A new analysis reveals that maternal and child mortality in the United States remains alarmingly high for Black, American Indian and Alaska Native (AIAN), and Native Hawaiian and Pacific Islander (NHPI) communities—often rivaling rates in lower-income countries.
In 2023, the maternal death rate for Black women reached 50.3 deaths per 100,000 live births, comparable to Brazil and Vietnam. AIAN mothers followed closely with a rate of 40.7, and NHPI mothers at 37.0. These figures far exceed the national average of 18.6 and are nearly triple the rate for white women and five times that of Asian women.
The disparities extend to children. Black children under age five had the highest mortality rate of any group in the U.S., at 13.4 deaths per 1,000 live births—similar to rates in Mexico and Laos. Infant mortality among Black, AIAN, and NHPI babies was 7.4 or higher, while Asian American infants had the lowest rate at 2.7.
The report attributes these disparities to structural racism, which creates unequal access to resources and care. “The unequal allocation of risks and resources creates structural disadvantages that build over the course of a person’s life,” the authors write.
States with restrictive health policies and limited social supports had outcomes comparable to politically unstable or low-income countries. The findings underscore the urgent need for federal protections and targeted investments to close racial gaps in maternal and child health.
See: “Maternal and Child Mortality: How Do U.S. States Compare Internationally?” (October 1, 2025)
