Black-White Disparities in Neonatal Mortality: Mechanisms and Cross-State Variation

• In Event: 201 - Regular Session. Place and Mortality - Mechanisms

Abstract

Black infants have twice the likelihood of neonatal mortality as white infants. To better understand this dramatic disparity, the black-white gap in neonatal mortality can be stratified based on two generating-mechanisms: 1) disparities due to differences in the distribution of birth weights, and 2) those due to differences in birth weight-specific mortality. In this project, I utilize this distinction to explore how the social context into which infants are born contributes to gaps in neonatal mortality between blacks and whites. Drawing on linked infant birth and death records from 1995-2002, I first provide evidence that the magnitude of the black-white gap in neonatal mortality varies across 38 states. For each state, I then calculate the relative contribution of differences in birth weight distribution versus differences in birth weight-specific mortality to disparities in neonatal mortality between whites and blacks. After controlling for key individual-level characteristics, two general patterns emerge. In some states, racial disparities in neonatal mortality are entirely a product of differences in health at birth. In other states, differential access to health care contributes to disparities in neonatal mortality between whites and blacks. This has important implications for efforts to understand the persistence of racial disparities in neonatal mortality.

Author

• Benjamin Sosnaud, Harvard University