Mississippi Urges Action as Infant Death Toll Surges
Mississippi Declares Public Health Emergency Over Rising Infant Mortality Rates
Mississippi health officials have declared a public health emergency after data revealed that the state’s infant mortality rate has reached its highest level in over a decade. In 2024, the state recorded 9.7 infant deaths for every 1,000 live births, nearly double the national average of 5.6 deaths per 1,000. Since 2014, more than 3,500 infants in Mississippi have died before their first birthday. This alarming trend has prompted officials to take urgent action, highlighting the broader national issue of infant mortality and the systemic challenges that contribute to it.
Infant Mortality Rate: A Nationwide Concern
The problem is not unique to Mississippi. Even in cities with robust healthcare systems like Boston, Black infants continue to face higher mortality rates compared to White infants. Recent reports from Boston show that Black infants die at more than twice the rate of the overall population and triple the rate of White infants. Despite the city's overall infant mortality rate falling below the national average, these disparities underscore the limitations of focusing solely on individual behavior or clinical care. Structural inequities remain a critical factor in the high number of infant deaths across the country.
Dr. Dan Edney, State Health Officer, emphasized the gravity of the situation when he announced the declaration. "Every single infant loss represents a family devastated, a community impacted, and a future cut short," he said. "We cannot and will not accept these numbers as our reality."
Causes Behind the Rising Mortality Rate
The leading causes of infant death in Mississippi include congenital malformations, premature birth, low birthweight, and Sudden Infant Death Syndrome (SIDS). Racial disparities are stark—Black infants in Mississippi are more than twice as likely as White infants to die before their first birthday, and recent data shows these gaps have widened.
Experts argue that declaring a public health emergency is a necessary step to address this crisis. Dr. Michael Warren, Chief Medical and Health Officer at March of Dimes, stated, "This is a novel and necessary step. It elevates infant mortality to the level of urgent crisis response, which it truly is."
Why the Declaration Matters
The declaration allows Mississippi to act swiftly to address gaps in care. The state’s plan includes expanding prenatal services in counties without obstetric providers, creating an obstetric system of care to regionalize services, and improving emergency transfers. Additionally, the state aims to strengthen home visiting and community health worker programs.
"Improving maternal health is the best way to reduce infant mortality," Dr. Edney said. Dr. Morgan McDonald of the Milbank Memorial Fund added that the declaration should draw attention to a preventable tragedy. "We applaud Dr. Edney and his team for raising the alarm in a way that honors the families who have suffered this loss and focuses on solutions."
However, experts caution that individual and clinical interventions alone are not enough. Dr. Rebekah Gee, CEO of Nest Health, stressed, "Healthy babies come from healthy moms. If women can't get continuous healthcare before, during, and after pregnancy, it's no surprise their babies are dying at higher rates."
Federal Funding Cuts and Their Impact
Federal funding cuts are complicating the state’s response. The Pregnancy Risk Assessment Monitoring System (PRAMS), a CDC program that collects data on maternal and infant health, has been targeted for elimination. CDC staff who conducted the survey for nearly 40 years were recently fired, and many Safe Motherhood initiatives are now at risk of losing funding.
"This is willful ignorance to cut vital programs when we have public health crises," said a former CDC staffer. "For many people, it's downright dangerous to be pregnant in the U.S. in the 21st century."
Polling suggests most Americans support maintaining these programs. According to the Emory-Rollins National Child Policy Poll, 65% of Americans believe PRAMS is important for improving outcomes, while only 10% think it's unnecessary.
Medicaid and Its Role in Maternal and Infant Health
Medicaid plays a significant role in Mississippi, financing almost 60% of births in the state. In 2023, the state extended postpartum Medicaid coverage from two months to a full year. However, Mississippi has not expanded Medicaid under the Affordable Care Act, leaving many low-income women uninsured before or between pregnancies.
Congressional proposals could further impact Medicaid coverage, including a reconciliation bill that would require many enrollees to prove they are working, volunteering, or in school to receive coverage. KFF analysts estimate that such policies could raise Mississippi’s uninsured rate by 1 to 2%, potentially leaving 20,000 to 40,000 more residents without coverage.
Public health experts warn that these policies could destabilize rural hospitals reliant on Medicaid reimbursement, limiting access to prenatal and delivery services in regions already described as "OB deserts."
Lessons from Other States
Other states that expanded Medicaid under the Affordable Care Act have seen measurable improvements in infant health. Arkansas reported a 29% reduction in Black infant mortality after expansion, while Louisiana saw increases in early prenatal care and decreases in premature births. Colorado also experienced declines in infant mortality, particularly in rural areas.
Nationally, one analysis found a 50% greater reduction in infant mortality in expansion states compared to non-expansion states, with the steepest gains among Black infants. Today, 40 states and the District of Columbia have expanded Medicaid, while Mississippi remains one of 10 holdouts.
A Call for Action
The U.S. has long treated infant mortality as a measure of societal health. Sociologist W.E.B. Du Bois argued over a century ago that high rates of infant deaths among Black families reflected inequities in living conditions rather than innate differences. Mississippi’s emergency declaration and Boston’s persistent disparities suggest these inequities remain deeply entrenched.
State officials say the declaration is intended to galvanize coordinated action across hospitals, state agencies, and community groups. "It will take all of us working together to give every child the chance to live, thrive, and celebrate their first birthday," Dr. Edney said.