Sudden infant deaths rise among Black babies, widening mortality gap

Overview

Updated 2 hours ago

After two decades of narrowing, the gap between Black and White infant mortality in the U.S. has grown since 2020. A study of 57.9 million live births, published in JAMA Network Open on September 23, finds the widening is driven largely by a rise in sudden unexpected infant deaths (SUID) among Black babies.

Preterm birth still explains most of the overall disparity. But the share of the gap from higher death rates among infants born at the same gestational age has climbed from 21% in 2003 to 32% in 2024. Researchers don't yet know why the SUID rate rose — the increase began during the pandemic, but the cause isn't established.

Why it matters

After two decades of progress, the Black-White infant mortality gap is widening again — sudden unexpected infant death is the largest single cause.

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Key Indicators

32%

Share of mortality gap from within-gestational-age risk, 2024

Up from 21% in 2003; preterm birth differences still dominate the gap.

6.4 per 1,000

Black-White infant mortality gap, 2024

Widened from 6.0 per 1,000 in 2019 after shrinking for two decades.

2.8x

Black-White SUID disparity ratio, 2020

Black infants died of SUID at 2.8 times the White rate, up from 2.2 in 2017.

57.9M

Live births analyzed in the study

U.S. linked birth-death records from 2003 to 2024.

Voices

Curated perspectives — historical figures and your fellow readers.

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People Involved

Leslie Root

Lead author, JAMA Network Open study; research associate, University of Colorado Boulder

Published the study September 23, 2026

Organizations Involved

University of Colorado Boulder

Research university

Conducted the study through its Institute of Behavioral Science

Research home of the team that published the 2026 JAMA Network Open study on infant mortality disparities.

JAMA Network Open

Peer-reviewed medical journal

Published the study September 23, 2026

Open-access journal of the American Medical Association network that published the mortality gap decomposition.

National Center for Health Statistics (CDC)

Federal statistics agency

Maintains the birth and death records used in the study

Federal agency that maintains the Period Linked Birth/Infant Death records and publishes annual infant mortality data.

Timeline

December 2020 September 2026

3 events Latest: 6 days ago

September 2026
JAMA study decomposes the widening gap
Latest Study

Analysis of 57.9 million births finds SUID is the largest contributor to the post-2020 widening.
6 days ago
March 2023
CDC documents widening SUID disparity
Report

Black-White SUID disparity ratio reaches 2.8 in 2020, up from 2.2 in 2017.
March 13th, 2023
December 2020
SUID rate among Black infants jumps
Data

Rate reaches 214 per 100,000 live births, above the 187-192 range of 2017-2019.
December 31st, 2020

Scenarios

CDC launches SUID prevention program targeting Black communities

Possible Resolves by End of 2027

Discussed by: Study authors at University of Colorado; CIDRAP

The JAMA study concludes that closing the gap requires addressing both preterm birth disparities and within-gestational-age mortality risk. A funded federal program modeled on the 1994 Back to Sleep campaign — expanding safe-sleep education and postpartum care access in Black communities — would mark the first coordinated response to the post-2020 rise.

Infant mortality gap keeps widening

Possible Resolves by Q3 2027

Discussed by: NCHS trend data; JAMA Network Open study

The study shows the absolute gap grew from 6.0 to 6.4 deaths per 1,000 live births between 2019 and 2024. If the trend holds, the next annual data release will show a larger gap for 2025 births, confirming the post-2020 reversal is not a temporary blip.

Researchers pin down a modifiable cause of the SUID rise

Uncertain Resolves by End of 2027

Discussed by: JAMA Network Open study authors; CDC researchers

The study notes diagnostic shifting — changing classification of infant deaths — may explain the 2020 SIDS increase, but not the full SUID rise among Black infants. Researchers suspect pandemic-era stress, disrupted healthcare access, and unsafe sleep practices, but no single cause is confirmed. A peer-reviewed study identifying a concrete modifiable risk factor would open a path to targeted prevention.

Historical Context

2 moments from history that rhyme with this story — and how they unfolded.

1994-2000s

Back to Sleep campaign (1994)

In 1994, the National Institute of Child Health and Human Development launched a national campaign urging parents to place infants on their backs to sleep. SIDS was the leading cause of post-neonatal death, killing about 5,000 U.S. infants a year.

Then

SIDS rates fell by more than half by the early 2000s as supine sleep became the norm.

Now

The campaign became the model for public health messaging on sleep safety, but declines were slower among Black families, and the racial disparity in SUID persisted.

Why this matters now

Shows a coordinated safe-sleep campaign can cut SUID deaths dramatically — and that equal reach across racial groups is the hard part.

2020-2021

COVID-19's disparate health impact (2020)

COVID-19 death rates for Black, Hispanic, and Native American people were roughly twice the rate for White people. The pandemic also disrupted routine care: well-baby visits, postpartum checkups, and safety-net programs like WIC.

Then

Infant mortality rose for Black babies in 2020 even as the national rate hit a record low, and Black maternal mortality climbed.

Now

Researchers suspect pandemic-era stressors — crowded housing, job loss, disrupted care — contributed to the SUID increase, though the mechanism isn't confirmed.

Why this matters now

The SUID rise among Black infants began in 2020, the first pandemic year, and researchers say the two are likely connected.