Infant Death Rate At New Low; Blacks Still Have Double Risk

A record proportion of American newborns are surviving to their first birthday, but black infants still are more than twice as likely to die as whites - a gap that is widening annually.

“We suspect this disparity will continue to prevail well into … the first decade of the next century,” said Gopal Singh of the National Center for Health Statistics.

The U.S. infant mortality rate reached a record low of 7.9 infant deaths for every 1,000 births in 1994, according to preliminary government figures released last week. The rate was 8.3 in 1993 and 8.9 in 1991.

The new figures back up Singh’s prediction, published today in the American Journal of Public Health, that the nation is on track to meet its goal of no more than seven infant deaths per 1,000 births by the year 2000.

But black babies aren’t faring so well, Singh’s study found. The black infant mortality rate was 16.5 in 1992, the latest year ethnic data were available. That made black babies 2.4 times more likely than white babies to die before their first birthday. The infant mortality rate for white babies was about 6.9 per thousand births in 1992.

It’s a gap that has widened from just a 60 percent greater risk in 1950. This racial disparity will persist at least until 2010 - and may worsen before it improves, according to Singh’s computer forecast of infant mortality rates, the number of babies who die before their first birthday.

The latest data Singh could find on other ethnic groups were from 1988, when babies of Chinese and Japanese descent had the nation’s lowest mortality rates, 30 percent and 23 percent, respectively, lower than whites.

The decline in overall infant mortality is due largely to improved treatment for premature and underweight babies, said Dr. William Oh, pediatrics chairman at Brown University.

But Singh’s figures show whites have derived the most benefit from this technology, which often saves babies in the perilous first 27 days of life.

For every 1,000 white babies born in 1992, just 5.1 died before day 28 compared with 10.7 black babies out of every 1,000 born. Blacks’ risk during this early period has tripled in the last 40 years.

Meanwhile, the top killer of white babies has changed from prematurity to birth defects.

However, prematurity and dangerously low birth weights not only are the top killers of black babies, but they also have increased 9 percent in the last decade.

Improving both medical care and prevention strategies for at-risk mothers and babies may become more difficult as Congress considers cutting the federal block grants that states use for maternal and child health care, warned Dr. A.W. Brann Jr. of Emory University.

Medicaid already spends just 30 percent of its budget on maternal and child health even though mothers and children make up 70 percent of Medicaid’s rolls, he said.