Infant mortality

Mississippi recorded 8.78.7 infant deaths per 1,000 live birthsEstimandcrude rate from the death count, normal intervalInterval95% CI 8.3 to 9.2n1,564 infant deathsWeightsnone (crude rate from counts)Populationlive births in MississippiPeriod2018 to 2022SourceCDC WONDER linked birth and infant death infant deaths for every 1,0001,000 live birthsEstimandthe denominator of an infant mortality rate (a definition)Weightsnone (definition)Populationall live birthsPeriodall years (a definition)SourceCDC WONDER linked birth and infant death live births in 2018 to 2022, the highest rate of any state. Massachusetts and New Hampshire recorded 3.73.7 infant deaths per 1,000 live birthsEstimandcrude rate from the death count, normal intervalInterval95% CI 3.5 to 3.9n1,260 infant deathsWeightsnone (crude rate from counts)Populationlive births in MassachusettsPeriod2018 to 2022SourceCDC WONDER linked birth and infant death, the lowest. An infant death is the death of a baby before its first birthday, and the infant mortality rateInfant mortality rateThe number of babies who die before their first birthday for every thousand live births. divides those deaths by the live births of the same years. Over 2018 to 2022 the rate for the United States as a whole was 5.55.5 infant deaths per 1,000 live birthsEstimandcrude rate from the death count, normal intervalInterval95% CI 5.5 to 5.6n102,503 infant deathsWeightsnone (crude rate from counts)Populationlive births in the 50 states and DCPeriod2018 to 2022SourceCDC WONDER linked birth and infant death.

State rates run from Massachusetts to Mississippi

The ratio of the rate in Mississippi to the rate in Massachusetts is 2.4 (95% CI 2.2 to 2.6)2.4 ratio of ratesEstimandratio of Mississippi's crude rate to Massachusetts's, log-normal interval on the two death countsInterval95% CI 2.2 to 2.6n2,824 infant deathsWeightsnone (crude rates from counts)Populationlive births in Mississippi and in MassachusettsPeriod2018 to 2022SourceCDC WONDER linked birth and infant death. Each of these rates pools a state's infant deaths and live births over the period, so the unit is the state and the population is every live birth in it. Arkansas, Louisiana and Alabama follow Mississippi in the ranking. Pooled over births, the Census South region had a rate of 6.3 (95% CI 5.9 to 6.9)6.3 infant deaths per 1,000 live birthsEstimandpooled crude rate over the states of the group (17 states), bootstrap interval over those statesInterval95% CI 5.9 to 6.9n17 statesWeightsbirths in each statePopulationlive births in the Census South region (16 states and DC)Period2018 to 2022SourceCDC WONDER linked birth and infant death against 5.1 (95% CI 4.6 to 5.7)5.1 infant deaths per 1,000 live birthsEstimandpooled crude rate over the states of the group (34 states), bootstrap interval over those statesInterval95% CI 4.6 to 5.7n34 statesWeightsbirths in each statePopulationlive births outside the Census South regionPeriod2018 to 2022SourceCDC WONDER linked birth and infant death in the rest of the country.

Figure 1

Infant mortality ran from 3.7 per 1,000 in Massachusetts and New Hampshire to 8.7 in Mississippi

Infant deaths per 1,000, by state and DC, 2018 to 2022; the first tab maps the rates and the second ranks them with intervals

Map of statesStates ranked

Mississippi's rate of 8.7 is 2.4 times Massachusetts's 3.7

The dots fall from Mississippi at the top to Massachusetts and New Hampshire at the bottom, whose intervals overlap, and the dashed rule marks the national rate of 5.5. The whiskers are 95% intervals on the death counts.

Show data

Data for Infant mortality ran from 3.7 per 1,000 in Massachusetts and New Hampshire to 8.7 in Mississippi, States ranked

