As a result of Sweden's efforts to eliminate poverty and to provide comprehensive health care, there are only small social class differences in infant mortality. The wider social differences in US infant mortality are a consequence of less consistent and thorough attempts at social equity and universal health care. US Black infant mortality continues to be twice that of Whites, and the excess may partially result from racism. Public health research should examine the role of racism in infant mortality and develop interventions to eliminate racism and its effects on the health of Black Americans.