Differing postneonatal mortality rates of African-American and white infants in Chicago: an ecologic study

Matern Child Health J. 2002 Jun;6(2):99-105. doi: 10.1023/a:1015464207740.


Objectives: This study sought to determine whether neighborhood impoverishment explains the racial disparity in urban postneonatal mortality rates.

Methods: Stratified and multivariate logistic regression analyses were performed on the vital records of all African-Americans and whites born in Chicago by means of a linked 1992-1995 computerized birth-death file with appended 1990 U.S. census income and 1995 Chicago Department of Public Health data. Four community-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. Communities with one or more ecologic risk factors were classified as impoverished.

Results: The postneonatal mortality rate of African-Americans (N = 104,656) was 7.5/1000 compared to 2.7/1000 for whites (N = 52,954); relative risk (95% confidence interval) equaled 2.8 (2.3-3.3). Seventy-nine percent of African-American infants compared to 9% of white infants resided in impoverished neighborhoods; p < 0.01. In impoverished neighborhoods, the adjusted odds ratio (controlling for infant and maternal individual-level risk factors) of postneonatal mortality for African-American infants equaled 1.5 (0.5-4.2). In nonimpoverished neighborhoods, the adjusted odds ratio of postneonatal mortality for African-American infants equaled 1.8 (1.1-2.9).

Conclusions: We conclude that urban African-American infants who reside in nonimpoverished neighborhoods are at high risk for postneonatal mortality.

Publication types

  • Comparative Study

MeSH terms

  • African Americans / statistics & numerical data*
  • Birth Weight
  • Cause of Death
  • Chicago / epidemiology
  • Humans
  • Infant
  • Infant Mortality*
  • Odds Ratio
  • Poverty / ethnology*
  • Poverty Areas
  • Residence Characteristics / classification
  • Residence Characteristics / statistics & numerical data
  • Risk Factors
  • Sudden Infant Death / ethnology
  • Whites / statistics & numerical data*