State and county level income inequality and infant mortality

Risk: the moderating role of race and socioeconomic status

Effective Dates: 7/27/15-6/30/18
Grant: R15 MD010223
Principal Investigator: Roman Pabayo

This study looks at the impact of contextual income inequality, at the U.S. state and county level, on the risk for infant birth mortality. Since infants from African-American and low socioeconomic groups are more likely to die before their first birthday, we will evaluate whether the mechanisms involved differ across racial and socioeconomic groups. In 2011, around 24,000 infants died in the United States, resulting in an infant mortality rate of 6.1 deaths occurring before the first birthday per 1,000 live births. This rate is high in comparison to other OECD countries. Income inequality, or the distribution of wealth in an area such as a U.S. state or county, can play a role in infant mortality. Income inequality might have a more detrimental effect on African-Americans and might explain why the infant mortality rate is higher among this population group in comparison to White Americans.

Project Aims

  1. To examine the causal association between contextual income inequality and risk for infant mortality
  2. To identify the mechanisms that link contextual income inequality and risk for infant mortality
  3. To test for differential effects of contextual income inequality on risk for infant mortality across racial and socioeconomic groups.

Project Design

To achieve these aims, we will conduct novel statistical methods using birth-mortality linked data. We anticipate that findings from this project will improve our understanding of the causes of and mechanisms leading to infant mortality. The proposed study will generate knowledge that is valuable and will inform policy makers and public health professionals to develop and implement policies and programs aimed at lowering the risk for infant mortality, especially among those at greatest risk such as those from African-American or low socioeconomic backgrounds.