conf_high	conf_low	n	rate	state
9.17	8.31	178,940	8.74	Mississippi
8.03	7.22	180,269	7.63	Arkansas
7.88	7.25	289,800	7.57	Louisiana
7.49	6.87	290,226	7.18	Alabama
7.14	6.74	656,808	6.94	Ohio
7.24	6.63	284,416	6.93	South Carolina
7.45	6.35	87,834	6.90	West Virginia
7.13	6.48	243,308	6.81	Oklahoma
7.46	6.11	56,872	6.79	South Dakota
7.04	6.53	400,716	6.79	Indiana
6.97	6.55	596,437	6.76	North Carolina
6.94	6.54	625,219	6.74	Georgia
6.85	6.35	403,872	6.60	Tennessee
6.62	6.19	529,293	6.40	Michigan
6.46	5.94	353,119	6.20	Missouri
6.74	5.35	48,103	6.05	Alaska
6.69	5.25	43,900	5.97	District of Columbia
6.11	5.82	1,091,908	5.97	Florida
6.62	5.30	52,873	5.96	Delaware
6.18	5.67	346,879	5.92	Maryland
6.26	5.54	175,138	5.90	Kansas
6.08	5.65	483,476	5.87	Virginia
6.15	5.56	263,188	5.86	Kentucky
6.09	5.55	309,792	5.82	Wisconsin
5.98	5.62	678,780	5.80	Illinois
6.61	4.93	31,541	5.77	Wyoming
6.33	5.12	59,728	5.73	Maine
5.89	5.52	663,470	5.70	Pennsylvania
5.83	5.36	393,508	5.60	Arizona
5.95	5.12	123,488	5.54	Nebraska
5.97	4.95	80,709	5.46	Hawaii
5.90	5.03	110,907	5.46	New Mexico
5.56	5.35	1,887,748	5.45	Texas
5.70	5.01	171,286	5.35	Nevada
5.80	4.55	50,828	5.17	North Dakota
5.45	4.87	232,217	5.16	Utah
5.38	4.55	109,817	4.96	Idaho
5.40	4.25	55,789	4.82	Montana
5.03	4.54	312,580	4.79	Colorado
5.04	4.41	184,889	4.73	Iowa
4.85	4.38	325,254	4.61	Minnesota
5.19	4.01	51,515	4.60	Rhode Island
4.64	4.24	421,310	4.44	Washington
4.68	4.05	173,445	4.36	Connecticut
4.60	4.03	204,273	4.31	Oregon
4.36	4.11	1,075,631	4.23	New York
4.94	3.39	26,626	4.17	Vermont
4.20	4.03	2,161,370	4.11	California
4	3.66	503,152	3.83	New Jersey
4.20	3.23	60,327	3.71	New Hampshire
3.88	3.48	342,375	3.68	Massachusetts

How we know

The counts come from the linked birth and infant death records on CDC WONDER, which match each infant death certificate to the infant's birth certificate.[1] The state files cover every state and the District of Columbia. WONDER publishes every state total in full, so no state rate rests on a withheld count, and the state file for 2021 reproduces the national rate that NCHS reports for that year. The rates are crude ratesCrude rateDeaths or births divided by the population, with no adjustment for age. A place with older residents has a higher crude death rate even if health at each age is the same., with no adjustment for the age or health of mothers. The pooled period includes the pandemic years, but no single year sets the pooled rates. The report gives every estimate with its interval and sample size.

Across large counties the rate rises with deprivation

WONDER's linked file names only counties of 250,000250,000 residentsEstimandpopulation size at which WONDER names a county in the linked file (a definition)Weightsnone (definition)Populationcounties that CDC WONDER linked birth and infant death names individuallyPeriodinfant deaths and live births in 2018 to 2022SourceCDC WONDER linked birth and infant death residents or more and pools every other county in a state into one row. To place counties on one scale, each census tract carries its Area Deprivation IndexArea Deprivation Index (ADI)A score that ranks neighborhoods by income, education, employment and housing conditions drawn from the American Community Survey. In this book a higher national percentile means a more deprived neighborhood. national rank, which orders neighborhoods by deprivation, with a higher rank meaning more deprived.[2] A county's rank is the average of its tracts' ranks, weighted by population.

WONDER withholdsSuppressionThe withholding of a number because the count behind it is too small to publish without risking the identification of a person. A suppressed value is missing, not zero. a county's count in any year with too few deaths to publish, so a county's published years are its high years. The chapter therefore leaves out whole any named county with a withheld year. The withheld county-years could hold at most 0.6%0.6% percent of infant deathsEstimandlargest share of deaths the withheld county-years could hold: 9 deaths in each withheld county-year, over published deaths plus that limitWeightsnone (an upper limit from the cell count)Populationinfant deaths in the named countiesPeriod2018 to 2022SourceCDC WONDER linked birth and infant death of infant deaths in the named counties. The counties that remain hold 62.3%62.3% percent of live births in the United StatesEstimandshare of births in the counties usedn18,484,949 birthsWeightsnone (full count)Populationlive births in the 50 states and DCPeriod2018 to 2022SourceCDC WONDER linked birth and infant death of births in the United States. Split into quarters, the rate rises from 3.9 (95% CI 3.7 to 4.1)3.9 infant deaths per 1,000 live birthsEstimandbirths-weighted mean of county rates (the pooled rate), bootstrap interval over countiesInterval95% CI 3.7 to 4.1n60 countiesWeightsbirths in each countyPopulationlive births in the least deprived quarter of the counties used, by county deprivation rankPeriod2018 to 2022SourceCDC WONDER linked birth and infant death in the least deprived quarter of these counties to 7.2 (95% CI 6.7 to 7.6)7.2 infant deaths per 1,000 live birthsEstimandbirths-weighted mean of county rates (the pooled rate), bootstrap interval over countiesInterval95% CI 6.7 to 7.6n60 countiesWeightsbirths in each countyPopulationlive births in the most deprived quarter of the counties used, by county deprivation rankPeriod2018 to 2022SourceCDC WONDER linked birth and infant death in the most deprived. The quarters are quarters of large counties, so the most deprived quarter is relative to large counties and not to the nation.

