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Infant mortality rate hits record low, although racial disparities persist

Liz Szabo
USA TODAY
Mother and child.

The USA’s infant mortality rate hit a record low in 2013, falling to 5.96 deaths per 1,000 live births, or about 23,400 deaths, according to a report issued Thursday. While health officials cheered those new numbers, they noted that the USA still lags behind other nations and that mortality among black babies is far higher than among whites.

Infant mortality in the USA has dropped 13% since 2005, according to the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. Infant mortality rates are considered one of the strongest measures of a country’s health, because they reflect women’s well-being, overall access to health care, quality of health care, social and economic conditions, and public health practices.

The falling rate in infant mortality reflects progress made in reducing the number of babies born prematurely, said Edward McCabe, medical director of the March of Dimes. Rates of premature birth — before the 37th week of a typical 40-week pregnancy — rose for three decades, peaking in 2006 at 12.8% of all newborns before falling to 11.4% in 2013.

Prematurity puts infants at much higher risk of death. According to the new report, two-thirds of infant deaths were among premature babies.

“We’re doing a better job at giving newborns in the U.S. the care that they need to get a strong, healthy start in life,” said physician Barbara Levy, vice president of health policy for the American College of Obstetricians and Gynecologists. “This is great news.”

But health leaders say the USA needs to lower the infant mortality rate much more.

“Every time an infant dies, somebody out there is crying," said T.J. Mathews, a demographer at the National Center for Health Statistics and lead author of the new study. "Other countries are doing a lot better job."

The USA’s infant mortality rate is nearly three times higher than that of Finland's and Japan's.

In terms of infant mortality, the USA ranks last among 26 high-income countries, according to the Organisation for Economic Co-operation and Development,   below even former Eastern Bloc countries such as Hungary and Poland.


The USA is one of only eight countries worldwide where the maternal mortality ratio — the number of deaths among pregnant or postpartum women per 100,000 live births — actually got worse from 2003 to 2013, according to a 2014 study in The Lancet.

And infant mortality among blacks — 11.1 deaths per 1,000 births — remains more than twice as high as among whites, according to the CDC study.

Black infants’ high death rates reflect high rates of prematurity. About 16% of black babies were born premature in 2013, compared to 10% of white infants, according to the study. Black babies were also more likely than whites to be born very small. Their mothers were less likely to be married but more likely to give birth as teenagers and to suffer pregnancy complications than the mothers of white babies.

These gaps reflect “across-the-board” disparities in health between blacks and whites, said physician LaMar Hasbrouck, executive director of the National Association of County & City Health Officials.

Multiple studies show that blacks are more likely than whites to live in poverty and to suffer from chronic illnesses, such as hypertension and diabetes. Blacks have higher death rates from many cancers — including tumors of the breast, colon, prostate and cervix — as well as shorter overall life expectancies.

Infant mortality rates also vary sharply by state, from a high of 9.25 deaths per 1,000 live births in Mississippi to a low of 4.21 in Massachusetts, the report said.

The March of Dimes is one of several groups trying to reduce premature births.

Reducing the prematurity rate from 12.8% in 2006 to 11.4% in 2013 saved nearly $12 billion and allowed 231,000 babies to be born full term over those seven years, according to a March of Dimes study published last year in Pediatrics.

The March of Dimes has set a new goal to reduce premature births to 5.5% by 2030.

Several measures could help the USA reach that goal, according to the 2014 study. Those measures include reducing the number of women who choose to deliver two to three weeks early; changing IVF procedures to reduce the risk of multiple births; increasing the use of the hormone progesterone among certain high-risk pregnant women; and offering more women help to quit smoking.

Even in a best-case scenario, however, adopting all of these measures would only lower the USA’s premature birth rate to 8.2%, which is still well above rates in other developed countries, according to the March of Dimes study.

About one in five premature births has no known medical cause.

That suggests that the USA needs to invest significantly into researching the cause of premature birth, and putting the results of that research into practice, according to the March of Dimes study.

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