Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 1;151(5):e2022060512.
doi: 10.1542/peds.2022-060512.

Disparities in Mortality Trends for Infants of Teenagers: 1996 to 2019

Ashley M Woodall  1 , Anne K Driscoll  1 , Ali Mirzazadeh  2 , Amy M Branum  1
Affiliations

Disparities in Mortality Trends for Infants of Teenagers: 1996 to 2019

Ashley M Woodall et al. Pediatrics. .

Abstract

Background and objectives: Although mortality rates are highest for infants of teens aged 15 to 19, no studies have examined the long-term trends by race and ethnicity, urbanicity, or maternal age. The objectives of this study were to examine trends and differences in mortality for infants of teens by race and ethnicity and urbanicity from 1996 to 2019 and estimate the contribution of changes in the maternal age distribution and maternal age-specific (infant) mortality rates (ASMRs) to differences in infant deaths in 1996 and 2019.

Methods: We used 1996 to 2019 period-linked birth and infant death data from the United States to assess biennial mortality rates per 1000 live births. Pairwise comparisons of rates were conducted using z test statistics and Joinpoint Regression was used to examine trends. Kitagawa decomposition analysis was used to estimate the proportion of change in infant deaths because of changes in the maternal age distribution and ASMRs.

Results: From 1996 to 2019, the mortality rate for infants of teens declined 16.7%, from 10.30 deaths per 1000 live births to 8.58. The decline was significant across racial and ethnic and urbanization subgroups; however, within rural counties, mortality rates did not change significantly for infants of Black or Hispanic teens. Changes in ASMRs accounted for 93.3% of the difference between 1996 and 2019 infant mortality rates, whereas changes in the maternal age distribution accounted for 6.7%.

Conclusions: Additional research into the contextual factors in rural counties that are driving the lack of progress for infants of Black and Hispanic teens may help inform efforts to advance health equity.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Trends in mortality rates for infants of non-Hispanic white, non-Hispanic Black, and Hispanic or Latina teens aged 15 to 19: United States, 1996–1997 through 2018–2019. Source: National Center for Health Statistics (NCHS), National Vital Statistics System (NVSS), linked birth and infant death file.
FIGURE 2
FIGURE 2
Trends in mortality rates for infants of teens aged 15 to 19 who live in large central, large fringe (suburbs), medium and small, and rural counties: United States, 1996–1997 through 2018–2019. Source: NCHS, NVSS, Linked birth and infant death file.
FIGURE 3
FIGURE 3
Trends in mortality rates for infants of teens aged 15 to 19 by maternal race and ethnicity in (A) large central, (B) large fringe (suburbs), (C) medium and small, and (D) rural counties: United States, 1996–1997 through 2018–2019. Source: NCHS, NVSS, Linked birth and infant death file.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

References

    1. Ely DM, Driscoll AK. Infant mortality in the United States, 2019: data from the period linked birth/infant death file. Natl Vital Stat Rep. 2021;70(14):1–17 - PubMed
    1. National Center for Health Statistics. Table 2. Infant, neonatal, postneonatal, fetal, and perinatal mortality rates, by detailed race and Hispanic origin of mother: United States, selected years 1983–2018. Available at: https://www.cdc.gov/nchs/hus/data-finder.htm. Accessed March 22, 2022
    1. Ehrenthal DB, Kuo HD, Kirby RS. Infant mortality in rural and nonrural counties in the United States. Pediatrics. 2020;146(5):e20200464. - PMC - PubMed
    1. Ely DM, Driscoll AK, Matthews TJ. Infant mortality rates in rural and urban areas in the United States, 2014. Available at: https://www.cdc.gov/nchs/products/databriefs/db285.htm. Accessed March 22, 2022 - PubMed
    1. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: final data for 2019. Natl Vital Stat Rep. 2021;70(2):1–50 - PubMed