Figure 2

Infant mortality rises from 3.9 per 1,000 in the least deprived quarter of large counties to 7.2 in the most deprived

Infant deaths per 1,000 by county deprivation, WONDER 2018 to 2022 for the large counties and County Health Rankings 2015 to 2021 for all counties with a rate

Large counties, 2018 to 2022All counties with a rate, 2015 to 2021

Across 240 large counties the infant mortality rate moves with the deprivation rank, a correlation of 0.80

• Dot area: births, 2018 to 202251,000180,000510,000

Dots drift up from left to right and the quartile means follow them. Each dot is a county, with area in proportion to its births; the line plots the births-weighted rate in each quarter of counties with a 95% interval from a bootstrap over counties.

Show data

Data for Infant mortality rises from 3.9 per 1,000 in the least deprived quarter of large counties to 7.2 in the most deprived, Large counties, 2018 to 2022

adi	births	conf_high	conf_low	county	imr
27.27	24712	5.68	3.95	Ada County, ID	4.82
31.50	30996	6.27	4.63	Adams County, CO	5.45
7.82	87316	3.81	3.04	Alameda County, CA	3.42
60.06	61976	6.97	5.71	Allegheny County, PA	6.34
67.85	26159	8.09	6.05	Allen County, IN	7.07
37.23	18908	6.14	4.06	Anchorage Borough, AK	5.02
26.31	34328	5.23	3.80	Anne Arundel County, MD	4.52
41.11	20680	5.51	3.63	Anoka County, MN	4.50
25.25	37521	5.53	4.12	Arapahoe County, CO	4.82
54.06	13899	7.64	4.95	Atlantic County, NJ	6.19
42.28	47439	7.24	5.79	Baltimore County, MD	6.51
64.94	37283	9.78	7.87	Baltimore city, MD	8.82
64.57	30340	7.68	5.83	Bell County, TX	6.76
19.42	45255	3.32	2.34	Bergen County, NJ	2.83
60.09	22847	7.10	5.07	Berks County, PA	6.08
54.44	33665	5.94	4.40	Bernalillo County, NM	5.17
59.17	130037	6.54	5.69	Bexar County, TX	6.11
49.43	23485	6.16	4.31	Brazoria County, TX	5.24
48.90	25720	7.23	5.29	Brevard County, FL	6.26
34.02	27992	5.09	3.55	Bristol County, MA	4.32
31.09	91577	5.39	4.48	Bronx County, NY	4.94
40.97	105205	5.56	4.69	Broward County, FL	5.12
29.71	28196	4.12	2.73	Bucks County, PA	3.37
40.10	22548	4.61	2.97	Burlington County, NJ	3.73
58.33	21858	8.50	6.23	Butler County, OH	7.37
76.41	14759	13.47	9.97	Caddo Parish, LA	11.72
54.47	30660	6.48	4.80	Camden County, NJ	5.64
84.05	30306	6.10	4.46	Cameron County, TX	5.28
35.04	24786	7.41	5.42	Charleston County, SC	6.41
56.20	18040	8.44	5.97	Chatham County, GA	7.21
26.68	27190	4.92	3.39	Chester County, PA	4.16
40.91	19995	7.02	4.88	Chesterfield County, VA	5.95
39.24	128486	5.71	4.92	Clark County, NV	5.32
26.64	27580	4.93	3.41	Clark County, WA	4.17
71.44	18045	9.94	7.24	Clayton County, GA	8.59
59.97	13801	8.41	5.57	Cleveland County, OK	6.88
37.38	44285	6.11	4.73	Cobb County, GA	5.42
26.55	59079	4.58	3.55	Collin County, TX	4.06
12.71	58952	4.22	3.24	Contra Costa County, CA	3.73
47.08	282978	6.27	5.70	Cook County, IL	5.99
30.73	13937	6.02	3.66	Cumberland County, ME	4.74
72.53	26502	9.36	7.17	Cumberland County, NC	8.26
69.33	66965	8.62	7.27	Cuyahoga County, OH	7.94
35.84	25220	4.34	2.83	Dakota County, MN	3.53
51.84	184635	6.68	5.96	Dallas County, TX	6.32
37.44	28463	5.66	4.04	Dane County, WI	4.85
62.88	16619	7.79	5.33	Dauphin County, PA	6.56
38	49796	7.43	5.99	Davidson County, TN	6.71
26.64	24783	5.75	4.01	Davis County, UT	4.88
44.32	51244	7.61	6.17	DeKalb County, GA	6.89
47.79	31972	7.26	5.51	Delaware County, PA	6.38
31.79	52331	4.76	3.65	Denton County, TX	4.20
21.31	45889	5.36	4.10	Denver County, CO	4.73
16.41	43900	6.69	5.25	District of Columbia, DC	5.97
55.92	40205	6.94	5.40	Douglas County, NE	6.17
34.30	49162	4.39	3.30	DuPage County, IL	3.84
41.88	20648	6.90	4.82	Durham County, NC	5.86
55.54	63717	8.47	7.10	Duval County, FL	7.78
61.83	28385	9.38	7.25	East Baton Rouge Parish, LA	8.31
32.73	45669	6.25	4.88	El Paso County, CO	5.56
74.50	56931	4.90	3.81	El Paso County, TX	4.36
62.29	47598	6.99	5.57	Erie County, NY	6.28
74.57	13589	9.12	6.18	Erie County, PA	7.65
62.76	18763	9.27	6.72	Escambia County, FL	7.99
21.97	42043	4.40	3.22	Essex County, MA	3.81
33.03	49864	5.40	4.19	Essex County, NJ	4.79
