Questions for Danielle Ely, Ph.D., Statistician and Lead Author of “Infant Mortality Rates in Rural and Urban Areas in the United States, 2014”
Q: What is the most significant finding in your study?
DE: The most significant finding in this study was the consistency with which infants in rural areas have significantly higher mortality rates than infants in urban places. Higher rural infant mortality was generally observed by race and Hispanic origin, mother’s age, and by infant age at death.
Q: Why are infant mortality rates higher in rural areas vs urban areas?
DE: Generally, previous research shows that health outcomes are poorer in rural places compared with urban places and this study is consistent with those findings. This study did not examine the factors that might be influencing the higher rural infant mortality in comparison with urban infant mortality.
Q: Is this surprising, or are problems with poverty, substance abuse, and health care that much worse in rural areas?
DE: Higher infant mortality in rural places compared with urban places is not necessarily surprising based on the number of other poor health outcomes (such as higher overall mortality rates, higher rates of disability) that rural residents have in comparison to urban residents.
Q: Are there any theories in the literature as to why this infant mortality disparity exists between rural and urban?
DE: Given there are some poorer health outcomes in rural areas, it is possible more pregnant women in rural areas have poorer general health than pregnant women in urban areas that can lead to poor infant outcomes. Further, there is generally less access to health care due to distance and number of providers available in rural areas, which can impact health outcomes.
Q: Any other findings of note that you find significant?
DE: These findings highlight the importance of place for infant survival and suggests the need for including place in research on health outcomes, as well as a need for further research on the greater risk of infant death in rural settings.