Examining and predicting black and white disparities in infant mortality in the United States using the linked birth-infant death data, 1995-2007

Objectives: This paper examines Black and Whites disparities and trends in infant mortality rates (IMRs) between 1995 and 2007 in the U.S. We focus on the role of socioeconomic (i.e. marital status, education and prenatal care) determinants. Finally, we explore whether current trends are aligned with Healthy People 2020 objectives. Methods: Data from the Center of Disease Control and Prevention Linked Birth-Infant Death files were used. Descriptive statistics models and linear regression models were used in the analyses. Results: Unmarried mothers had higher IMRs than married mothers. Among unmarried mothers, the largest racial disparity in IMRs was found at the lowest levels of education. Over time, the largest declines in IMRs among Black women were found among those with the lowest levels of education, regardless of their marital status. Among unmarried White women, declines in IMRs were faster at lowest educational levels, but for married ones, declines were faster for those with higher schooling. For both races, those with no prenatal care or late prenatal care had the highest IMRs. Only educated Whites are predicted to reach the Healthy People 2020 objectives of IMR<6.0. Educated Blacks are predicted to have an IMR of 10.6. Uneducated Blacks are predicted to have the highest IMR and the largest gap from this goal. Conclusion: We estimate that 61,059 infant deaths among Blacks could have been prevented if Blacks and Whites had the same IMRs between 1995 and 2007. Predicted trends in IMRs illustrate a consistent racial disparity until the year of 2020.