African American Infant Mortality

Collaborating to decrease African American/Black infant mortality rates in Denver

Infant mortality rates are a very sensitive measure often used to gauge the health and well-being of a community. In Denver, infants born to black women are four times more likely to die before their first birthday than infants born to white (non-Hispanic) women. This Health Indicator explains what Denver is doing to eliminate that difference.

DPH AA Infant Mortality Health Indicator Graph

What are we measuring and how are we measuring it?

Infant mortality refers to the death of an infant before his or her first birthday. Rates are calculated by counting the number of infant deaths for every 1,000 live births. Since numbers are small in Denver, creating variation from year to year, we measure infant mortality as a three-year moving average. This approach averages each year with its surrounding years for a more meaningful measure.

Annual data on births and deaths is collected through birth and death certificates from the Colorado Department of Public Health and Environment’s Vital Statistics Section.

Why do we measure this?

Infant mortality rates are a very sensitive measure. Unlike other health outcomes, which may take years to develop, infant deaths give us our first indication of changes in a population’s health. For this reason, infant mortality rates are often used as important indicators of the health and well-being of a community.

Across the United States, black women are significantly more likely than white women to experience the loss (death) of a baby within the first year of life. Our goal is One Number – everyone at the same low rate. If one population group can experience low infant mortality rates, we should be able to lower the rate for all families to the same level.

What is the story behind the graph?

The rate of black infant deaths to white infant deaths is four to one. This means infants born to black women in Denver are four times more likely to die within their first year than infants born to white women. Despite major improvements in maternal and child health over the past decade for all groups, as the white infant mortality rate continues to decline over time, we are making less progress in reducing the black infant mortality rates, which leads to an ever widening gap or inequity.

Other information not shown in this graph but presented in Denver Public Health’s Perinatal Periods Of Risk Report, along with national data shows that the majority of the difference in infant deaths between black and white babies is related to the mother’s health before and during pregnancy and cannot solely be attributed to the “usual suspects,” like income or education level. This fact, that African American infant mortality rates are not explained by income or education, highlights the importance of thinking about health over the entire lifespan. We need to address multigenerational effects on health, including prolonged exposure to stress.

What works to lower black/African American infant mortality rates?

  • Raising awareness of infant mortality rates. In many communities, raising awareness has led to innovations, best practice adoption, and community actions regarding the social determinants of health.1
  • Group prenatal care, like the support provided when pregnant women meet as a group and help each other as part of their prenatal care, has been shown to reduce preterm birth for African American women who attend group prenatal care programs.2 Preterm birth is a major cause of infant mortality in Denver.

What strategies are being used to reduce black/African American infant mortality rates in Denver?

  • Group prenatal care: Montbello Family Health Center currently offers a group program which Denver Health hopes to expand to the Eastside and Westside Family Health Centers in 2016.
  • The Healthy Start Program is an initiative focused on reducing the rate of infant mortality and improving perinatal outcomes. Families Forward Resource Center’s (FFRC) Healthy Babies, Strong Families Healthy Start program serves African American families;in the Denver  and Aurora area at the individual, family and community level.
  • The Community Action Network, pools the collective efforts of the community to address health care, social isolation and the impact of racism and unjust systems on African American health.
  • The CoIIN: Collaborative Improvement; Innovation Network to Reduce Infant Mortality is a public-private partnership to reduce infant mortality and improve birth outcomes. Participants learn from one another and national experts, share best practices and lessons learned, and track progress toward shared benchmarks. Denver has joined forces with other experts and community members at the state and national level through the Colorado CoIIN.
  • The Perinatal Periods of Risk (PPOR) is a data-driven approach for understanding and acting on conditions related to fetal and infant loss. Denver’s PPOR results showed us specific risk factors for infant mortality and helped us engage community members in the effort to achieve One Number.
  • Improving health before and between pregnancies is an important factor in reducing infant mortality. Denver Public Health partners with the Show your Love campaign to promote preconception health.
  • Better coordination of perinatal health efforts across disciplines can improve birth and infant outcomes. Denver Public Health participates in a perinatal care collaboration involving experts in Family Medicine, Obstetrics, Maternal Fetal Health, Public Health, Data Analytics and Mental Health. 

To print this health indicator, please download a PDF of African American/Black Infant Mortality Rates in Denver.

Who are our partners?

Additional sources of data related to the measurement being monitored

For more information or to partner with us, please contact

Last Updated: 5/20/2016


  1. World Health Organization Definition of the Social Determinants of Health: The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.
  2. Picklesimer AH, Billings D, Hale N, Blackhurst D, Covington-Kolb S. The effect of Centering Pregnancy group prenatal care on preterm birth in a low-income population. Am J Obstet Gynecol. 2012;206(5):415 e411-417.

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