More than 23,000 babies born in the United States in 2016 died before their first birthdays. Each death was tragic, but, taken as a whole, the number represents good news: The U.S. has one of the lowest infant mortality rates in the world, 5.8 deaths per 1,000 births. But that’s only part of the story. It turns out that infant mortality rates vary widely from state to state. Products of race and income, to be sure, but also products of location. When it comes to infant mortality, northeast states almost all have rates below 5 deaths per 1,000, in league with the wealthiest nations. In rural America those rates climb to 7, 8, and 9 per 1,000. On paper, Alabama and Mississippi look like developing nations.
The country data represented in the map below, which illustrates global parallels, comes from the Central Intelligence Agency’s World Factbook, which compiles average infant mortality rates for 225 countries and is current as of 2017. The states data is from the Centers for Disease Control and Prevention, and is current as of 2016. It is noteworthy that Vermont, with only 19 infant deaths in 2016, was literally without peer in the entire world. The closest nation was Japan, which has only two infant deaths per 1,000 children born.
Scientists have long noticed that infant death rates are highest in rural areas and lowest in large urban communities. Minorities fare even worse—in rural areas, black babies are twice as likely to die before their first birthdays as white or Hispanic babies. Studies suggest at least some of these inequalities can be chalked up to socioeconomics. Mothers living in rural and minority communities tend to have less access to healthcare, less information about how to stay healthy while pregnant, and fewer funds to pay for medical interventions. The non-profit Save The Children highlighted these and other inequalities found in rural communities in a recent report.
“In order to reduce infant deaths…states need to address racial and ethnic disparities disadvantaging black children in both rural and urban areas,” according to the report. “Further, solutions must be highly contextualized to address the differences in direct and underlying causes of infant death in urban and rural areas. No baby should die from a preventable cause.”