Research spotlight: Colorado sees decades of progress with infant mortality, yet racial and ethnic disparities persist

Written by: Erica Manoatl
Date Posted: March 9, 2018

All of Colorado’s babies deserve to thrive in their first months of life. Analyzing infant mortality data is essential to understanding how we might continue to keep the youngest Coloradans healthy and prevent infant deaths in our state. Colorado has seen significant progress in improving the well-being of babies—the drop in our state’s infant mortality rate has been one of the fastest in the nation.

The infant mortality rate (IMR) is a public health indicator that measures the number of infant deaths from all causes within their first year per 1,000 live births. It is often used as an indicator of overall maternal and child health in a region. In the past decade, infant mortality rates have fallen all over the country, and Colorado has been a national leader in this trend. Between 2005-2007 and 2012-2014, the infant mortality rate in the United States decreased by 15 percent overall; Colorado was one of four states with the largest percent decreases during this time, with the state infant mortality rate falling by more than 20 percent.[1]  By 2016, with an IMR of 4.8 deaths per 1,000 live births, only eight states in the nation had lower rates of infant mortality than Colorado.[2]

infant Mortality Rate by states, 2016Source: Centers for Disease Control and Prevention, National Center for Health Statistics 2016

Looking more closely at the specific causes of infant mortality, Sudden Unexpected Infant Death (SUID) is considered one of the larger contributors to infant deaths nationally, and includes cases of Sudden Infant Death Syndrome (SIDS), deaths from unknown causes and accidental deaths in bed.[3] A recent study examining trends in SUID rates per 100,000 live births between 1990 and 2015 found that while the U.S. saw the SUID rate fall significantly in the 1990s, the national rate fell only slightly between 2000 and 2015.[4]

In Colorado however, the rate of infant mortality due to SUID decreased dramatically in both timespans. Between 1990-1992 and 2000-2002, the SUID rate in Colorado was cut in half, falling by 54 percent from 213.1 to 97.6.[5] This rate fell an additional 41 percent between 2000-2002 and 2013-2015 to 57.7 per 100,000, the second greatest SUID rate percent decline in the nation.[6] By 2013-2015, Colorado was one of 18 states that met or exceeded the Healthy People 2020 aim of SUID rates at or below 84 deaths per 100,000 live births.

SUID rates per 100, 000 Live Births

Colorado’s progress in lowering overall infant mortality and rates of SUID should be celebrated, as babies across the state are safer and more likely to thrive in their first year. However, a significant gap in mortality rates for different racial and ethnic groups persists, and the fact remains that babies in our state face very different odds of survival depending on their race.

Infant Mortality Rates, 1991 and 2016

In comparison to the early 1990s, infant mortality rates in Colorado today remain disproportionately high for black, American Indian/Alaska Native, and Hispanic babies. For black babies specifically, infant mortality rates remain high even when controlling for a mother’s income and level of education. As of 2014, a black family in Colorado making between $50,000 and $75,000 per year faced an infant mortality rate nearly twice as high as a white family earning less than $15,000 per year.[7]

What’s behind the high rate of mortality among black babies, if income and educational differences don’t explain it? A recent study in Colorado measured cortisol, a stress hormone linked to adverse pregnancy outcomes, in pregnant women and new moms. Cortisol levels were shown to be much higher among black moms than among white or Hispanic moms.[8] The study is consistent with other research that suggests that the stress associated with racism, discrimination and social isolation can have tangible impacts—and in some instances, tragic impacts—on the health of moms and babies.

Colorado has proven that it can make remarkable progress on infant mortality, and should continue to focus on improving the well-being of babies into the next decade. It’s essential that efforts to decrease infant mortality acknowledge racial and ethnic disparities, and remove the remaining barriers to health for mothers of color and their children.

Learn more about our long-range trends in child well-being in the 25th anniversary edition of KIDS COUNT in Colorado! We’ll release the report on March 22 and share details in KidsFlash the next day.



[1] Driscoll, A.K. & Mathews, T.J. (2017). Trends in Infant Mortality in the United States, 2005–2014. NCHS Data Brief No. 279. Retrieved from:

[2] Centers for Disease Control and Prevention. (2018). Infant Mortality Rates by State. Retrieved from:

[3] Centers for Disease Control and Prevention. (2018). About SUID and SIDS. Retrieved from:

[4] Erck Lambert AB, Parks SE, Shapiro-Mendoza CK. National and State Trends in Sudden Unexpected Infant

Death: 1990–2015. Pediatrics. 2018;141(3):e20173519.

[5] Ibid.

[6] Erck Lambert AB, Parks SE, Shapiro-Mendoza CK. National and State Trends in Sudden Unexpected Infant

Death: 1990–2015. Pediatrics. 2018;141(3):e20173519.

[7] Colorado Department of Public Health and Environment, Health Statistics Section.

[8] Hoffman, et al. (2016). Measures of maternal stress and mood in relation to preterm birth. Obstetrics and Gynecology 127(3).

Erica Manoatl

About Erica Manoatl

Erica Manoatl is the Research Analyst for the Colorado Children’s Campaign. In this role, she supports the organization’s research priorities, data analysis, and writing in all issue areas. She holds a Bachelor of Arts in English from George Washington University and a Master of Public Health in Population and Family Health from Columbia University.