The increasing racial disparity in infant mortality rates: composition and contributors to recent US trends.
OBJECTIVE
We examined trends in birthweight-gestational age distributions and related infant mortality for African American and white women and calculated the estimated excess annual number of African American infant deaths.


METHODS
Live births to US-resident mothers with a maternal race of white or African American were selected from the National Center for Health Statistics' linked live birth-infant death cohort files (1985-1988 and 1995-2000).


RESULTS
The racial disparity in infant mortality widened despite an increasing rate of white low-birthweight infants. White preterm infants had relatively greater gains in survival and the white advantage in survival at term increased. Annually, African American women experience approximately 3300 more infant deaths than would be expected.


CONCLUSIONS
The increasing US racial disparity in infant mortality is largely influenced by changes in birthweight-gestational age-specific mortality, rather than the birthweight-gestational age distribution. Improvement in the survival of white preterm and low-birthweight infants, probably reflecting advances in and changing access to medical technology, contributed appreciably to this trend.
Alexander
Greg R
GR
Department of Pediatrics, University of South Florida College of Medicine, Tampa, FL, USA.
Wingate
Martha S
MS
Bader
Deren
D
Kogan
Michael D
MD
D001741:Black or African American / Q000706:statistics & numerical data*; D001724:Birth Weight; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000208:ethnology* / Q000639:trends; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D050498:Live Birth / Q000208:ethnology; D008423:Maternal Age; D011247:Pregnancy; D011287:Prejudice; D011336:Probability; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*