In 2022, 5.60 out of every 1,000 infants in the US passed away before their first birthday, marginally more than 2021’s 5.44 out of 1,000.[1] This is known as the US infant mortality rate, and it’s one of the markers officials use to measure American society's health.
The rate has improved in recent decades thanks to several advancements — dropping 85% between 1940 and 2005, thanks to advances in medicine, prenatal care, and improved sanitation —but disparities in infant mortality rates across demographic groups persist.
American Indians, Native Hawaiians, and Black Americans all had infant mortality rates above the national average, while rates for Hispanic, white, and Asian American communities were below.
The Black infant mortality rate in particular is nearly double the national average. Compared to non-Hispanic white infants, non-Hispanic Black newborns were 2.4 times more likely to pass before they turned one and were 30% more likely to suffer from birth defects.[2]
According to a 2020 Centers for Disease Control (CDC) study, a range of factors contribute to these disparities, including access to and utilization of pre- and post-natal care, prenatal screenings, insurance types, nutrition, and more.
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What are the leading causes of infant mortality?
In 2021, birth defects were responsible for nearly one out of every five infant deaths nationwide. Birth defects — structural changes to any body part present at birth — affect one in every 33 babies born in the US each year and vary from mild to severe.
Other common causes of infant death were preterm births, sudden infant death syndrome (commonly called SIDS), accidental injuries sustained during or after birth, and pregnancy complications.
What factors contribute to infant mortality?
According to CDC data, smoking, substance abuse, having a child at an older age, residing in rural areas, not getting proper nutrition, and skipping early childhood immunization are all associated with an increased risk of infant mortality.
Which states have the highest infant mortality rates?
Geographically, the South recorded the highest infant mortality, while the Northeast had the lowest rates.
In 2021, Mississippi had the highest infant mortality rate, at 9.39 per 1,000 births, with Arkansas (8.59) and Alabama (7.56) just behind. North Dakota had the lowest at 2.77, with Vermont close at 3.16[3] and Massachusetts at 3.23.
Twenty states reached the 2030 government target of five or fewer infant deaths per 1,000 live births.
Regional variations in infant mortality rates can be influenced by healthcare access and quality of care, socioeconomic status, public health initiatives targeting maternal health, and environmental factors, among other factors.
These rankings also do not take demographic variables into account, including the ratio of racial/ethnic groups, the age distribution of the population, or general population sizes by state.
Which country has the highest infant mortality rate?
According to 2023 estimates from the Central Intelligence Agency (CIA), Afghanistan has the highest infant mortality rate in the world at just over 10%, or 103.06 deaths per 1,000 births. They are followed by Somalia (85.06), the Central African Republic (81.74), Equatorial Guinea (77.85), and Sierra Leone (72.30).
The worldwide average for 2023 is estimated at 30.8 across all countries and territories monitored by the CIA. The US ranked 54th in infant mortality out of 227 measured countries and territories at a predicted rate of 5.12 deaths per 1,000 births. This rate is a preliminary estimate for 2023, and is subject to change depending on up-to-date CDC data.
International differences in infant mortality rates tie back into the same factors impacting infant deaths in the US, with the addition of varying levels of economic development, conflict and political instability, the prevalence of infectious diseases, vaccination coverage, and more.
According to the CDC, more than 50 million infant deaths worldwide could be prevented between 2021 and 2030 through immunizations.
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[1] 2022 infant mortality data comes from CDC and is considered provisional as of November 2023.
[2] The latter finding comes from a US study observing births between 2003– 2017.
[3] The CDC has marked this figure as unreliable.
