Paradox Revisited: A Further Examination of Race/Ethnic Differences in Infant Mortality in the U.S. by Maternal Age

Daniel A. Powers, University of Texas at Austin

We use the 1995-2002 U.S. NCHS linked birth-infant death files to analyze infant mortality by maternal age, race/ethnicity, and nativity and to reexamine the epidemiological paradox of lower infant mortality in specific populations relative to US-born non-Hispanic whites—the most relevant comparison groups being US-born Mexican Origin and Foreign-Born Mexican Origin women, due to their similarity to US-born non-Hispanic blacks on a number of risk factors. The six subpopulations considered here exhibit different maternal age distributions of births, with births skewed towards younger ages in the Mexican Origin and US-born Non-Hispanic black populations. Mexican Origin populations exhibit lower infant mortality at younger maternal ages relative to US-born Non-Hispanic whites—consistent with the epidemiological paradox. Infant mortality is higher at older ages in the Mexican Origin populations (relative to US-born Non-Hispanic whites)—consistent with the conceptual framework of “weathering.” These patterns persist after controlling for known risk factors in multivariate models.