Simulating the effects of poverty on the race disparity in postneonatal mortality

The U.S. postneonatal mortality rate has declined from over 60 postneonatal deaths per 1,000 live births at the turn of the century to below 4 deaths in 1987. It is generally accepted that this impressive decline is due to improvements in the general standard of living throughout the twentieth century. However, efforts to reduce the race differential in postneonatal mortality have been less successful. Black postneonatal mortality rates have been roughly double the white rate since race-specific data has been collected. This paper examines the degree to which the substantial race disparities in postneonatal mortality are a function of race disparities in the prevalence of poverty. The analysis specifies a race-specific model of postneonatal mortality. The model is then manipulated to allow for a simulation of the impact of reducing black poverty on the postneonatal mortality race disparity. It is concluded that racial postneonatal mortality differentials may be addressed by remedies which need not be explicitly medical intervention (e.g. effective policy that reduces disparities in socioeconomic status).