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At a rally in Houston, Democratic presidential candidate Michael Bloomberg apologized for supporting the stop-and-frisk policy he endorsed while serving as mayor of New York City from 2002 to 2013. Bloomberg told the mostly black audience at the rally that he should have acted sooner and faster to stop the policy and said if he were elected, he’d use the power of the presidency to right the wrongs of institutional racism. He used the rally as an opportunity to unveil a new initiative that he says will address issues specific to the black community in the United States: Mike for Black America. One issue he highlighted in his address was access to health care. We will build a future in which we better protect the health of black mothers and their babies, Bloomberg said at the rally. You should know that black babies die at rates twice as high as white babies because of a lack of access to affordable health care and here, in the wealthiest country in the world, we cannot accept that and we will change that. Bloomberg’s figure is accurate, but is he right in his assessment of the cause of this disparity? His team did not return a request for more information about his claim. Mortality rate higher for black infants The latest statistics on infant mortality from the Centers for Disease Control and Prevention show that there were 22,341 infant deaths reported in the United States in 2017, putting the mortality rate at 5.79 infant deaths per 1,000 live births. Statistics on infant mortality are compiled based on birth and infant death certificates in cases where infants less than a year died during the calendar year. Generally, the infant mortality rate has trended downward since 1995 and has declined 16% since 2005, when the rate was 6.86 deaths per 1,000 live births. The CDC also analyzes the infant mortality rate by race. In 2017, infants born to black women had the highest mortality rate of 10.97 deaths per 1,000 live births. The mortality rate for infants born to non-Hispanic white mothers was 4.67 deaths per 1,000 live births, meaning infants born to black mothers have an infant mortality rate 2.35 times higher than infants born to white mothers, according to the CDC. Bloomberg’s claim wasn’t limited to Texas, but this trend is also visible at the state level. A 2018 report from the CDC looked at infant mortality data from 2013 to 2015 by state and race and found that, in Texas, the mortality rate for infants born to non-Hispanic white women was 5 deaths per 1,000 live births and was 10.52 for infants born to black women. Exploring causes of disparity It’s true that infants born to black mothers have died at rates twice as high as white babies in recent years, but is it true that it is due to a lack of access to affordable health care? It isn’t that simple. The five leading causes of all infant deaths in 2017 identified by the CDC were all health related: Congenital malformations: 21% of infant deaths Disorders related to short gestation and low birthweight: 17% of infant deaths Maternal complications: 6% of infant deaths Sudden infant death syndrome (SIDS): 6% of infant deaths Unintentional injuries: 6% of infant deaths In a 2019 report, the CDC noted that infants born to black women had the highest mortality rates for disorders related to short gestation (premature birth) and low birthweight and maternal complications. Numerous academic studies and media investigations have highlighted correlations between access to health care and the disparity in infant and maternal mortality rates between black and white mothers. But access to health care is widely considered to be one of many contributing factors. One 2017 study published in the American Journal of Public Health identified other factors that contribute to the high black infant mortality rate: socioeconomic status, maternal behavior, exposure to protective and risk factors over the course of a woman’s life, and certain historical factors like segregation, limited educational opportunities, structural racism, and intergenerational poverty. This is not to say that a lack of access to health care is not a significant cause of this disparity. A study published in the Journal of the American Medical Association in 2019 explored how state Medicaid expansion associated with changes in low birthweight and preterm birth across different races — which are more likely to affect black mothers and infants than white mothers and infants. The study did not explore the link between Medicaid expansion and reducing infant mortality. Researchers found that overall, Medicaid expansion was not associated with differences in rates of low birth weight or preterm births. However, they identified significant improvements in relative disparities for black infants compared with white infants in states that expanded Medicaid vs. those that did not. In other words, states that expanded Medicaid saw rates of low birthweight and preterm births decline among black mothers and infants. In general, black mothers were less likely than white mothers to access prenatal care, according to data from the U.S. Department of Health and Human Services’s Office of Minority Health. In 2017, black mothers were 2.3 times more likely to receive no prenatal care or late prenatal care than non-Hispanic white mothers. The same year, 66.6% of black mothers received prenatal care during the first trimester, compared to 82.4% of white mothers who accessed early care. Our ruling Bloomberg said: Black babies die at rates twice as high as white babies because of a lack of access to affordable health care. Bloomberg’s figures about the black infant mortality rate vs. the white infant mortality rate are accurate. Studies show that access to healthcare is a contributing factor to this disparity, but it is far from being the only issue at play. We rate this claim Mostly True.
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