Each year in the United States, more than 23,000 infants die before reaching their first birthday. Though the mortality rate varies widely by state and county, the average in the United States is higher than in the rest of the world’s wealthy countries, worse than in Poland and Slovakia. Because infants are so vulnerable, their survival is considered a benchmark for a society’s overall health. What our infant-mortality rate tells us is that, despite spending more money on health care than any other country in the world, the United States is not very healthy. Looked at closely, it reveals that particular groups of Americans are starkly unwell.
White, educated American women lose their infants at rates similar to mothers in America’s peer countries. Most of the burden of the higher mortality rate here is borne by poorer, less-educated families, particularly those headed by unmarried or black women. Across the United States, black infants die at a rate that’s more than twice as high as that of white infants. The disparity is acute in a number of booming urban areas, from San Francisco—where black mothers are more than six times as likely to lose infants as white mothers—to Washington, DC. In the capital’s Ward 8, which is the poorest in the city and over 93 percent black, the infant-mortality rate is 10 times what it is in the affluent, predominantly white Ward 3.