A Deadly Disparity: A Unified Assessment of the Black-White Infant Mortality Gap

We provide a unified assessment of a striking disparity in the United States: the differential rate at which white and black infants die. We separate the overall mortality gap into three temporal components—fitness at birth, conditional neonatal mortality, and conditional post-neonatal mortality—and quantify the extent to which each of the components can be predicted using a flexible reweighting method. Almost 90 percent of the overall mortality gap is due to differential fitness at birth, little of which can be predicted by racial differences in background characteristics. The remaining mortality gap stems from conditional post-neonatal mortality differences, nearly all of which can be predicted by background characteristics. The predictability of the mortality gap has declined substantially over the past two decades, largely because the mortality gap among extremely low-fitness infants is increasingly unrelated to background characteristics.