As a result, trauma and stress that someone experiences as a child can alter how their body responds later in life and, during pregnancy, influence how a fetus develops and preemptively trains an infant in utero to expect more stress in life.

“In addition to placing the mother and her uterus and her pregnancy functions at immediate risk for challenges such as preterm birth or postpartum depression, it can also send certain chemicals and signals to the baby in utero that then program that baby to come out ready for a strong fight or flight and reactive immune system,” Bush said, “because the mom’s biology is trying to communicate to the baby ‘This is the world you’ll be born into, come out as prepared as you can.’”

Where Wisconsin stands

Nationally, the Black infant mortality rate is 11 per 1,000 live births, according to 2024 data from the National Center for Health Statistics, an agency that is part of the U.S. Centers for Disease Control and Prevention.

The national infant mortality rate for white babies that same year was 4.4 deaths per 1,000 births.

Also that same year, Wisconsin health data showed Black women were five times more likely than white women to die from pregnancy-related complications.

According to a 2025 study published in the Annals of Internal Medicine, Americans are living longer than ever and the difference in mortality between Black and white Americans has shrunk over the last half century, except when it comes to infants, where the disparity in mortality between Black and white babies has grown.

That Wisconsin ranks so poorly for Black infant and maternal mortality is not new. In 2009, Black babies were almost four times more likely to die within their first year of life than white babies.

The year before that, Dr. Richard Allan Aronson submitted a white paper to the University of Wisconsin School of Medicine and Public Health highlighting racial disparities in the state’s birth outcomes. Aronson served as medical consultant and chief medical officer for family and community health at the Wisconsin Division of Public Health from 1988 to 2002.

The Wisconsin Department of Health Services publicizes infant mortality statistics going back to 1985. In the four decades since, the mortality rate among white babies has consistently decreased in line with medical advancement. The rate among Black babies has remained largely stagnant, with the state having a higher rate of mortality among Black infants in 2023 than it did in 1991.

In his 2008 paper, Aronson identified segregation and disparate access to services as key factors in the racial gap in birth outcomes.

“Since infant mortality is a sentinel indicator of a community’s overall well being, the factors that contribute to racial and ethnic birth outcome disparities relate to all sectors of society. The neighborhoods in Wisconsin with the highest rates of black infant mortality are characterized by hypersegregation, unemployment, economic hardship, and inadequate housing,” Aronson wrote. “Systems that serve children and families in these communities are often fragmented, burdensome, culturally and linguistically disrespectful, and deficit-based.”

Aronson’s assessment of the situation in Wisconsin is as true today as it was nearly two decades ago. And from the year he issued his report to 2024, nearly 1,500 Black babies in Wisconsin died before their first birthday, according to data from the Wisconsin health department.

Had the rate been the same as it was for white babies, more than 970 of them would have survived.

Gaps in access to care and a lack of culturally competent medical services still play a key role in how Black Wisconsinites interact with the health care system, particularly during and after pregnancy, Zapata said.

Wisconsin’s largest cities still carry the spectre of racial segregation and redlining, policies that separated whole populations from necessary services.

Milwaukee, Wisconsin’s largest city with the highest population of Black residents and the highest total annual number of Black infant deaths, has also been consistently ranked as one of the most segregated cities in America.

Madison, which has a far lower population of Black residents, also faces notable racial and subsequently connected socioeconomic segregation.

“If you were going to design a strategy to adversely impact the well-being of a population, you couldn’t come up with a better policy than racial residential segregation. It’s actually brilliantly evil in its manifestations,” Iton, with The Health Trust in California, said.

‘It shouts racism’

Poor health outcomes are often explained away by poverty or low educational achievement, Iton said. But disparities in maternal and infant health outcomes for Black women and babies are shown to transcend both of these factors. This shows that something else is at work, he said.

National data shows Black mothers with a college degree still have higher infant mortality rates than white women who drop out of high school.

“It shouts racism,” Iton said. “If you’re not protected by income and social status from this outcome, that suggests that it’s not just material poverty or lack of resources, but it’s also your situatedness in society and what you perceive to be essentially a pervasive, large-scale devaluation of you as a human being.”

Those effects become clearer looking at data that show Black immigrants have better health outcomes when they come to the United States but exhibit poorer health outcomes the longer they are here, Iton said.

“The birth outcomes are so much better in the African immigrant women, and then as they acculturate, spend more time in America, their birth outcomes get worse,” he explained. “So the suggestion is that it’s really something in the environment in the United States.”

‘Preventing the fire in the first place’

Zapata, Wisconsin’s state specialist in child and maternal health, said she wants more focus on preventing the problems that hurt people in the first place.

“There’s always so much focus on just when you get pregnant and right after. It’s kind of like a house is on fire and it’s burning, and then you’re always just focusing on how can the fire truck get there faster,” she said. “Let’s focus on preventing the fire in the first place.”

That means addressing stressors faced by Black Wisconsinites across their lifespan.

“It’s like once you’re pregnant, you can qualify for all these services. But sadly, from a physiological and biological standpoint, a lot of times it’s too late,” Zapata said. “Because that birthing person — what happened to them all the way into their childhood, and even what was going on with their parents, and when they were in utero, the environment, the stress that their parents were having — that impacts them, that impacts their birth outcomes.”

Jeff Bauer

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Wisconsin’s Black infant mortality crisis is harming generations

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