Generations of loss: contemporary perspectives on black infant mortality

The U.S. black infant mortality rate (IMR) remains a significant public health concern. Although improved during the last four decades, the U.S. IMR remains within the lowest tier of IMRs for all industrialized countries, and black American infants remain disproportionately represented in low birthweight (LBW) and infant death statistics. Numerous risk factors have been analyzed for their relative contributions to the U.S. IMR and black-white infant survival health disparities. Those factors include prenatal care quality and access, maternal socioeconomic status (SES), HIV/AIDS status, infections, intrapartum risk factors, existing comorbidities, social support, and nutritional status. However, the role of these and other factors have not fully explained the higher infant mortality risks for black infants. This review will discuss a variety of risk factors that contribute to infant mortality disparities between non-Hispanic black and white infants. Among those factors, the goal will be to review selected topics pertaining to maternal SES, LBW, preterm birth, perinatology advances, birth record data quality, maternal stress, prenatal care adequacy, and physical and substance abuse, and the relationships of those topics to black-white IMR health disparities.