Determinants of Neonatal Mortality Rates in the U.S.: A Reduced Form Model

The aim of this paper is to contribute to an understanding of the determinants of differences in race-specific neonatal mortality rates among large counties of the U.S. in 1977. After estimating cross-sectional regressions, we apply their coefficients to national trends in the exogenous variables to "explain" the rapid decline in neonatal mortality since 1964. The regressions and the extrapolations point to the importance of abortion availability, neonatal intensive care availability, females schooling levels, and to a lesser extent Medicaid, BCHS projects, and WIC in trends in black neonatal mortality between 1964 and 1977. They also underscore the importance of schooling, neonatal intensive care, abortion, Medicaid, WIC, and to a lesser extent poverty and organized family planning clinics in trends in white neonatal mortality in those years. A particularly striking finding is that the increase in abortion availability is the single most important factor in the reduction in the black neonatal mortality rate. Not only does the growth in abortion dominate other program measures, but it also dominates trends in schooling, poverty,female employment, and physician availability. The actual reduction due to abortion amounts to 1.2 deaths per thousand live births or 10 percent of the observed decline.