural and small-to-medium urban areas (and much higher than postnatal mortality rates across all urbanization levels). In terms of maternal age, the pattern is the same: All age groups suffer the most losses in rural, and the least in large urban counties of residence. Those aged 40 and over suffer the most of them all. Though tragic, there is little surprise here either.
What’s more unnerving is the disparities in death rates between different ethnicities: non-Hispanic white, non-Hispanic black, and Hispanic. Across these groups, mortality rates decreased as urbanization levels increased. The mortality rate for infants with non-Hispanic white and Hispanic mothers in rural counties was 5.95 and 5.32 deaths, respectively. But the same rate for infants of non-Hispanic black mothers was 12.08: over double that of the others. No matter their location – urban or rural – newborns with black mothers are dying twice as often. This is a fact that cannot be ignored.
What Does This Mean?
The report’s summary suggests that the findings are consistent with previous research – that infants born in rural counties have a poorer chance of survival. Regarding the glaring gap between ethnic origins, which also reflects historical trends, the CDC included no comment.
Since 2005, infant death rates have declined by 20 percent among non-Hispanic black communities. This, and the overall drop in infant mortality, is great news. It perhaps even indicates that public health officials are working together to curb these cruel twists of fate – most commonly caused, in part, by preventable circumstances such as pregnancy complications and injuries.
Still, though death rates have dropped across the board, the correlation between racial and ethnic groups has “persisted and increased,” says the CDC, over the last 100 years. A special report on this issue suggests that minority groups have not benefited equally from social and medical advances. The study found that non-Hispanic black women would experience 71 percent fewer deaths if the most common causes (preterm-related, congenital malformations, sudden death infant syndrome (SIDS), and injuries) were brought down to non-Hispanic white levels. A strategy for how to go about doing this is something that the CDC data brief has yet to address.