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. 2014 Feb;104 Suppl 1(Suppl 1):S105-11.
doi: 10.2105/AJPH.2013.301349. Epub 2013 Dec 19.

The changing character of the Black-White infant mortality gap, 1983-2004

Todd E Elder  1 , John H Goddeeris, Steven J Haider, Nigel Paneth
Affiliations

The changing character of the Black-White infant mortality gap, 1983-2004

Todd E Elder et al. Am J Public Health. 2014 Feb.

Abstract

Objectives: We examined how changes in demographic, geographic, and childbearing risk factors were related to changes in the Black-White infant mortality rate (IMR) gap over 2 decades.

Methods: Using 1983-2004 Vital Statistics, we applied inverse probability weighting methods to examine the relationship between risk factors and 3 outcomes: the overall IMR gap, its birth weight component, and its conditional (on birth weight) IMR component.

Results: The unexplained IMR gap (the part not related to observed risk factors) was stable, changing from 5.0 to 5.3 deaths per 1000 live births. By contrast, the explained gap declined from 4.6 to 1.9. The decline in the explained gap was driven by the changing relationship between risk factors and IMR. Further analysis revealed that most of the unexplained gap occurred among infants weighing less than 1000 grams at birth, whereas most of the explained gap occurred among infants weighing more than 1000 grams.

Conclusions: The unexplained gap was stable over the last 2 decades, but the explained gap declined markedly. If the stability of the unexplained gap continues, even complete convergence of risk factors would reduce the Black-White IMR gap by only one quarter.

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Figures

FIGURE 1—
FIGURE 1—
Trends in (a) IMR by race, full series, and (b) IMR gaps, full and analytic series: United States, 1983–2004. Note. IMR = infant mortality rate. The full series refers to the entire sample of Blacks and Whites and the analytic series makes additional restrictions so that the covariates are defined consistently over time.
FIGURE 2—
FIGURE 2—
Changes over time in (a) cumulative IMR gaps, (b) unexplained cumulative IMR gaps, and (c) explained cumulative IMR gaps: United States, 1983–2004. Note. IMR = infant mortality rate. The analytic series was used to construct these graphs.
FIGURE 3—
FIGURE 3—
Cumulative components of the unexplained IMR gap: United States, 1983–2004. Note. IMR = infant mortality rate. The analytic series was used to construct these graphs.
FIGURE 4—
FIGURE 4—
Trends in (a) gaps in maternal risk factors and (b) explained IMR gaps: United States, 1983–2004. Note. HS = high school; IMR = infant mortality rate. The analytic series was used to construct these graphs. In part a, the legend lists the y-axis used for each characteristic (e.g., left or right). In part b, the legend lists the risk factors used in computing each explained IMR gap (e.g., the risk factors from the actual year, 1983, or 2004).
See this image and copyright information in PMC

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