Excess Infant Mortality in Metropolitan and Nonmetropolitan Areas by Race and Ethnicity — United States, 2014–2016

  • Our study found that, compared with more urban areas, rural areas have higher rates of infant mortality for all racial and ethnic groups. For non-Hispanic white and Hispanic infants, excess deaths were mostly due to birth defects and sudden unexpected infant deaths, which include sudden infant death syndrome (SIDS), accidental suffocation in a sleeping environment, and other deaths from unknown causes. For non-Hispanic black infants, complications related to premature birth and sudden unexpected infant deaths accounted for the largest share of excess deaths.
  • A greater proportion of deaths were attributable to differences in urbanization level for non-Hispanic white infants (14.3%), compared with non-Hispanic black infants (5.6%) infants and Hispanic infants (3.8%). These differences are largely due to a greater proportion of non-Hispanic white infants being born in areas that are more rural. However, the rates of infant mortality were substantially higher for non-Hispanic black infants across all urbanization levels compared with other racial and ethnic groups.
  • These findings are important because they show that infant mortality increases with rurality, but there are differences by race and ethnicity in terms of magnitude and cause of death. This study is an important step in understanding what causes of death contribute to the differences that we see in infant mortality by urbanization level and race/ethnicity, which can be used in the future to inform more targeted interventions to reduce preventable infant deaths.
Quote from the Disease Detective

“Our study found that 7.4 percent of all infant deaths would be prevented if all areas in the United States had the same infant mortality rate as large metropolitan areas. We also pinpointed specific causes of death that contribute to excess deaths in more rural areas, and found that non-Hispanic black infants experience substantially higher rates of infant mortality in all areas regardless of urbanization. These findings can be used to help inform preventive efforts to save the lives of infants across the United States.”

– Lindsay Womack, PhD, MPH, EIS Class of 2017

colleagues prepare to present their data[JPG - 1 MB]

EIS officer Lindsay Womack, PhD, MPH (left), and her colleague, Lauren Rossen, PhD, MS, prepare to present their data

EIS officer works on data analysis[JPG - 2 MB]

EIS officer Lindsay Womack, PhD, MPH, works on data analysis

Contact Information

CDC Media Relations
(404) 639-3286

Conference Information
Lindsay Womack


Lindsay Womack, PhD, MPH,
EIS Class of 2017
CDC National Center for Health Statistics Division of Vital Statistics

Education: PhD: University of South Florida, 2017
MPH: University of Florida, 2010
BA: University of Florida, 2008

Work Experience: Adjunct Instructor, Hillsborough Community College, Tampa, Florida, 2015-2016
Intern, Florida Department of Health, Tallahassee, Florida, 2010
Research Assistant, University of Florida, Gainesville, Florida, 2008-2009

Volunteer Experience: Volunteer, Give Kids the World,Kissimmee, Florida, 2004-Present
Student Volunteer, UF Health, Gainesville, Florida, 2005-2008