Temporal Trends in United States Infants: Implications for Achieving Health Equity - Abstract
Objective: In this descriptive study, we explored temporal trends and racial inequities in US infant mortality, low birth weight, and preterm births.
Method: The Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) was used to access Natality Data and the Linked Birth/Infant Death Records (LBIDR) from 2007 to 2019. Annual infant mortality per 1000 live births was obtained, as well as low birth weight and preterm birth rates. Annual percent changes (APCs) with 95% Confidence Intervals (CIs) and joinpoint regression were used to test for the significance of differences in trends.
Results: From 2014 to 2019, infant mortality fell, while low birth weight and preterm births rose. For all three indices, there are significant inequities between Whites and Blacks. Blacks, compared with Whites, experienced a significant 2-fold greater infant mortality and low birth weight and a 1.5-fold greater preterm birth rate.
Conclusions: These descriptive data indicate that the overall US infant mortality rate declined but low birth weight and preterm birth rates increased. These data suggest that infant mortality alone may be insufficient as a health indicator. While analytic studies are necessary to test the many hypotheses formulated by these descriptive data, there are clinical and public health challenges that arise from these findings.