14.29	64587	4.28	3.33	Fairfax County, VA	3.81
26.85	49089	4.33	3.24	Fairfield County, CT	3.79
55.11	18798	6.89	4.71	Fayette County, KY	5.80
62.43	22019	9.61	7.19	Forsyth County, NC	8.40
37.63	45977	5	3.79	Fort Bend County, TX	4.39
55.13	89264	8.11	6.97	Franklin County, OH	7.54
46.34	70267	6.50	5.36	Fresno County, CA	5.93
36.01	61856	7.68	6.36	Fulton County, GA	7.02
50.28	19552	6.29	4.25	Galveston County, TX	5.27
73.71	22242	8.41	6.16	Genesee County, MI	7.28
68.78	16516	7.31	4.92	Greene County, MO	6.12
52.19	31893	6.17	4.56	Greenville County, SC	5.36
62.39	29763	9.55	7.45	Guilford County, NC	8.50
41.21	54430	6.31	5.04	Gwinnett County, GA	5.68
33.43	18889	5.80	3.78	Hamilton County, IN	4.71
59.80	52488	8.79	7.25	Hamilton County, OH	8.02
51.80	21724	7.36	5.25	Hamilton County, TN	6.31
54.48	24027	6.25	4.40	Hampden County, MA	5.33
55.59	326538	5.90	5.39	Harris County, TX	5.65
47.60	44945	5.38	4.10	Hartford County, CT	4.74
36.21	75308	5.15	4.17	Hennepin County, MN	4.66
42.82	18663	7.23	4.99	Henrico County, VA	6.11
83.04	69018	5.14	4.13	Hidalgo County, TX	4.64
45.98	85289	7.12	6.03	Hillsborough County, FL	6.58
35.48	20792	4.90	3.14	Hillsborough County, NH	3.94
11.87	57712	6.02	4.82	Honolulu County, HI	5.42
57.80	15979	7.97	5.43	Horry County, SC	6.70
19.35	16518	6.36	4.11	Howard County, MD	5.15
24.79	47913	3	2.09	Hudson County, NJ	2.55
68	14800	8.45	5.74	Ingham County, MI	7.09
64.74	43660	8.04	6.44	Jackson County, MO	7.24
62.60	40646	9.41	7.62	Jefferson County, AL	8.51
19.12	27859	5.23	3.67	Jefferson County, CO	4.45
60.18	47503	6.76	5.36	Jefferson County, KY	6.06
75.11	16350	9.52	6.75	Jefferson County, TX	8.13
60.17	27429	7.40	5.50	Jefferson Parish, LA	6.45
35.27	34859	4.71	3.38	Johnson County, KS	4.04
60.96	14235	6.76	4.27	Kalamazoo County, MI	5.41
45.72	29065	6.06	4.40	Kane County, IL	5.23
51.75	41330	6.13	4.71	Kent County, MI	5.42
52.63	63025	6.17	5	Kern County, CA	5.59
12.92	118597	4.30	3.59	King County, WA	3.95
9.96	177304	3.65	3.11	Kings County, NY	3.38
52.49	26154	6.98	5.10	Knox County, TN	6.04
52.55	17380	6.93	4.63	Lake County, FL	5.70
42.15	34279	4.79	3.43	Lake County, IL	4.11
65.67	27602	7.86	5.90	Lake County, IN	6.88
55.73	18657	6.41	4.31	Lancaster County, NE	5.36
49.56	34889	6.56	4.96	Lancaster County, PA	5.76
37.21	15763	6.03	3.80	Lane County, OR	4.82
24.18	15478	5.57	3.41	Larimer County, CO	4.39
47.61	35217	6.44	4.87	Lee County, FL	5.65
54.75	20497	6.85	4.76	Lehigh County, PA	5.81
57.97	14368	11.13	7.94	Leon County, FL	9.54
62.02	16300	7.33	4.88	Lexington County, SC	6.01
64.59	16003	7.19	4.75	Lorain County, OH	5.87
14.23	507627	4.05	3.70	Los Angeles County, CA	3.87
11.94	24624	4.27	2.76	Loudoun County, VA	3.45
67.26	20115	6.38	4.36	Lubbock County, TX	5.37
74.43	25684	10.20	7.87	Lucas County, OH	9.03
75.48	16015	7.11	4.69	Luzerne County, PA	5.81
58.72	44601	5.68	4.36	Macomb County, MI	5.02
53.80	21699	7.07	5	Madison County, AL	6.04
46.74	17713	6.75	4.54	Manatee County, FL	5.65
36.11	253434	5.68	5.10	Maricopa County, AZ	5.39
66.59	17607	8.41	5.91	Marion County, FL	7.16
67.02	69959	8.79	7.45	Marion County, IN	8.12
38.99	20047	4.91	3.12	Marion County, OR	3.94
40.70	73809	5.69	4.66	Mecklenburg County, NC	5.18
42.31	19125	5.32	3.41	Merced County, CA	4.29
42.50	20404	5.97	4.03	Mercer County, NJ	5
37.24	146849	5.11	4.41	Miami-Dade County, FL	4.76
14.53	81044	3.07	2.36	Middlesex County, MA	2.71
29.18	43015	4.40	3.23	Middlesex County, NJ	3.81
66.79	61939	9.02	7.58	Milwaukee County, WI	8.30
72.95	26321	9.38	7.18	Mobile County, AL	8.28
20.24	30024	3.76	2.47	Monmouth County, NJ	3.06
65.30	38357	6.91	5.34	Monroe County, NY	6.13
16.90	28437	5.81	4.17	Monterey County, CA	4.99
18.93	59475	5.05	3.97	Montgomery County, MD	4.51
72.95	31169	9.12	7.12	Montgomery County, OH	8.12
31.41	42442	4.40	3.23	Montgomery County, PA	3.82
43.03	38709	5.19	3.85	Montgomery County, TX	4.52
24.43	38803	4.51	3.27	Multnomah County, OR	3.89
13.81	69152	3.29	2.49	Nassau County, NY	2.89
43.82	30714	7.17	5.40	New Castle County, DE	6.28
48.10	42444	5.94	4.56	New Haven County, CT	5.25
8.92	75763	3.10	2.36	New York County, NY	2.73
