TABLE 6.-Postneonatal and childhood mortality, by State, 1953 and 1950 Mothers and infants in rural areas frequently have more limited family resources and access to health and welfare facilities than is the case in highly urbanized sections and the immediately surrounding localities. Some States have been more successful than others in curbing maternal and infant losses in counties which are isolated from metropolitan counties. The financial resources of the States, as well as many other factors, have affected the extent of accomplishment in equalizing risks to mothers and infants in different areas of the States. In the low per capita income States, maternal mortality in isolated counties in 1948-52 was more than 70 percent higher than in metropolitan counties of these States, whereas in the high per capita income group of States maternal mortality rates in isolated and metropolitan counties were approximately the same. (See table 7.) Infant mortality presents the same kind of picture but county differences are less sharp. (See table 8.) TABLE 7.-Maternal mortality, United States,1 1948-52, by county groups 1 Exclusive of Alaska, Hawaii, Puerto Rico, and Virgin Islands. 2 The classification of counties is based on 1950 census. Metropolitan counties include counties with cities of 50,000 or more population; adjacent counties have no city of 50,000 or more and border on or have ready access to metropolitan counties. All other counties are classified as isolated from metropolitan counties. Isolated counties include those with no urban place as large as 2,500 and those with larger urban places but less than 50,000 population. Source of data: National Office of Vital Statistics. TABLE 8.-Infant mortality, United States,1 1948–52, by county groups 1 Exclusive of Alaska, Hawaii, Puerto Rico, and Virgin Islands. 2 The classification of counties is based on 1950 census. Metropolitan counties include counties with cities of 50,000 or more population; adjacent counties have no city of 50,000 or more and border on or have ready access to metropolitan counties. All other counties are classified as isolated from metropolitan counties. Isolated counties include those with no urban place as large as 2,500, and those with larger urban places but less than 50,000 population. Source of data: National Office of Vital Statistics. Wide inequalities exist in fatal hazards in infancy between different socioethnic subgroups of our population, which generally speaking are also characterized by different levels of family income. In the years 1951 and 1952, for example, the infant mortality rate among Negroes in the United States was 45.6 per 1,000 infants as compared with 25.7 per 1,000 infants born to white mothers. Among Indians, the rate was about three times as great as for white infants, 78.7 per 1,000. Trends in infant mortality among nonwhite and white infants, CHART 1 INFANT MORTALITY BY AGE; 1916-53 (U. S. Birth Registration Area) INFANT (under one year) deaths in the specified period per 1,000 live births (log scale) 200 100 80+ 60+ 40+ 20+ white nonwhite 1915-53, are shown in chart 1. It will be noted that in recent years the differentials have been increased somewhat rather than diminished. Fetal and neonatal losses among nonwhite infants in the United States are notably higher than among white infants. (See chart 2.) These losses include deaths before and during birth of infants who have reached 20 or more weeks of gestation, and deaths of infants born alive before 28 days of age. The joint fetal and neonatal mortality rate for nonwhite infants, in the 30 States having 5 percent or more nonwhite births, was 61 percent higher than the rate for white infants. The fetal death rate alone, for the nonwhite group (fetal deaths per 1,000 total births to nonwhite mothers), was 85 percent higher than CHART 2 FETAL AND NEONATAL DEATHS PER 1,000 TOTAL BIRTHS the rate for white infants. The neonatal rate for the nonwhite infants exceeded the rate for white infants by 42 percent. Some of the excess of fetal and neonatal loss in the nonwhite group reflects the fact that nonwhite mothers begin bearing children at an earlier age than white mothers. During their reproductive years, nonwhite mothers also bear a larger number of children. However, |