An infant mortality rate above 10 deaths per 1,000 live births is widely considered high by global health standards. The rate measures how many babies in a given area die before their first birthday for every 1,000 born alive. It serves as one of the most telling indicators of a population’s overall health, reflecting everything from the quality of medical care to the economic conditions families live in.
How Infant Mortality Rate Is Calculated
The formula is straightforward: divide the number of infant deaths (under age one) in a geographic area by the total number of live births in that same area during the same time period, then multiply by 1,000. A country with 50 infant deaths out of 10,000 live births would have a rate of 5.0 per 1,000. This standardized calculation allows meaningful comparisons between countries, states, and communities of vastly different sizes.
What Counts as High, Low, or Average
There is no single official cutoff that labels a rate “high,” but international benchmarks make the picture clear. The United Nations Sustainable Development Goal 3.2 calls for every country to bring its newborn mortality rate to 12 or fewer deaths per 1,000 live births by 2030, treating anything above that as unacceptable. Most wealthy nations sit well below that line. Japan, Finland, and several other high-income countries consistently report rates under 3 per 1,000.
The United States, despite its wealth, has a rate of about 5.4 per 1,000 live births as of mid-2025, placing it behind most other high-income countries. Countries like Colombia (16.8 per 1,000), along with Brazil, Peru, Indonesia, South Africa, and India (all reporting rates of roughly 12 or higher per 1,000), represent the higher end of the spectrum among nations tracked by the OECD. In sub-Saharan Africa, some countries exceed 40 or even 50 per 1,000, rates that would have been common worldwide a century ago.
As a rough guide: rates under 5 per 1,000 are typical of countries with strong healthcare systems, rates between 5 and 10 suggest room for improvement, and anything above 10 signals serious gaps in maternal and infant health infrastructure.
Leading Causes of Infant Death
The five leading causes of infant death in the United States in 2022 were birth defects, preterm birth and low birth weight, sudden infant death syndrome (SIDS), unintentional injuries such as car crashes, and complications from the mother’s pregnancy. Globally, the picture shifts somewhat: infectious diseases, malnutrition, and lack of access to clean water play a larger role in countries with the highest rates. But preterm birth and birth defects remain dominant causes everywhere.
Many of these causes are preventable or treatable with the right resources. Babies born too early, for example, often survive in hospitals with neonatal intensive care units but die in settings without that level of support. Birth defects like neural tube defects can be reduced significantly when mothers get enough folic acid before and during pregnancy.
Why Some Communities Have Higher Rates
Infant mortality is not distributed evenly, even within a single country. In the United States, the disparity by race is stark. In 2021, Black infants died at a rate of 10.55 per 1,000 live births, more than double the rate for White infants at 4.36. Native Hawaiian or Pacific Islander infants (7.76) and American Indian or Alaska Native infants (7.46) also faced significantly elevated risk. Asian infants had the lowest rate at 3.69, and Hispanic infants fell in between at 4.79.
These gaps are not explained by biology. They track closely with social and economic conditions. Research consistently links higher infant mortality to communities with greater poverty, lower levels of maternal education, lack of health insurance, and limited access to maternity care. A study published in BMJ Public Health found that the socioeconomic status of a community and its racial and ethnic composition were both independently associated with increased infant death risk. Factors like crowded housing, lack of transportation, and unemployment compound the problem, making it harder for pregnant women to access consistent medical care.
Areas that lack maternity care providers entirely, sometimes called “maternity care deserts,” tend to see higher infant death rates simply because mothers cannot get to prenatal appointments or deliver in well-equipped facilities.
What Lowers the Rate
The interventions that reduce infant mortality are well established. Early and regular prenatal care is one of the most effective, catching complications like high blood pressure or gestational diabetes before they threaten the baby. Folic acid supplementation before and during pregnancy prevents neural tube defects, a category of serious birth defects affecting the brain and spine.
After birth, safe sleep practices make a measurable difference. Placing babies on their backs to sleep and keeping the sleep area free of soft bedding, bumpers, and toys reduces the risk of SIDS. Newborn screening, which tests for dozens of conditions that are invisible at birth but treatable if caught early, prevents deaths that would otherwise occur in the first weeks or months of life.
At a population level, expanding health insurance coverage, improving access to affordable housing, and investing in community health programs all correlate with lower rates. Countries that have driven their infant mortality rates below 3 per 1,000 typically share a few features: universal or near-universal healthcare access, strong social safety nets, and widespread public health education for new parents. The gap between those countries and communities still reporting rates above 10 or 20 per 1,000 is, in almost every case, a gap in resources and access rather than medical knowledge.