Poverty and Infant Mortality in the United States

This paper examines the theoretical and empirical relationship of income poverty to infant mortality differentials in the comtemporary United States. Using national data gathered in 1964-65, this study estimates the relative impact of a variety of biological, social, and economic factors upon the risk of infant death. Methods for the analysis of multidimensional contingency tables permit the combination of birth and death data, and coefficient estimates from these models provide estimates of the relative risks of infant death observed in various subpopulations. Within the white population of legitimate births in 1964-65, coefficient estimates indicate that poverty is associated with relative risks of neonatal and postneonatal mortality 1.5 times greater than that experienced by infants not born in poverty, independent of a variety of maternal and familial characteristics and the birth weight of the infant. Hospital care during the neonatal period, however, appears to attenuate this increased risk for some high risk infants. The estimated direct effects of poverty upon infant mortality are larger than the effects of poverty mediated by the birth weight of the infant. The persistence of poverty and the continuing unequal distribution of health care resources to pregnant women and young mothers in the United States imply the reproduction of these differentials to the present day. Increasing access to health services and increased help to families through income supports and employment programs are indicated as possible policy actions to reduce these differentials.