14.99	35515	3.39	2.27	Norfolk County, MA	2.79
68.22	21911	6.26	4.33	Nueces County, TX	5.29
43.65	63665	5.28	4.21	Oakland County, MI	4.74
35.14	47818	3.39	2.42	Ocean County, NJ	2.91
66.32	55427	7.28	5.93	Oklahoma County, OK	6.60
67.47	24676	6.31	4.47	Onondaga County, NY	5.39
11.18	163437	3.50	2.95	Orange County, CA	3.22
44.12	82031	6.25	5.21	Orange County, FL	5.73
36.70	26515	4.50	3	Orange County, NY	3.70
51.55	21909	8.34	6.09	Orleans Parish, LA	7.21
47.66	23048	5.38	3.65	Osceola County, FL	4.51
38.83	73930	5.19	4.20	Palm Beach County, FL	4.69
55.44	26164	6.20	4.43	Pasco County, FL	5.31
34.54	31863	4.41	3.06	Passaic County, NJ	3.73
62.40	99523	7.53	6.49	Philadelphia County, PA	7.01
26.23	55649	5.73	4.54	Pierce County, WA	5.14
53.40	51086	6.21	4.91	Pima County, AZ	5.56
50.23	23631	6.63	4.71	Pinal County, AZ	5.67
48.07	38298	6.59	5.06	Pinellas County, FL	5.82
23.13	26014	4.34	2.85	Plymouth County, MA	3.54
62.59	41609	8.18	6.53	Polk County, FL	7.35
55.05	32415	5.70	4.17	Polk County, IA	4.94
33.05	57070	7.60	6.24	Prince George's County, MD	6.92
23.33	31727	5.76	4.20	Prince William County, VA	4.98
42.93	34996	6.14	4.60	Providence County, RI	5.37
68.10	25254	10.33	7.97	Pulaski County, AR	9.15
16.43	127498	4.01	3.35	Queens County, NY	3.68
46.60	34908	6.68	5.07	Ramsey County, MN	5.87
64.44	23223	8.14	5.98	Richland County, SC	7.06
15.94	25520	4.99	3.40	Richmond County, NY	4.19
28.37	139031	4.83	4.12	Riverside County, CA	4.47
21.10	29748	3.53	2.28	Rockland County, NY	2.86
41.48	21292	7.36	5.23	Rutherford County, TN	6.29
27.87	92812	5.60	4.68	Sacramento County, CA	5.14
27.27	77022	5.92	4.88	Salt Lake County, UT	5.40
31.95	137256	5.86	5.07	San Bernardino County, CA	5.46
13.98	190765	3.87	3.33	San Diego County, CA	3.60
3.15	39750	3.17	2.16	San Francisco County, CA	2.67
28.64	49351	6.08	4.78	San Joaquin County, CA	5.43
3.18	39199	3.41	2.35	San Mateo County, CA	2.88
17.02	27310	4.86	3.34	Santa Barbara County, CA	4.10
5.05	100305	3.03	2.39	Santa Clara County, CA	2.71
68.53	33214	7.85	6.06	Sedgwick County, KS	6.95
40.38	22970	6.59	4.65	Seminole County, FL	5.62
66.30	63231	9.03	7.61	Shelby County, TN	8.32
17.55	48396	4.04	2.98	Snohomish County, WA	3.51
20.56	24894	5.20	3.56	Solano County, CA	4.38
14.25	22266	3.82	2.33	Sonoma County, CA	3.01
66.48	19748	6.44	4.39	Spartanburg County, SC	5.42
40.64	29031	5.14	3.61	Spokane County, WA	4.37
44.15	21156	5.86	3.97	St. Charles County, MO	4.92
70.57	14336	10.17	7.13	St. Clair County, IL	8.65
71.71	16710	9.18	6.50	St. Joseph County, IN	7.84
53.57	54322	6.56	5.26	St. Louis County, MO	5.91
70.84	18927	10.39	7.68	St. Louis city, MO	9.03
50.80	16350	6.43	4.15	St. Lucie County, FL	5.20
33.77	36279	5.78	4.31	Stanislaus County, CA	5.04
71.61	19961	7.58	5.35	Stark County, OH	6.46
16.54	42713	4.50	3.32	Suffolk County, MA	3.91
19.74	77073	4.32	3.44	Suffolk County, NY	3.88
66.08	28116	7.07	5.24	Summit County, OH	6.15
48.92	136253	6.25	5.44	Tarrant County, TX	5.84
30.13	15251	6.53	4.16	Thurston County, WA	5.25
27.39	77756	4.53	3.63	Travis County, TX	4.08
50.21	33845	5.81	4.30	Tulare County, CA	5.05
64.81	43862	8.17	6.56	Tulsa County, OK	7.36
28.09	33101	4.57	3.22	Union County, NJ	3.90
26.08	58954	5.36	4.24	Utah County, UT	4.80
14.46	43372	4.43	3.27	Ventura County, CA	3.85
38.95	26879	6.51	4.72	Virginia Beach city, VA	5.62
55.90	24368	6.61	4.72	Volusia County, FL	5.66
32	64176	5.88	4.75	Wake County, NC	5.31
21.83	30945	4.47	3.10	Washington County, OR	3.78
28.88	25572	6.64	4.78	Washoe County, NV	5.71
40.20	16820	6.77	4.46	Washtenaw County, MI	5.53
34.74	19067	5.69	3.70	Waukesha County, WI	4.62
72.84	109697	10.22	9.05	Wayne County, MI	9.64
73.52	22421	5.87	4.03	Webb County, TX	4.95
32.31	22285	4.77	3.09	Weld County, CO	3.86
20.19	49530	4.29	3.22	Westchester County, NY	3.76
66.04	14352	6.78	4.30	Westmoreland County, PA	5.43
43.71	35331	5.87	4.38	Will County, IL	5.12
31.02	35958	4.39	3.12	Williamson County, TX	3.75
76.98	16888	9.41	6.70	Winnebago County, IL	8.05
35.79	42128	4.72	3.49	Worcester County, MA	4.11
58.42	23830	5.62	3.87	York County, PA	4.74

