September 29, 2026
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Disparities in infant mortality rates among white and Black infants have been increasing again in recent years, research shows.
Researchers have long tried to understand racial and ethnic disparities in maternal and infant mortality rates.
Maternal mortality rates are three times higher for Black women than white women, at 49.4 deaths per 100,000 births versus 14.9 per 100,000, respectively. Also, infants born to Black women have more than twice the risk of death than those born to white women, according to a KFF analysis of federal statistics.
The disparities result from differences in access to health care, insurance coverage, as well as education and economic factors that can be linked to systemic inequities rooted in racism and discrimination, research shows. Black women are more likely than white women to have preterm births and give birth to infants with low birth weights. Both outcomes increase the risk of infant mortality, according to the 2025 KFF analysis.
Now, a new study has found that sudden unexplained infant death rates among Black Americans have ticked up since 2020 compared to white Americans, adding another possible explanation for the gap.
The Centers for Disease Control and Prevention defines sudden unexplained infant death, or SUID, as all sudden and unexpected deaths of babies under one year. Included in this category are sudden accidental deaths from suffocation in a sleeping environment and sudden natural deaths from infections, neurological disorders and other medical issues. The SUID umbrella also includes sudden infant death syndrome (SIDS), defined as unexplained deaths of babies between one month and one year, even after a thorough investigation. Homicides also are included.
Differences in the gestational age at birth seemed to continue to be the biggest factor affecting disparities in infant death rates. But the new study suggests that one third of the gap in infant mortality rates between Black and white Americans may be attributed to SUID.
"This finding suggests that even if preterm birth disparities were eliminated entirely, a large mortality gap would remain, and sudden unexpected infant death is what is driving the increase," the study's co-author Leslie Root, a demographer and assistant research professor in the Institute of Behavioral Science at University of Colorado Boulder, said in a news release.
The research, published Sept. 22 in JAMA Network Open, analyzed data from the U.S. National Center for Health Statistics between 2003 and 2024. The data included information about 366,384 infant deaths among Black mothers and 224,733 infant deaths among white mothers.
The infant mortality rate for Black babies fell from 13.2 per 1,000 live births in 2003 to 10.7 deaths per 1,000 live births in 2024. The infant mortality rate for white babies dropped from 5.6 per 1,000 live births to 4.3 per 1,000.
Overall, infant mortality decreased from 7.7 to 6.0 deaths per 1,000 live births between 2003 and 2019. But in 2020, infant mortality began rising again, increasing to 6.4 deaths per 1,000 live births by 2024, with Black infant mortality increasing as white infant mortality fell.
A higher rate of preterm births among Black women compared to white women between 2020 to 2024 continued to be a leading cause of the gap in infant mortality. But SUID had the largest increase of any factor impacting disparities in infant mortality rates, at 35% of the net change.
"This study provides evidence that there is an acute crisis right now in sudden unexplained infant death, a category of cause of death that we assumed we got under control a long time ago," Root said.
According to the CDC, in 2024 there were about 3,400 sudden, unexplained infant deaths. SIDS accounted for 1,351 of those infant deaths. There were 1,099 deaths from unknown causes and 947 deaths from accidental strangulation and suffocation in bed.
The cause of sudden infant death syndrome is unclear, but risk factors include exposure to smoking during and after pregnancy, unsafe sleeping position or environment, exposure to alcohol during and after pregnancy and other factors, the Cleveland Clinic says.
Having babies sleep on their backs, removing loose bedding from cribs, avoiding co-sleeping and not swaddling once babies can roll over may help reduce the risk of SIDS.
