Infant mortality rates in Texas vary dramatically from one zip code to the next, according to new study

AUSTIN— Infant mortality rates in Texas vary dramatically even across neighboring zip codes, according to a new analysis and mapping tool from researchers at The University of Texas System and UT Health Northeast. The analysis and searchable map, which are the first of their kind in Texas, use data from Texas Vital Statistics Linked Birth and Death Records from 2011-2014.

In Fort Worth, for example, the infant mortality rate was over six times higher in the 76164 zip code than in neighboring 76107. Among just black mothers in Houston, there was an eight-fold difference in infant mortality rates across the city. Some zip codes in the state have not experienced an infant death in this four-year time period, whereas others have experienced more than 1 percent of their infants dying before their first birthday.

The zip code level rates were calculated for communities with 400 or more births in this four-year period, and were identified by the mother’s zip code of residence at delivery. The data were obtained from the Texas Department of State Health Services (DSHS).

“What this reveals is that the infant mortality picture is dramatically more complex than we knew,” said David Lakey, MD, Chief Medical Officer and Vice Chancellor for Health Affairs for UT System. “The state average, which is lower than the national average, obscures zip codes where rates are terribly high. Some of the higher city or county level rates, on the other hand, have obscured the variation within communities, including neighborhoods where rates are very low.”

The variations, said Lakey, are both geographic and racial/ethnic. White women in Texas have a relatively low risk of their baby dying within the first year after birth. However, as with the infant mortality rate for all infants, there are significant community-level differences in infant mortality rates among this group. The highest infant mortality rates for white infants were seen outside the major metro areas. For example, Longview and Wichita Falls each had more than one zip code with a white infant mortality rate that was two or more times the overall infant mortality rate in the state.

Of the three major racial/ethnic groups in Texas, Hispanic women have the lowest rate of infant mortality. However, as with white women, infant mortality rates for Hispanic women varied greatly based on where they lived when they were pregnant. In San Antonio, for example, adjacent zip codes 78203 and 78220 both had Hispanic infant mortality rates that were over double the state rate.

Non-Hispanic black families in Texas and the U.S. are disproportionately impacted by infant mortality. However, as for infants of Hispanic and white mothers, mortality rates for infants of black mothers varied across zip codes, even within the same city. Within Houston, for example, mortality rates for infants of black mothers varied eight-fold across zip code, from
3.3 to 28.7 deaths per 1,000 births in zip codes 77077 and 77026, respectively.

Although the map shows the wide geographic variation in the state, it does not show why the variation exists. Researchers with UT System will continue to work towards understanding why this variation exists and what can be done to reduce rates overall. UT System is also making public use data files available, as well as other technical information, to facilitate work by other researchers.

“Texas is deeply committed to reducing infant mortality in every community,” said Lakey. “Having a lower than average rate, nationally, is not enough, particularly when we know that there are communities where rates are tragically high. What this kind of analysis should enable us to do, moving forward, is to even more precisely identify what best practices to emulate, where to target our interventions, and how best to deploy our resources. We strongly encourage others to make use of this data, and to work on finding solutions. The sooner we can understand why babies are dying, the better off we will all be.”

Background Materials

• Report: Infant Mortality in Communities Across Texas
• Interactive Map: Texas Zip Code Level Infant Mortality Rates by Race/Ethnicity: 2011-2014
• Static Maps and Figures
• Public Use Data Files

About The University of Texas System
Educating students, providing care for patients, conducting groundbreaking basic, applied and clinical research, and serving the needs of Texans and the nation for more than 130 years, The University of Texas System is one of the largest public university systems in the United States. With 14 institutions and a projected enrollment of more than 234,000 students, the UT System confers more than one-third of the state’s undergraduate degrees, educates approximately two-thirds of the state’s health care professionals annually and accounts for almost 70 percent of all research funds awarded to public institutions in Texas. The UT System’s operating budget for FY 2018 is $18.3 billion, funded in part by $3.6 billion in sponsored programs from federal, state, local and private sources. With more than 20,000 faculty – including Nobel laureates and members of the National Academies – and nearly 80,000 health care professionals, researchers, student advisors and support staff, the UT System is one of the largest employers in the state.

About UT Health Northeast
For 70 years, UT Health Northeast has provided excellent patient care to the citizens of Texas and beyond. Signature programs include cancer, chest diseases, primary care, behavioral health, and public and community health, along with over 25 additional medical specialties. As the only university medical center in Northeast Texas, its mission also includes education and research. Graduate medical education residencies are in family medicine, rural family medicine, internal medicine, occupational medicine, and psychiatry with many newly trained physicians electing to stay in Northeast Texas, a medically underserved region of the state. Graduate degrees include biotechnology and public health. In addition, scientists in the Center for Biomedical Research have been awarded more than $137 million in competitive funding since 2004. With an annual operating budget of over $200 million, UT Health Northeast is a major economic engine for the region.