County Health Rankings, built from the same NCHS vital statistics, reaches smaller counties but covers 2015 to 2021 rather than WONDER's 2018 to 2022. It publishes a rate only for counties with at least 2020 infant deathsEstimandfewest infant deaths in the period for which County Health Rankings publishes a county rate, which is also the book's map floor (a definition)Weightsnone (definition)Populationcounties on the mapPeriodinfant deaths and live births in 2015 to 2021SourceCounty Health Rankings infant deaths in the period, which in practice leaves out small counties. Across tenths of the counties it covers, the rate is higher in the most deprived tenth than in the least deprived, but the line is not monotone and dips across the eighth and ninth tenths.

White rates also differ across states

The linked file reports the mother's race only for 2018 and 2019, and WONDER counts mothers by single race, with Hispanic mothers included in each group. In those years infants of Black mothers died at a higher rate than infants of white mothers in each of the 3636 statesEstimandcount of statesWeightsnone (full count)Populationstates that publish infant deaths for both Black and white mothers in both 2018 and 2019Periodinfant deaths and live births in 2018 and 2019SourceCDC WONDER linked birth and infant death states that publish both groups in both years. Those states hold 98.0%98.0% percent of live birthsEstimandshare of those births in the states shownWeightsnone (full counts of births)Populationlive births to Black mothers (single race, any ethnicity) in the United StatesPeriod2018 and 2019SourceCDC WONDER linked birth and infant death of births to Black mothers, and in none of them does the interval for one group touch the interval for the other.

