Boston Public Health Commission: Decline in Black Infant Mortality

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Boston Public Health Commission: Decline in Black Infant Mortality

Progress attributed to citywide partnerships to improve black women’s health

Black babies are dying at higher rates than other babies in Boston. For years it has been a stark reminder that inequities and disparities in health outcomes can exist even in places with a world-class health-care system.

After more than a decade of a concerted effort to improve the health of black women and their children, the Boston Public Health Commission (BPHC) recently released a data brief showing that progress is being made, and announced new funding to continue its work. The data shows:

Significant improvement in the black infant mortality rate (IMR)
Historic narrowing of the IMR gap between black infants and white infants
Reduction in preterm births for black infants born in the city
Decreases in the number of black infants born at low birth weight
“These data are encouraging and a reminder that no matter what the issue, or how intractable the problem seems to be, that communities can and must work to eliminate health inequities. This is not a victory, but it is progress and it validates the comprehensive approach we’ve taken to work with our partners across the city to improve the health of black women before, during and after they have given birth,” said Barbara Ferrer, Ph.D., former BPHC executive director.

The Commission analyzed infant mortality—defined as babies dying within the first year of life—over 12 years, breaking down the data into three four-year periods. The data show that black IMR decreased from 13.1 deaths per 1,000 live births in 2001–2004, to 7.4 in 2009–2012, a rate 44 percent lower than the 2001–2004 rate. This improvement is equivalent to 59 fewer black infant deaths from 2005 to 2012.

For decades the gap in mortality between black and white infants has been increasing, a fact not unique to Boston. In the United States, from 1935 to 2007, the gap between white and black infant mortality grew. In 1935, the IMR for black infants was 58 percent higher than white infants in the U.S. By 2007, the black IMR was 135 percent higher than the white infant mortality rate.

Consistent with trends seen nationally, the new BPHC data show the persistent gap may be narrowing. The IMR gap between black and white infants shrunk by 25 percent between each of the three time periods analyzed from 2001–2012. That means that the black IMR went from being four times the white IMR in 2001–2004, to two times the white IMR in the 2009–2012 time period.

The Commission also noted improvements in low birth weight and preterm births among black infants in Boston; an important finding given that premature births and low birth weight are major contributing factors to infant mortality. Compared to 2001–2004, the 2009–2012 rates of low birth weight and preterm black infants were 10 percent and 16 percent lower, respectively.

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