During the 20th century, the United States has seen its infant mortality rate decline substantially. However, disparities by race and ethnicity remain. Although advances in healthcare continues to improve the infant mortality rate, a key factor in continued improvement and the disparities is addressing the underlying social determinants associated with infant mortality. Improvements in the health of women, who are pregnant, and their future children could be improved by funding for non-healthcare programs and services such as better housing and nutrition. How good is the return on investment for these state and local government expenditures? Goldstein et al (10.1542/peds.2020-1134) conducted a longitudinal study of state-level infant mortality and state and local spending in an article we are early releasing this month.
The authors looked at state and local expenditures focused on education, social services, housing, and the environment between 2000 and 2016 to determine how changes in such spending affected infant mortality over time. They also stratified their results by race, ethnicity, and maternal age. The results are somewhat promising, especially for high-risk populations. The authors found that increased spending in areas such as housing, public health, parks and recreation, and solid waste management were associated with the largest reduction in infant mortality rates.
To better understand the importance of these findings and how infant mortality can be reduced by making further medical and public health inroads in treatment and prevention strategies, we invited Drs. Woodie Kessel and Michele Kiely (10.1542/peds.2020-027995), public health champions, to offer their perspective in an accompanying commentary. They reflect on the progress we have made in improving infant mortality rates in this country but also offer a call to action regarding what we can do statewide and locally to reduce health disparities by advocating for more funds to address the social determinants of health.
If you want to better understand the problem of infant mortality and be part of a solution in your state or community, check out both this fascinating new study and the accompanying commentary to learn more.