Mississippi has the smallest Black-white ratio of these states and also the highest white rate, 6.7 (95% CI 5.8 to 7.5)6.7 infant deaths per 1,000 live birthsEstimandcrude rate from the death count, normal intervalInterval95% CI 5.8 to 7.5n263 infant deathsWeightsnone (crude rate from counts)Populationlive births to white mothers (single race, any ethnicity) in MississippiPeriod2018 and 2019SourceCDC WONDER linked birth and infant death. The lowest white rate is 3.2 (95% CI 2.9 to 3.5)3.2 infant deaths per 1,000 live birthsEstimandcrude rate from the death count, normal intervalInterval95% CI 2.9 to 3.5n457 infant deathsWeightsnone (crude rate from counts)Populationlive births to white mothers (single race, any ethnicity) in New JerseyPeriod2018 and 2019SourceCDC WONDER linked birth and infant death, in New Jersey. The white rate itself therefore differs across states, and the state ranking is not only a difference in the racial composition of births.

Figure 3

Black mothers' infants died at a higher rate than white mothers' in all 36 states that publish both, by a median ratio of 2.1

Infant deaths per 1,000 by mother's single race, any ethnicity, 36 states, 2018 and 2019, with 95% intervals, ordered by the Black-white difference

• White mothers (any ethnicity)
• Black mothers (any ethnicity)

Show data

Data for Black mothers' infants died at a higher rate than white mothers' in all 36 states that publish both, by a median ratio of 2.1

black	hi_b	hi_w	lo_b	lo_w	n_b	n_w	state	white
11.67	14.62	4.78	9.18	2.66	6,429	13,325	Delaware	3.60
12.73	13.79	5.02	11.68	4.35	44,064	163,307	Michigan	4.68
12.66	14.45	5.41	10.87	4.56	15,162	103,924	Wisconsin	4.98
12.29	16.08	5.35	9.21	4.05	4,312	42,773	Nebraska	4.70
12.97	13.96	5.86	11.97	5.22	50,431	208,964	Ohio	5.54
12.13	13.09	5.19	11.18	4.60	51,108	213,812	Illinois	4.90
11.72	12.83	5.24	10.61	4.25	36,444	73,958	South Carolina	4.75
12.15	15.23	5.89	9.56	4.74	6,173	62,047	Kansas	5.32
12.69	14.83	6.76	10.56	5.63	10,713	73,285	Oklahoma	6.19
11.93	13.07	6.03	10.78	5.18	34,960	121,143	Tennessee	5.60
11.16	11.97	5.39	10.34	4.69	64,533	157,420	North Carolina	5.04
10.63	11.25	4.81	10.01	4.34	106,859	317,717	Florida	4.58
10.41	13.25	4.92	8.05	3.90	6,338	65,737	Iowa	4.41
10.64	11.30	5.36	9.97	4.63	93,071	145,932	Georgia	5
10.60	11.53	5.29	9.68	4.68	47,243	207,572	Pennsylvania	4.99
10.99	12.06	6.16	9.92	5.10	36,953	76,765	Alabama	5.63
11.47	13.18	6.81	9.76	5.50	15,082	55,070	Arkansas	6.16
9.34	10.20	4.48	8.48	3.60	48,404	80,981	Maryland	4.04
9.43	11.17	4.49	7.69	3.80	11,984	131,533	Washington	4.14
9.77	10.36	5	9.17	4.65	105,253	604,692	Texas	4.83
10.37	11.66	5.88	9.07	5.03	23,828	116,241	Missouri	5.45
8.11	9.06	3.53	7.16	2.94	34,767	141,428	New Jersey	3.23
10.82	11.76	6.54	9.88	5.38	46,868	68,003	Louisiana	5.96
8.63	9.98	4.29	7.28	3.52	18,199	101,548	Minnesota	3.91
10.64	11.98	6.42	9.31	5.59	22,926	134,146	Indiana	6.01
9.06	13.09	5.77	6.02	3.61	3,092	16,093	Rhode Island	4.60
9.18	10.06	5.17	8.30	4.43	45,536	133,860	Virginia	4.80
7.96	8.56	3.81	7.37	3.38	87,384	307,616	New York	3.60
10.99	12.13	7.45	9.86	5.85	32,561	39,548	Mississippi	6.65
9.33	11.13	5.79	7.53	4.55	11,042	51,823	Nevada	5.17
9.20	10.97	5.47	7.43	4.70	11,303	132,097	Arizona	5.09
8.16	8.89	4.21	7.43	3.90	58,843	677,920	California	4.06
9	10.74	5.50	7.26	4.58	11,443	92,669	Kentucky	5.04
7.66	9.46	4.28	6.12	3.23	11,231	52,490	Connecticut	3.75
8.25	10.42	4.97	6.43	4.17	8,488	109,155	Colorado	4.57
6.83	7.97	3.90	5.68	3.18	20,073	104,559	Massachusetts	3.54

