Baby deaths are at a record high in the US for the second year in a row and much higher than in peer nations.
A new report from the CDC showed there were 5.61 per every 1000 deaths among infants under one year old in 2023, around the same level in 2022, which officials hoped was a blip.
The rate in the US is up to 75 percent higher than in countries like the UK and Australia, with experts blaming America’s spiraling maternal healthcare crisis.
The leading causes of infant deaths were birth defects, disorders related to pre-term birth, sudden infant death syndrome, accidental injuries and maternal sickness.
But there were big disparities between states. Mississippi, Arkansas, Louisiana, Ohio and Oklahoma had rates between seven and nine deaths per 1,000 births.
Black babies were found to be at a two fold risk of dying within their first year of life, which experts attribute to poorer maternal healthcare for black women and a lack of access to doctors in many predominantly black areas.
Other experts pin poor outcomes for all babies on a lack of national insurance – which has poorer mothers skipping doctors appointments before and after birth.
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This can lead deadly illnesses to go undetected. For example, in 2023, the CDC reported cases of babies born with syphilis had increased tenfold in a decade.
Had the mothers with syphilis known they had the condition, they could’ve had it treated during pregnancy to avoid passing it to their child.
Instead, the condition caused 231 stillbirths and 51 infant deaths in 2022.
Dr Danielle Ely, a co-author of the report, told ABC News: ‘So what we’re seeing is that what we were hoping would be just a one-year blip is now a two-year higher rate.’
In 2022, the rates of seasonal viruses like the flu and RSV rebounded after being flattened during quarantine – both of these can be deadly to the fragile immune system of a newborn.
Dr Eric Eichenwald, a Philadelphia-based neonatologist, told PBS this uptick was ‘disturbing’ and blamed the viruses for the uptick. It’s possible that the 2023 rate simply represents the continuation of this trend.
In addition, Demographer Amanda Jean Stevenson, who was not involved in the research, pinned the blame on a lack of standardized national care.
Dr Stevenson told CNN: ‘We can certainly expect that maternal complications overall are increasing because the standard of care for pregnancy-related complications is not being met in many states.’
Though this rate stayed the same nationally between 2022-23, in a few states, like Nevada and Washington, the rate of newborn deaths actually increased, by 31 percent and 16 percent, respectively.
In Mississippi in 2023, there were 34,459 live births and 308 deaths, meaning in every 1000 births, there were about 8.94 deaths.
Similarly, in Arkansas, there were 35,264 and 290 deaths, representing 8.22 deaths per every 1000 births.
In Ohio, there were were 126,896 births and 909 deaths, representing 7.16 deaths per every 1000 births.
The above graph shows the infant mortality rate by ethnic group in 2021 (blue) and 2022 (green)
According to the American Journal of Managed Care, as of 2022 the US has the highest infant mortality rate of similarly developed countries, including Australia, Canada, France, Germany and Japan.
In the UK, 3.9 deaths of every 1000 births ends in an infant death and in Australia its 3.2 deaths of every 1000 births.
Dr Sandy Chung, the president of the American Academy of Pediatrics, told CNN: ‘We live in a country with significant resources, so the infant mortality rate and the increase are shockingly high’.
The National Vital Statistics System, the arm of the CDC that releases this report, collected birth certificate data, researchers sorted them based on race, sex, state of residents and ten leading causes of infant death.
Maternal sicknesses included conditions like pre-eclampsia, a dangerously high blood pressure which affects an estimated 9.5 percent of pregnancies.
Black children continued to be more likely to die than any other group, followed closely by Native Americans and Native Hawaiians or other pacific islanders.
Aside from measuring the overall rates of each state, there were a few states whose rate of infant mortality got worse over the year.
Though Nevada and Washington saw the biggest increases, the rates also jumped in states like Rhode Island, Alabama and Kentucky.
Experts from the National Bureau of Economic Research said this gap between the US and other countries is largely owing to two factors.
First, in Europe, doctors are more likely to count infants born after 24 weeks as a miscarriage, whereas the US is more likely to count them as live births.
Second, babies in the US are more likely to be born pre-term or with a low birth weight. Both of these factors can make a baby more likely to die.
Outside of a national statistic, Dr Chung said that differences in healthcare from state to state, based both on the number of doctors and the type of public insurance available, may be contributing to differences.
The US regularly outranks other developed nations in terms of infant mortality.
In some states, women have to drive for hours to get to a doctor – meaning they might skip check ups during pregnancy and might not even make it to the hospital to give birth.
In Mississippi, for example, a 2023 report found that half of the women live in a county without access to maternity care. 24 percent of women didn’t have a birthing hospital within 30 minutes of their home.
Dr Chung said: ‘We know that for people who live in or near poverty and for certain racial and ethnic groups there are significant challenges with getting access to a doctor or getting treatments.’
In addition, research has shown that state’s who expand Medicaid coverage to cover mothers in the year after they give birth decreases the number of infant deaths. This is largely because uninsured women may be more likely to skip doctors visits after giving birth than women who are covered by a plan.
Many states have since moved to adopt this plan. Arkansas, which ranks in the top five for the worst infant mortality rates, did not.
Dr Chung said: ‘We need to change policies to help lift families out of poverty and help them get access to healthcare sooner, before is it too late.’
