Despite an overall decline in U.S. infant mortality rates, the black/white disparity persists: Recent trends and future projections

This paper has two objectives. First, we examine the Black-White disparity in the U.S. infant mortality rate (IMR) between 1995 and 2009, and explore the influence of socioeconomic characteristics (e.g.; marital status, education, and prenatal care) on this racial gap. Second, we calculate projected IMRs and compare these results to the objectives of the Healthy People 2020 program. Descriptive statistics were calculated and linear regression models were conducted using data from the Centers for Disease Control and Prevention's linked birth and infant death files. Between 1995 and 2009, the IMR declined by 11.9 % for White mothers and 15.3 % for Black mothers. Among unmarried mothers, there was a 19.6 % decline for Whites and a 15.2 % reduction for Blacks. In comparison, among married mothers, there was a 19.3 % decline for Whites and an 18.1 % reduction for Blacks. For both Blacks and Whites, the largest percent declines occurred among women with the lowest and highest levels of education. For both racial groups, those with no prenatal care had the highest IMRs. Despite these significant declines, educated White women are the only group predicted to reach the Healthy People 2020 objective of an IMR lower than 6.0 infant deaths per 1,000 live births. The predicted IMR for highly educated Black women in 2020 is 10.6, and the projected rates for Black mothers with low education levels are even higher. Although the IMR has declined since 1995, the racial disparity between Blacks and Whites will most likely persist through 2020. Whereas educated White mothers are projected to meet the Healthy People 2020 IMR goal, other groups will fall short. The racial disparity persists even when mothers are grouped by marital status, educational attainment, and access to care. Future policies and prevention programs should address these racial disparities.