The rise holds within states and within groups of mothers

Counties in the South have higher deprivation ranks and higher rates, so the rise across counties could come from differences between states alone. Comparing counties inside the same state, the slope of the rate on the deprivation rank is nearly the same as across all large counties. The rise also holds separately for births to white mothers and for births to Black mothers in 2018 and 2019, in the counties that publish each group in both years. The slope for Black mothers is larger than the slope for white mothers. In 2018 and 2019, counties with higher ranks also had a larger share of births to Black mothers. The slope for all births therefore combines a rise within each group with a shift in the mix of mothers.

Figure 4

The rise with county deprivation holds within states and for births to white mothers and to Black mothers, at 0.63 deaths per 1,000 for each 10-point step across all births

Change in infant deaths per 1,000 for each 10-point rise in county deprivation rank (births-weighted slope) with 95% intervals, counties of 250,000 residents or more

Show data

Data for The rise with county deprivation holds within states and for births to white mothers and to Black mothers, at 0.63 deaths per 1,000 for each 10-point step across all births

conf_high	conf_low	group	label	n	slope
0.715	0.544	All births	All births, 2018 to 2022 (240 counties)	240	0.631
0.840	0.467	All births	All births, 2018 to 2022, within states (44 states)	240	0.624
0.709	0.518	All births	All births, 2018 and 2019 (240 counties)	240	0.619
0.440	0.289	White	White mothers, 2018 and 2019 (203 counties)	203	0.362
1.01	0.617	Black	Black mothers, 2018 and 2019 (115 counties)	115	0.817

These are patterns of places. A county's rate is not the risk facing any one infant, and a slope across counties does not say that a family moved to a less deprived county would see a different outcome. The conditions that come before many infant deaths, low birthweight and preterm birth, are in Chapter 2.1, Birthweight and preterm birth.

What this cannot tell you

The county comparison describes large counties that publish a count in every year, which are not a sample of all counties. The Area Deprivation Index understates deprivation in high-cost cities (Chapter 1.1, What the deprivation index measures), and it draws on the American Community Survey for 2019 to 2023 while the deaths are from 2018 to 2022. The files carry no cause of death, no birthweight or gestational age, and nothing on mothers beyond race, so nothing here identifies a mechanism.

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Go deeper

• The report: every estimate with its interval and sample size.
• Tables: every figure of the report as a table.

Data sources

• CDC WONDER linked birth and infant deathCDC WONDER linked birth and infant death, state totals and race, county totals and age at death, 2018 to 2022 (mother's race 2018 and 2019 only)Years: 2018-2022 · Weights: none (full counts; crude rates) · License: Public domain (NCHS, CDC); WONDER data-use restrictions apply
• Area Deprivation IndexNeighborhood Atlas Area Deprivation Index 2023 (v4.0.1), tract national rank, averaged to counties with 2019-2023 tract populationYears: 2023 release (version 4.0.1; built on ACS 2019-2023) · Weights: 2019-2023 tract population · License: Free for non-commercial use; cite the Neighborhood Atlas and Kind and Buckingham
• County Health RankingsCounty Health Rankings 2024, infant mortality (infant deaths per 1,000 live births, 2015 to 2021), counties with at least 20 infant deathsYears: 2024 release · Weights: births (County Health Rankings denominator) · License: CC BY 4.0 (University of Wisconsin Population Health Institute)

All data sources

References

1. Ely, Danielle M.; Driscoll, Anne K. (2023). Infant Mortality in the United States, 2021: Data From the Period Linked Birth/Infant Death File. National Vital Statistics Reports 72(11). doi:10.15620/cdc:131356
2. Kind, Amy J. H.; Buckingham, William R. (2018). Making Neighborhood-Disadvantage Metrics Accessible: The Neighborhood Atlas. New England Journal of Medicine 378(26): 2456-2458. doi:10.1056/NEJMp1802313

How to cite

@misc{singh2026infantmortality,
  author = {Singh, Vishal},
  title = {Infant mortality},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/infant-mortality},
  note = {In ZIP Code Destiny. Published 9 October 2026.}
}