Document Type

Article

Publication Date

12-1-2021

Abstract

The U.S. Black neonatal mortality rate is more than twice the White rate. This dramatic disparity can be decomposed into two components: (1) disparities due to differences in the distribution of birth weights, and (2) disparities due to differences in birth weight–specific mortality. I utilize this distinction to explore how the social context into which infants are born contributes to gaps in mortality between Black and White neonates. I analyze variation in Black–White differences in neonatal mortality across 33 states using 1995–2010 data. For each state, I calculate the contribution of differences in birth weight distribution versus differences in birth weight–specific mortal ity to the total disparity in mortality between White and Black neonates. Disparities are largely a product of different birth weight distributions between Black and White newborns (mirroring the pattern for the United States as a whole). However, in at least nine states, differences in birth weight–specific mortality make a notable contribution. This pattern is observed even among those from advantaged sociodemographic backgrounds and is driven by differences in mortality among very low birth weight neonates. This calls attention to inequality in medical care at birth as an important contributor to racial disparities in neonatal mortality.

Identifier

PMID: 34568897

DOI

10.1215/00703370-9510578

Publisher

Duke University Press

ISSN

00703370

Publication Information

Demography

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