The gap between black and white infant mortality is creeping up again, leaving researchers puzzled

The gap in infant mortality between black and white babies in the U.S. had been steadily closing for nearly a decade, but appears to be widening, researchers said Monday in a new study.

The research team, led by Jay Kaufman of McGill University in Montreal, is still trying to figure out what’s going on — from 2005 to 2012, the infant mortality rate dropped for both black and white babies, with the decline much steeper for black babies. Then, in 2012, something changed. The mortality rate for white babies continued its steady drop, but for black babies (defined in the study as non-Hispanic), things plateaued. By 2015, the latest year for which data is available, it had even bumped up.

“When we see a year in which things are starting to get worse again, that’s kind of a canary in the coal mine, that’s kind of a warning sign,” said Kaufman. “The end of this period of improvement is something that’s very alarming.”

Historically, the mortality rate for black babies has been significantly higher than for white — a discrepancy that is attributed to various factors, including social, educational, and health care inequalities. In 2005, 14.3 black babies died per 1,000 births; 5.7 white babies per 1,000 births did. By 2012, the number of black babies dying in infancy had dropped to 11.5, and for white babies, five deaths. But by 2015, the decline in black infant mortality had slowed, and the rate for that year was 11.7.

Martha Hargraves, a social policy researcher retired from the University of Texas who was not involved in the study, said the infant mortality gap in the U.S. is a well-known problem, and research now needs to focus on what she calls “the whole environment of the mother of the infant.”

“We need a combination of interventions that deal with the everyday lives of people. A more comprehensive approach to the issue,” she said. “We need a medical intervention, we need a social-contextual intervention, and we need an empowerment intervention. Those kinds of interventions take time, but they can make all the difference in folks’ everyday lives.”

In the study, published in JAMA Pediatrics, the researchers pulled data from the Centers for Disease Control and Prevention U.S. National Vital Statistics System on race, ethnicity, and cause of death for infants who were born alive but died before their first birthday between 2005 and 2015. In addition to the stalled decline, they found that black infants were four times more likely to die due to complications associated with premature birth, which was the leading cause of black infant mortality, and plateaued along with the overall mortality rate in 2012.

Kaufman pointed out that over the past few years, technology and access to medical care have improved on the whole, making the lack of progress in black infant mortality particularly concerning.

“We have values of social equality, that people should have equal life chances and equal opportunities and equal access to basic human rights like medical care and the right to have a healthy pregnancy, and these kinds of observations about these tremendous inequalities are evidence that we’re far from that goal,” Kaufman said.