Black and White Disparities in Overall and Cause-Specific Infant Mortality in the U.S., 1983-2002

Seung-Eun Song, University of Texas at Austin
Parker Frisbie, University of Texas at Austin

Relative disparity between black and white infant mortality in the U.S. has been increasing despite substantial declines in the overall infant mortality rate. Objective: To help account for this phenomenon by analyzing variations in racial disparity trajectories for1983-2002 for the five leading specific causes of infant death. Data: NCHS linked birth/infant death cohort files. Method: We estimated annual bivariate and adjusted changes in cause-specific risk of death for blacks and whites using a multilevel random coefficient model with birth cohort as the second-level unit to capture cross-sectional and temporal variations. Findings: Racial disparities, presented in terms of changes in log-odds, increased for the three causes (congenital anomalies, sudden infant death syndrome, and respiratory distress syndrome) regarding which beneficial innovations in perinatal care emerged. For the other two causes for which no such innovations occurred (short gestation and unspecified low birth weight and maternal complications), little change in disparities was evident.