(NEW YORK) — Infant mortality rates in the United States increased by 3% in 2022, according to a new federal report published early Thursday morning.
Researchers from the Center for Disease Control and Prevention’s (CDC) National Center for Health Statistics looked at linked birth and death data sets — information from the death certificate linked to the information from the birth certificate — from the National Vital Statistics System.
Data showed the rate increased from 5.44 infant deaths per 1,000 live births in 2021 to 5.61 deaths per 1,000 live births in 2022. This equates to a total of 20,577 infant deaths reported in 2022, up 3% from 2021.
Although the rate is lower than the 7.57 per 1,000 recorded in 1995 — the first year the linked birth/infant death file was available — it marks the second straight year of increases.
“It is concerning that the rate bumped up by 3% compared to ’21,” Dr. James Greenberg, co-director of the Perinatal Institute at Cincinnati Children’s and co-founder of Cradle Cincinnati — a non-profit working to improve infant mortality rates in Hamilton County, Ohio — told ABC News.
“The overall trend for the last many decades has been, in general, a downward trend, but the United States infant mortality rate is still much higher than almost every other developed country in the world,” he continued. “So, when we see an uptick like this, it’s certainly a cause for additional concern.”
The report found that the overall mortality rate increased for infants born to American Indian/Alaska Native women, white women and Dominican women in 2022 while other racial and ethnic groups did not see significant increases from 2021 to 2022.
Meanwhile, infants of Black women had the highest mortality rate at 10.90 per 1,000 live births in 2022 followed by infants of American Indian/Alaska Native women and Native Hawaiian or Other Pacific Islander women.
Greenberg, who was not involved in the report, said the data is further evidence of the racial and ethnic disparities seen in infant mortality rates when it comes to minority women.
“This has been a rather intractable problem in the United States…and the disparities between white and non-Hispanic, Black infant mortality and white and American Indian/Alaska Native infant mortality are quite striking and continue to be very, very troubling,” he said.
Greenberg called the Black infant mortality rate “extraordinary” and said it was “on par with some parts of the world that have very limited resources.”
The report also found that infant mortality rates were highest in the South and Rust Belt middle America and lowest in the Northeast, Northwest and West, which Greenberg said is in line with where rates are traditionally higher and lower.
Data from the report showed in 2022, the five leading causes of all infant deaths were the same as those in 2021 including congenital malformations, disorders related to short gestation and low birth weight, sudden infant death syndrome (SIDS), unintentional injuries and maternal complications.
Greenberg said preterm birth is the actual leading cause of infant death based on research conducted by his team, but there’s not a single code for a death certificate that covers preterm births.
“It’s a reflection of the way coding around cause of death is done. The problem is that the causes related to preterm birth are subdivided, so you have to actually add them up in order to get the whole impact of preterm birth,” he said. “It’s not congenital malformations, certainly not to denigrate that, that cause, but preterm birth is where it’s at.”
Greenberg said other factors that may have played a role in the bump in 2022 include an RSV and flu season in 2022 that began much earlier than usual after COVID-19 pandemic mitigation measures began to be lifted. Another role may have been the impact of a COVID-19 infection in pregnant women, which may have forced some to deliver early and, in turn, raised the risk of infant mortality.
Another factor contributing to the bump may be the overturning of Roe v. Wade in 2022, which led to anecdotal reports of women forced to carry to term babies that would die upon being born or shortly after birth.
He said it’s too soon to tell if any of the other three factors played a role, but anecdotal evidence suggests this may be the case.
Greenberg has actively been involved in working to reduce infant mortality rates in Hamilton County, where Cincinnati is located, as a co-founder of Cradle Cincinnati.
He said the county has seen a steep decrease in infant mortality since 2013 from being 70% above the national average to being right around the national average in 2023 by focusing on reducing infant mortality related to pre-term birth and improving Black infant mortality.
Efforts include promoting smoking cessation and getting pregnant people into early prenatal care by eliminating barriers in vulnerable communities.
“Our experience in Hamilton County suggests that it is possible to accelerate the reduction in infant mortality, and that it’s worth doing because infant mortality is really a signal for overall health and well-being of the whole country,” he said. “It’s not just babies. It’s a reflection of our health care system, and our ability to deliver health care effectively. It’s our reflection of our ability to do it in a way that people everywhere value and can embrace.”
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