Infant mortality, death in the first year of life, is a generally accepted barometer of the overall health and well-being of a population. In the United States, the infant mortality rate has steadily declined over the last century, to a rate of 5.6 deaths per 1000 live births in 2019.1,2 Celebration of continued improvement can mask the reality that 20 927 infants died in 2019 before reaching their first birthday. For perspective, assuming that a jumbo jet carries 400 people, the current number of infant deaths would be equivalent to a jumbo jet crashing, killing everyone on board, every week for an entire year. If that happened in this country, air traffic would likely halt after a crash or two, the government would investigate, and the industry would quickly deploy solutions to prevent further deaths. Yet, for infant deaths, it seems that our society is complacent to accept the slow, if steady, pace of progress as sufficient improvement. Moreover, infant deaths are not evenly distributed across populations. Non-Hispanic Black, Native Hawaiian/Other Pacific Islander (NHOPI), and American Indian/Alaska Native (AI/AN) infants die at a rate of approximately twice that of non-Hispanic White infants (2.4, 1.8, and 1.8 times greater, respectively; Fig 1). Populations with the highest infant mortality rates in the United States have the longest histories of racial subjugation, violence, and cultural trauma beginning with their forcible removal from native lands and loss of sovereignty.
PEDIATRICS: Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030