Two areas receiving much scrutiny recently are the adverse health outcomes associated with income inequality and health disparities between blacks and whites. Although race and income are closely linked in the political economy of the US, few reports have explored their interaction at the aggregate level.
We studied trends over the past half-century using data from the US census and vital statistics. Between 1950 and 1995, although the US infant mortality rate fell by 74%, the US position internationally deteriorated from 6th to 24th. The ratio of US IMR to the lowest national rate reported in each year (either Sweden or Japan, depending on the year) rose from 1.4 to 2.0. In parallel to this, the ratio of black to white IMR within the US rose from 1.7 to 2.4. On closer inspection, the B-W gap did not rise steadily: it increased from 1950 to 1960, leveled out and fell until 1975, then rose even more steeply to 1995. Income inequality in the US, as measured by Gini index, showed a similar pattern: it also fell until 1970, reversed by 1975 and then rose to an all-time high in 1995.
Conclusion: Increasing income inequality in the US is temporally associated with a worsening US international ranking in infant mortality. Both indicators track with widening racial disparities in IMR. These findings suggest that attainment of the year 2010 Federal Health Initiative goal to eliminate racial disparities in infant outcome will require deeper understanding of the relationship of race and class inequality.
Learning Objectives: At the conclusion of this session, the learner will be able to: 1. Discuss temporal trends in US infant mortality and the black-white gap in this indicator. 2. Relate racial disparities in IMR to class disparities in income. 3. Discuss plausible political economic explanations for the observed trends.
Keywords: Infant Mortality, African American
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.