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Despite advancements in healthcare, African American babies in the United States are still dying at more than twice the rate of White babies, a glaring health gap that experts say is preventable and tied to systemic failures.
According to data from the U.S. Department of Health and Human Services’ Office of Minority Health, for every 1,000 live births, 10.9 non-Hispanic Black infants died before their first birthday. In comparison, the number for White babies stood at 4.5.
This means Black babies were 2.4 times more likely to die in infancy, a trend that has persisted for decades.
Behind the statistics are real human stories and systemic issues that continue to affect African American families disproportionately.
Low birthweight, preterm birth, sudden infant death syndrome (SIDS), and complications during pregnancy remain the leading causes of infant mortality in the Black community.
Data from the Office of Minority Health shows that Black infants are 3.6 times more likely to die from low-birth-weight complications, 3.2 times more likely to die due to pregnancy-related complications and 3.2 times more likely to die from sudden infant death syndrome (SIDS)
These numbers are not just the result of individual health choices but are strongly linked to the quality of healthcare, access to medical services, and how patients are treated within the system.
“We can’t talk about infant mortality rates and racial disparities without talking about structural racism, social determinants of health, like where someone resides, lack of transportation, and food insecurity,” said Dr. Tosin Goje, a reproductive infectious disease specialist at Cleveland Clinic.
Dr. Goje stressed the importance of what she called “wraparound resources” for pregnant women, services that go beyond just medical check-ups and include emotional, nutritional, and financial support throughout pregnancy and childbirth.
A mother’s health before and during pregnancy plays a critical role in infant outcomes. But Black women face high rates of chronic conditions such as type 2 diabetes and hypertension, both of which can increase risks during pregnancy and lead to early births or complications.
Despite efforts to promote prenatal care, the same report revealed that Black mothers are still twice as likely to receive late or no prenatal care at all.
Ironically, they are also 40% less likely to smoke during pregnancy, a known risk factor for infant death, than their White counterparts.
This contradiction points away from personal behaviors and toward structural issues in how healthcare is delivered.
Beyond physical health, many experts now point to chronic stress from racism and discrimination as a major factor affecting Black maternal and infant health.
This is supported by the “weathering” hypothesis, coined by public health researcher Dr. Arline Geronimus, which suggests that the daily stress of racial inequality can accelerate health deterioration in Black women.
Long-term stress raises hormone levels that can affect the placenta and contribute to early labor. This is not just theory, it’s a reality for many African American mothers.
Tonjanic Hill, a Texas mother, delivered twins prematurely at 34 weeks. But her first pregnancy ended in tragedy after her concerns were dismissed by hospital staff.
“That’s where I had the most traumatic, horrible experience ever,” Hill recalled in an interview with CBS News Texas.
Doctors initially sent her home when she reported severe symptoms. She later returned and was rushed into emergency care, but it was too late. She lost the baby.
Another major threat is Sudden Infant Death Syndrome (SIDS), the unexplained death of a seemingly healthy baby, often during sleep.
In 2022, Black infants died from SIDS at a rate of 1.08 per 1,000 live births, compared to 0.51 for White infants.
Health professionals believe that unsafe sleeping environments, lack of awareness about sleep practices, and social stressors contribute to these deaths.
Campaigns like “Safe to Sleep” have been launched to promote safe sleeping positions and conditions, but more culturally tailored outreach is needed in Black communities.
Solving this crisis will take more than awareness. Experts say systemic change is required. Solutions being proposed include:
Improved Access to Prenatal Care to ensure that all expectant mothers can access quality, timely care regardless of income, location, or race.
Bias Training for Healthcare Providers to address implicit biases in medical settings to ensure fair treatment.
Support Services to provide wraparound support that includes housing, nutrition, transportation, and mental health resources.
Community-Based Programs to support trusted organizations within Black communities to deliver culturally competent education and care.
The Office of Minority Health is urging hospitals, community clinics, and local governments to take concrete steps to reduce disparities.
State-level programs in places like California and New York are piloting targeted interventions. In Texas, where maternal and infant mortality is also high, lawmakers are beginning to look into expanding Medicaid coverage for postpartum women and increasing funding for Black maternal health initiatives.
However, many say these efforts are still falling short.
While systemic reforms will take time, there are immediate steps that families and health workers can take to lower risks: encourage early prenatal checkups, educate about safe sleep practices, manage chronic health conditions before pregnancy, and build strong support networks for expecting mothers
Dr. Goje added that “Every prenatal visit is an opportunity, not just to check the baby’s heartbeat, but to ask about a mother’s job, food access, mental health, and home life. That’s how we begin to close this gap.”
At the heart of the issue is the question of justice and equity. The right to a healthy birth and life shouldn’t depend on skin color. As the nation reflects on its commitments to racial equality and health equity, advocates say infant mortality is a clear indicator of how much work remains.
By: Joshua Narh