Rising Infant Mortality in Delaware: An Examination of Racial Differences in Secular Trends

Objectives: Despite improvements in infant mortality rates (IMR) in the United States, racial gaps in IMR remain and may be driven by both structural racism and place. This study assesses the relationship between structural racism and race-specific IMR and the role of urban-rural classification on race-specific IMR and Black/White racial gaps in IMR.Methods: We conducted an analysis of variance tests using 2019 County Health Rankings Data to determine differences in structural racism indicators, IMR and other co-variates by urban-rural classification. We used linear regressions to determine the associations between measures of structural racism and county-level health outcomes.Results: Study results suggest that racial inequities in education, work, and homeownership negatively impact Black IMR, especially in large fringe, medium, and small metro counties, and positively impact White IMR. Structural racism is also associated with Black-White gaps in IMR.Conclusions: Factors related to structural racism may not be homogenous or have the same impacts on overall IMR, race-specific IMR, and racial differences in IMR across places. Understanding these differential impacts can help public health professionals and policymakers improve Black infant health and eliminate racial inequities in IMR. Ethn Dis. 2020;30(3):389-398; doi:10.18865/ed.30.3.389

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Racial Differences in Health in the United States

The Oxford Handbook of Economics and Human Biology ◽

10.1093/oxfordhb/9780199389292.013.6 ◽

2015 ◽

pp. 729-750 ◽

Cited By ~ 1

Author(s):

Leah Boustan ◽

Robert A. Margo

Keyword(s):

United States ◽

Infant Mortality ◽

Life Expectancy ◽

Racial Differences ◽

20Th Century ◽

Racial Inequality ◽

The United States ◽

Peak Period ◽

Long Run ◽

Inequality In Health

The United States has a long and ongoing history of racial inequality. This chapter surveys the literature on one aspect of that history: long-run trends in racial differences in health. We focus on standard measures such as infant mortality and life expectancy but also consider available data on specific diseases and chronic conditions. Our basic conclusion is that large improvements have occurred in the average health of African Americans during the 20th century, both in absolute terms and relative to whites. These health advancements occurred steadily throughout the 20th century, with the peak period of improvement between 1920 and 1945 (infant mortality) and 1940 and 1960 (overall life expectancy). We attribute the improvements to successful efforts to fight specific diseases, improvements in public health, and narrowing of racial gaps in education and income. Although racial inequality in health outcomes has fallen in the long term, significant disparities remain today.

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Racial differences in infant mortality attributable to birth defects in the United States, 1989–2002

Birth Defects Research Part A Clinical and Molecular Teratology ◽

10.1002/bdra.20308 ◽

2006 ◽

Vol 76 (10) ◽

pp. 706-713 ◽

Cited By ~ 100

Author(s):

Quanhe Yang ◽

Huichao Chen ◽

Adolfo Correa ◽

Owen Devine ◽

T.J. Mathews ◽

...

Keyword(s):

United States ◽

Infant Mortality ◽

Racial Differences ◽

Birth Defects ◽

The United States

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Secular Trends in Excess Fetal and Infant Mortality Using Perinatal Periods of Risk Analysis

Journal of the National Medical Association ◽

10.1016/s0027-9684(15)31546-7 ◽

2008 ◽

Vol 100 (12) ◽

pp. 1450-1456 ◽

Cited By ~ 4

Author(s):

V. James Guillory ◽

Jinwen Cai, ◽

Gerald L. Hoff,

Keyword(s):

Infant Mortality ◽

Risk Analysis ◽

Secular Trends ◽

Perinatal Periods Of Risk

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Racial differences in birthweight for gestational age and infant mortality in extremely‐low‐risk US populations

Paediatric and Perinatal Epidemiology ◽

10.1046/j.1365-3016.1999.00174.x ◽

1999 ◽

Vol 13 (2) ◽

pp. 205-217 ◽

Cited By ~ 92

Author(s):

Alexander ◽

Kogan ◽

Himes ◽

Mor ◽

Goldenberg

Keyword(s):

Infant Mortality ◽

Racial Differences ◽

Gestational Age ◽

Low Risk

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Racial differences in the relationship between infant mortality and socioeconomic status

Journal of Biosocial Science ◽

10.1017/s0021932000022094 ◽

1996 ◽

Vol 28 (1) ◽

pp. 73-84 ◽

Cited By ~ 12

Author(s):

Edward G. Stockwell ◽

Franklin W. Goza

Keyword(s):

Infant Mortality ◽

Racial Differences ◽

Low Income ◽

Census Data ◽

Economic Status ◽

Policy Implications ◽

Inverse Association ◽

Death Rates ◽

Income Status ◽

The Relationship

SummaryThis paper presents an ecological analysis of the relationship between infant mortality and economic status by race in metropolitan Ohio, using census data on mother's residence, and economic status determined by the percentage of low income families living in each area. White–non-white comparisons for total infant mortality are examined for the US censuses of 1960, 1970, 1980 and 1990; and more detailed period- and broad cause-specific rates are presented for 1990. A pronounced inverse association is found between income status and infant mortality for whites, but not for non-whites. Non-white post-neonatal death rates were higher for the lowest income area, but for neonatal mortality, total infant deaths, and exogenous and endogenous cause-specific death rates, there was no discernible socioeconomic differential. It is concluded that low income whites and non-whites at all income levels have infant mortality rates that are substantially higher than the overall rate for the population. Policy implications are discussed.

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