August 6, 2019

US infant mortality, in 3 charts

Daily Briefing

    The U.S. infant mortality rate remained stable in 2017 at 5.79 infants per 1,000 live births, but racial disparities in infant mortality remain, according to a CDC report released Thursday.

    You can't tackle infant mortality without addressing racial disparities. Here's how.

    For the report, researchers reviewed birth and death certificates from all 50 states, Washington, D.C., and U.S. territories for infants under the age of one who died in 2017.

    Findings

    Overall, the researchers found the United States reported a total of 22,341 infant deaths in 2017—down from 23,157 in 2016. The researchers found the U.S. infant mortality rate has decreased since 1995, which is the first year CDC began tracking the rate. The researchers noted the U.S. infant mortality rate reached a high of 6.86 infants per 1,000 live births in 2005, but decreased by 16% to 5.79 infants per 1,000 live births in 2017.

    In addition, the researchers found the neonatal mortality rate, which includes infant deaths at fewer than 28 days, and postneonatal mortality rate, which includes infant deaths at 28 days or more, generally have decreased since 1995.

    For instance, the researchers found the neonatal mortality rate decreased by 15% from 2005 to 2017. However, the researchers found the neonatal mortality rate remained virtually unchanged from 2016 to 2017, declining slightly from 3.88 neonatal deaths per 1,000 live births in 2016 to 3.85 neonatal deaths per 1,000 live births in 2017.

    The researchers also found that the postneonatal mortality rate decreased by 16% from 2005 to 2017. However, the researchers noted that the United States' postneonatal mortality rate remained nearly unchanged from 1.99 postneonatal deaths per 1,000 live births in 2016 to 1.94 postneonatal deaths per 1,000 live births in 2017:

    The researchers found infant mortality rates varied by state in 2017, ranging from a low of 3.66 infant deaths per 1,000 births in Massachusetts to a high of 8.73 infant deaths per 1,000 births in Mississippi:

    The researchers also found that racial disparities in infant death rates persisted in 2017. Specifically, the researchers found the infant mortality rate for infants of non-Hispanic black women was more than twice as high as the infant mortality rate for infants of non-Hispanic white women, non-Hispanic Asian women, and Hispanic women:

    The researchers found preterm-related causes of death accounted for 34% of infant deaths in 2017, which is unchanged from 2016. According to the researchers, the five leading causes of infant deaths in 2017 were:

    • Congenital malformations, which were associated with 21% of infant deaths;
    • Disorders related to short gestation and low birthweight, which were associated with 17% of infant deaths;
    • Maternal complications, which were associated with 6% of infant deaths;
    • Sudden infant death syndrome, which was associated with 6% of infant deaths; and
    • Unintentional injuries, which were associated with 6% of infant deaths.

    Reaction

    Deborah Campbell, director of Montefiore Health System's neonatology division who was not involved with the report, said the overall decrease in the infant mortality rate is a positive sign, but the racial disparities are concerning. Campbell said many non-Hispanic black women have a higher risk of experiencing complications during their pregnancies because they are disproportionately affected by chronic health conditions—such as asthma, diabetes, and hypertension—which are linked to infant deaths.

    Campbell said physicians will better serve communities by understanding how infant mortality rates differ across the nation and what factors might reduce infant mortality rates. "I think it's vital for us to look at this, to know what the landscape is across the country," she said (Kommers, Becker's Hospital Review, 8/1; D'Ambrosio, MedPage Today, 8/1; CDC report, 8/1).

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