Black infant mortality rate more than double the rate among white infants: CDC

Infant mortality rates remained relatively unchanged from 2022 to 2023, but racial and ethnic disparities still persist, new provisional federal data released early Thursday finds.

The U.S. provisional infant mortality rate in 2023 was 5.61 infant deaths per 1,000 live births, unchanged from the 2022 rate, according to a report from the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

The report also found that infants born to Black mothers still died at much higher rates than those born to white and Asian mothers -- more than double the rate of white infant mortality, according to the CDC.

Additionally, changes in the neonatal mortality rate from 3.59 deaths per 1,000 live births in 2022 to 3.65 deaths per 1,000 live births in 2023, and the postneonatal mortality rate from 2.02 deaths per 1,000 live births to 1.96 deaths per 1,000 live births from 2022 to 2023 were not seen as statistically significant, the report's authors said.

Neonatal refers to the first four weeks of an infant's life and postneonatal refers to the period between 28 days and 364 days after birth.

Dr. Danielle Ely, co-author of the report and a health statistician at the NCHS, said 2022 was the first year there was a significant increase in the infant mortality rate in about 20 years. That the rate did not increase in 2023 shows the rise in 2022 was likely not a fluke, she said.

"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," she told ABC News. "It is unfortunate that it did not go down again to where it was in 2021 at least or at least down from 2022. It just quite literally stayed the same, the infant mortality did."

Black infants died at a rate of 10.9 infant deaths per 1,000 live births, more than double the rate of 4.5 deaths per 1,000 live births for white women and 3.4 deaths per 1,000 live births for Asian women, per the CDC data.

Infants born to American Indian and Alaska Native women also had higher rates than white and Asian women at 9.2 deaths per 1,000 live births, according to the report.

Data also showed infants born to Hawaiian or Pacific Islander women died at a rate of 8.2 deaths per 1,000 live births, and those born to Hispanic women died at a rate of 5.0 deaths per 1,000 live births.

Robin Jacob, an associate research professor at the Institute for Social Research and the School of Education at the University of Michigan, told ABC News she was not surprised by the findings.

"I am not surprised; in particular infant mortality among Black women and infants is consistently higher than for white women, but I am disappointed that despite increased awareness and efforts to reduce the disparities, we are not seeing any progress in reducing the infant mortality rate among this population," she said.

Why racial disparities continue to persist is "the $100 million question," Dr. Kirsten Bechtel, a pediatric emergency medicine physician at Yale New Haven Children's Hospital and an expert in infant mortality, told ABC News.

"One of things that's great about this data is that it helps us work backward. It's like the canary in the gold mine," Bechtel, who was not involved in the report, said. "Death is an outcome that everyone agrees on is a problem, but why that problem happens is oftentimes subject to vigorous discussion."

She said one reason behind the disparities could be that Black mothers have a higher rate of pre-term birth, and pre-term birth is associated with higher infant mortality.

"That has a lot to do with access to timely prenatal care," Bechtel said. "Trying to get folks access to timely care during pregnancy and timely care that is evidence-based. We also know there is some elements of structural racism that is built into some of the care these women receive."

Jacobs said other reasons could be neighborhood and environmental factors, including greater exposure to pollution and other toxins for Black residents, and economic instability, leading to more limited access to high quality medical care.

Bechtel said the findings show that pregnant people need to be supported financially with access to medical care and by the community helping take care of a child.

"Raising a child can be very daunting, especially if you have socioeconomic challenges or you have to go to work and you can't take time off after your baby's birth," she said. "So we really need to look at policies that support pregnant people."

Harika Rayala, M.D., MSJ, is a neurology resident physician at the University of Virginia and a member of the ABC News Medical Unit.