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Infant Mortality in the U.S. 1915-2007: Large Social Inequalities Have Persisted for Over a Century

This study, conducted by Drs. Gopal Singh and Stella Yu, is the first comprehensive attempt to empirically examine disparities in infant mortality in the United States by race/ethnicity, socioeconomic status, geographic area, and cause of death by using more than 100 years of vital statistics data. According to the study, social inequalities in infant mortality have persisted and remained marked, with the disadvantaged racial/ethnic and socioeconomic groups and geographic areas experiencing substantially increased risks of mortality despite the declining trend in mortality over time. Widening social inequalities in infant mortality are a major factor contributing to the worsening international standing of the United States. During 1915-2017, the infant mortality rate declined dramatically overall and for black and white infants. However, racial disparities in mortality increased through 2000. Detailed comparisons show an approximately five-fold difference in infant mortality among racial/ethnic groups, with rates ranging from 2.3 infant deaths per 1,000 live births for Chinese infants to 8.5 for American Indian/Alaska Natives and 11.2 for black infants. Educational disparities in infant, neonatal, and postneonatal mortality widened between 1986 and 2016. Geographic disparities were marked and widened across regions, with states in the Southeast region having the highest infant mortality rates. Infant mortality from major causes of death such as perinatal conditions, birth defects, Sudden Infant Death Syndrome (SIDS), respiratory distress syndrome, and pneumonia and influenza showed a downward trend during the past 5 decades. However, infant mortality from prematurity/low birthweight and unintentional injury has increased in recent years.

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