Mississippi’s infant mortality rate reached a five-year high in 2021, according to the latest numbers from the Centers for Disease Control and Prevention.

The death rate of babies under one year of age rose from 8.3 deaths per 1,000 live births in 2020 to 9.39 deaths per 1,000 live births in 2021, the most recent year for which data is available. Nationally, the rate remained relatively stable from 2020 to 2021.

A total of 330 Mississippi babies died before their first birthday in 2021.

Mississippi continues to have the highest rate of infant mortality of any state at nearly twice the national average of 5.44 infant deaths per 1,000.  

The report does not break down specific causes of death by state, though Mississippi’s infant mortality review committee will release a report with more details. 

“These numbers are extremely concerning, but we will have to wait on the Fetal Infant Mortality Review Committee reports to determine the causes of increased mortality rates. I suspect that we will see that the COVID-19 pandemic, high rates of congenital syphilis, and the issues of poverty and access to care had a detrimental effect on infants in the state,” State Health Officer Dr. Dan Edney said in an emailed statement to Mississippi Today. 

The committee releases reports annually.

In the six years ending in 2021, Mississippi saw a 900% increase in babies born with syphilis – a sexually transmitted disease that is passed to an infant during pregnancy. The disease can cause miscarriages and death, and children that survive can have major malformations and life-long complications.

The state Health Department responded by adopting a regulation that mandates physicians test pregnant people for the disease. Before that, Mississippi was one of only six states in the nation that did not require syphilis screenings in pregnancy by law.

Nationally, the leading causes of infant mortality are: congenital malformations; disorders related to short gestation and low birthweight; Sudden Unexpected Infant Death (SUID); unintentional injuries and maternal complications. 

Dr. Anita Henderson, the past president of the Mississippi chapter of the American Academy of Pediatrics, said she is “very concerned” by the latest numbers. 

“Black babies are more than twice as likely to die before their first birthday compared to white babies. There are several preventable causes of death that are increasing, especially here in Mississippi. Our Sudden Unexpected Infant Death rate includes accidental suffocation and Mississippi, sadly, has the highest SUID rate in the nation,” according to the 2020 data, she said. 

Henderson also pointed to several other drivers of the problem: the state’s high rate of premature birth, its maternal health provider shortage and the difficulty low-income women have in receiving timely prenatal care.

“Presumptive eligibility for moms on Medicaid would facilitate timely access to prenatal care for that critical, first trimester OB visit. Over half of the counties in Mississippi do not have an OB or a delivering hospital,” she said. “Lack of access is dangerous and potentially deadly for Mississippi moms and babies.” 

If a state offers presumptive eligibility, a low-income pregnant woman who is pregnant and seeking medical services will be presumed eligible for Medicaid coverage and the medical provider can provide prenatal care and be reimbursed by Medicaid – presumably allowing her to receive prenatal care earlier. Mississippi does not currently have presumptive eligibility for pregnant women. 

Mississippi is also one of only 10 states that has not expanded Medicaid under the Affordable Care Act, leaving hundreds of thousands of Mississippians without health insurance. It is one of only three states that has neither expanded Medicaid or provides pregnancy presumptive eligibility as of 2020, according to the Kaiser Family Foundation.

This legislative session, lawmakers approved extending health care coverage for mothers on Medicaid to one year after giving birth. Moms had previously only been covered for 60 days postpartum. Proponents of the extension said there is a direct link between healthy mothers and healthy babies.

The Mississippi Delta saw some of the highest rates of infant mortality in the state in 2021 at 13.7 infant deaths per 1,000 births, according to state Health Department data. The rate represents 32 babies who died – the highest rate for the area since 2017.