When we talk about infant mortality, the focus often falls on modern statistics — which communities have the highest loss, which health systems struggle, which regions carry the heaviest burden. But these numbers didn’t suddenly appear in the 20th or 21st century. They were shaped by a long history of unequal care, unequal access, and unequal value placed on different families.
Infant mortality isn’t simply a medical measurement.
It’s a mirror reflecting the systems families live within.
To understand why some communities face higher risks today, you have to look back at how early America distributed — or denied — food, shelter, protection, medical care, and freedom itself.
This isn’t about biology.
It’s about history.
Enslaved women endured forced labor during pregnancy, malnutrition, medical neglect, unsafe birthing conditions, and family separation. Infants born into slavery faced:
High infant mortality was framed as natural when it was anything but.
Displacement disrupted food systems, housing stability, and cultural birthing practices. Boarding schools, poor reservation healthcare, and federal neglect all contributed to high infant mortality.
Poor sanitation, contaminated water, insufficient wages, and limited medical access made infant survival difficult in many immigrant neighborhoods.
Rural poverty, lack of medical infrastructure, exploitative labor systems, and limited access to clean water contributed to high infant mortality across poor White communities as well.
Hospitals, physicians, and charitable organizations often served middle- and upper-class White families first, leaving marginalized communities without adequate care.
Infant mortality reflected who society invested in — and who it didn’t.
Black, Indigenous, and many immigrant families were relegated to underfunded wards, if allowed in at all.
Some early maternal and infant health initiatives focused on White families, excluding communities of color from services like nutrition programs, milk stations, and visiting nurses.
Doctors sometimes dismissed concerns in marginalized families, missing early signs of illness.
Transportation, segregation, cost, and discrimination prevented many mothers from receiving early or continuous medical care.
Toxic industries, polluted water sources, and substandard housing disproportionately affected communities with fewer political resources.
Infant mortality became a systemic issue — not an individual one.
Experienced the highest rates due to the compounded legacy of slavery, segregation, underfunded hospitals, and systemic bias.
Faced loss of land, cultural disruption, insufficient healthcare, and federal neglect that led to extremely high infant death rates.
Low wages, poor housing, limited access to services, and discrimination contributed to early infant mortality crises.
Rural isolation, lack of infrastructure, and class-based stigma shaped outcomes in Appalachia, the rural South, and other regions.
Often navigated social hostility and medical systems that treated them inconsistently.
While the specific causes differed, the pattern was the same: when families lacked power and access, their infants faced greater risk.
Even with advances in medicine, the patterns persist:
The disparities look modern — but their roots are old.
Infant mortality isn’t just a statistic.
It reflects the health of entire communities.
When infants thrive, it means families have:
When infants don’t thrive, it shows us where systems are failing — and who has been left out of the promise of equal care.
Across the country, communities and organizations are working to reverse these inequities:
Change is happening — because communities demanded it.
Understanding the history of infant mortality helps us see:
When we understand the roots, we can build solutions that actually reach the families who need them most.
Black Mamas Matter Alliance
https://blackmamasmatter.org/
National Indian Child Welfare Association
https://www.nicwa.org/
CDC — Infant Mortality Data
https://cdc.gov/
NIH — Social Determinants of Infant Health
https://www.nih.gov/
NMAAHC — Medical Racism & Family Health Collections
https://nmaahc.si.edu/