Racial Disparities in Maternal and Infant Health: An Overview

Stark racial disparities in maternal and infant health in the U.S. have persisted for decades despite continued advancements in medical care. Growing calls for racial justice and the disparate impact of the COVID-19 pandemic for people of color have brought a new focus to health disparities, including the longstanding inequities in maternal and infant health. This brief provides an overview of racial disparities for selected key measures of maternal and infant health.1 It finds:

  • Black and American Indian and Alaska Native (AIAN) women have higher rates of pregnancy-related death compared to White women. Pregnancy-related mortality rates among Black and AIAN women are over three and two times higher, respectively, compared to the rate for White women (40.8 and 29.7 vs. 12.7 per 100,000). Racial disparities for these groups increase by maternal age and persist across education levels. There were small differences in pregnancy-related death between Asian and Pacific Islander and White women (13.5 vs. 12.7 per 100,000), and the rate for Hispanic women was lower compared to that of White women (11.5 vs. 12.7 per 100,000).
  • Black, American Indian and Alaska Native (AIAN), and Native Hawaiian and Other Pacific Islander (NHOPI) women are more likely compared to White women to have births with risk factors that increase likelihood of infant mortality and can have long-term negative consequences for children’s health. They have higher shares preterm births, low birthweight births, or births for which they received late or no prenatal care compared to White women. Hispanic women also have a higher share of births for which they received late or no prenatal care compared to White women.
  • Reflecting increased birth risks, infants born to Black, AIAN, and NHOPI have markedly higher mortality rates than those born to White women. In particular, the infant mortality rate among infants born to Black mothers is over twice as high as the rate for those born to White mothers (10.8 vs. 4.6).

These disparities, in part, reflect increased barriers to health care among people of color. However, research also highlights the major role social and economic inequities and historic and ongoing racism and discrimination play in driving disparities. Improving maternal and infant health is key for preventing unnecessary illness and death and advancing overall population health. A range of initiatives are underway that are designed to address rising maternal mortality rates and ongoing disparities in maternal and infant health, including efforts through Medicaid. Looking ahead, the COVID-19 pandemic further highlights the urgency and importance of addressing health disparities in maternal and infant health and beyond, given its significant disproportionate health and economic impacts for people of color.

Issue Brief

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