Joinpoint Trend Analysis of Infant Mortality Disparities in Wisconsin, 1999-2016.

Objectives: To address shortcomings of previous research exploring trends in racial, educational, and race by educational disparities in infant mortality rates (IMRs) by using nonlinear methods to compare improvement within and between disparity domains.

Methods: We used joinpoint regression modeling to perform a cross-sectional analysis of IMR trends from linked birth and death certificates in Wisconsin between 1999 and 2016.

Results: In the race and education domains, IMR decreased by 1.9% per year for infants of White mothers and 1.1% per year for infants of less-educated mothers. Further analysis showed these IMR reductions to be among infants of White mothers with more education (-0.6%/year) and Black mothers with less education (-2.0%/year).

Conclusions: As previously reported, gaps in IMR by race and education in Wisconsin appear to be closing; however, only the change by education is statistically significant. Evidence suggests the racial divide in IMR might soon widen after years of progress in reducing IMR among infants of Black mothers. Public Health Implications. Those advancing strategies to address IMR disparities should pursue data and methods that provide the most accurate and refined information about the challenges that persist and progress that has been realized.