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New Report Confirms Babies of Color Face Severe Inequities Even Before Birth

Jun 11, 2020

State of Babies Yearbook: 2020 explores how where in the U.S. a baby is born impacts their chance for a strong start in life

According to a new report released today by early childhood nonprofit ZERO TO THREE, where a baby is born in America can have major implications for the rest of their life. But the data also confirm what many have long known – that Black and Brown babies start at a major disadvantage no matter what state in the U.S. they are born.

The State of Babies Yearbook: 2020 makes it abundantly clear that systemic racism and social injustices adversely affect communities of color and that major inequities begin before birth, especially for Black children. This comprehensive look at how the state where a baby is born can influence whether or not they get a strong start in life also includes a deeper look at equity, finding that Black and Brown infants and toddlers are more likely to be poor, to be born too small or too soon, and to live in environments that challenge their families’ security.

To view the State of Babies Yearbook: 2020 website, click here.

To read the full State of Babies Yearbook: 2020 report, click here.

To read the accompanying brief, “Maternal and Child Health Inequities Emerge Before Birth,” click here.

“Our nation has been complacent for too long and has looked the other way when Black and Brown families have struggled. But our babies deserve more than what we’re giving them - they deserve the same opportunities as any other child,” stated Myra Jones-Taylor, Chief Policy Officer at ZERO TO THREE. “Black babies are twice as likely as White babies to die before their first birthday. Black women’s maternal mortality rate is more than three times higher than among White women. And Black women have a 55 percent higher rate of preterm births than White women. This is an unmitigated crisis that impacts babies and families in every single state in our country, and it has long-lasting impacts throughout our lives. If we want to truly address the issues plaguing Black and Brown communities in the United States, we need to start by identifying disparities, addressing them with specific policies and budgets, and making the potential of every baby a national priority.”

“The Yearbook shows us— and the current pandemic and national unrest in response to police brutality and racism have heightened our awareness—that too many issues that have gone unaddressed for far too long,” said Wes Moore, CEO of Robin Hood, Army combat veteran, and best-selling author. “What we are seeing right now is the result of long-standing barriers for Black and Brown babies. But out of these crises, we must realize that simply rebuilding is not good enough, and now is the time to challenge systems and policies that we have not challenged before.

Protests around the country, as well as the ongoing COVID-19 pandemic, have exposed and exacerbated long-standing cracks in the systems that support the healthy development and well-being of infants, toddlers, and their families. The demand has never been greater for well-thought out responses to both the immediate and long-term needs of America’s babies.

The State of Babies Yearbook, an initiative of ZERO TO THREE’s Think Babies, bridges the gap between science and policy with national and state-by-state data on the well-being of America’s babies. The Yearbook compiles nearly 60 indicators, specifically for children ages 0 to 3, to measure progress in the domains of Good Health, Strong Families, and Positive Early Learning Experiences. 2020 marks the second year that ZERO TO THREE has released the State of Babies Yearbook.

The Yearbook breaks down the data for selected indicators by race/ethnicity, income, and rural/urban areas, enabling a closer look at the disparities that can exist even within states whose babies, on average, are doing well.

The data are clear: In a country where more than half of all infants are children of color, the state where a baby is born makes a big difference in their chance for a strong start in life. And by nearly every measure, babies of color and children living in low income families face the biggest obstacles, including low birthweight, unstable housing, and limited access to quality early learning experiences.

Although the State of Babies Yearbook: 2020 continues to place states in tiers, we urge state policymakers and advocates to focus on the needs and disparities indicated within their own states. The Yearbook uses a transparent ranking process to group states into one of four tiers to provide a quick snapshot of how states fare on the selected indicators and domains. These tiers represent four groupings of states that are approximately equal in size and ordered from highest to lowest performing. The following scale designates a given state’s placement in one of the four tiers:

  • “GROW” for Working Effectively
  • “GRO” for Improving Outcomes
  • “GR” for R**eaching Forward
  • “G” for Getting Started

Simply put, all states need to do better for babies. In every state—even among those with high averages—significant disparities exist in the opportunities available to allow babies of color to thrive, often driven by historical and structural inequalities.

While all states have room to grow, the disparities between them and within them reflect differing levels of investment in services and systems for babies that can help buffer the effects of poverty and other adverse experiences.

Noteworthy findings from the Yearbook include:

  • Infant mortality: On average, 6 in 1,000 babies in the U.S. will not survive to see their first birthday. In some states, 9 in 1,000 babies born will not survive. Mortality is more than twice as high for Black infants (11.1 per thousand births) as it is for White infants (4.8); and mortality for Hispanic infants is slightly higher (5.0).
  • Maternal mortality: A new indicator in the 2020 Yearbook, maternal mortality, occurs at a rate of 17 deaths per 100,000 live births nationally. Maternal mortality among Black women is more than three times higher (40.8) than among White women (13.2) – a gap that has not decreased over multiple decades.
  • Preterm birth and low birthweight: Babies of color have a higher incidence of preterm birth and low birthweight than white babies, which can undermine healthy development. Nationally, the preterm birth rate for Black women (14.1 percent) is 55 percent higher than the rate for White women (9.1 percent), and the rate for Hispanic women (9.7 percent) is 7 percent higher.
  • Poverty: In the United States, 42 percent of babies live in families without enough income to make ends meet, down slightly from State of Babies Yearbook: 2019 data (45 percent). As the economic impacts of this pandemic become clearer, even more families with young children will find themselves facing these barriers.
  • Crowded housing: Overall, 15.5 percent of infants and toddlers live in crowded housing, but children living in families with a low-income are three times more likely to live in this setting (24.6 percent) than those living in families above low-income (7.9 percent). Hispanic babies (29 percent) are more than three times as likely and Black babies (17.6) and babies of Other Race (17.5) are twice as likely to live in crowded housing than White babies (7.6 percent).
  • Child care: The high cost of infant care is far out of reach for many families, exceeding the cost of college tuition in more than half of states. Across states, the cost of care as percentage of the median income of a single parent ranges from 25 percent to 89 percent.
  • Early Head Start: Early Head Start is a proven program that improves parenting and child outcomes, yet only reaches 7 percent of income eligible children. Three-quarters of EHS participants are infants and toddlers of color.

In order to better lift up babies of color in America, and to provide all of our babies and toddlers with an opportunity to thrive, ZERO TO THREE embraces the demand for reforming policing policies and investing funds in policies that promote equity and strong futures for babies. The organization further recommends a number of policies to help all infants reach their full potential, including:

  • Health insurance coverage for all children and adults;
  • Access to comprehensive health care through maternal and child health care systems and programs shaped by women and families in the communities they serve;
  • Comprehensive economic security policies that support families with young children and close the opportunity gap created by wealth disparities;
  • National family-oriented workplace policies extended to all workers, including national paid family and medical leave, paid sick days, and fair work schedules; and
  • Comprehensive, high-quality child care available to all families, with early childhood mental health supports and training on recognizing implicit bias.

Above all, ZERO TO THREE calls on policymakers to implement a comprehensive, multidisciplinary approach that engages diverse stakeholders and community members in planning and developing solutions. The State of Babies Yearbook makes clear that improved data collection is absolutely necessary to facilitate ongoing monitoring of critical indicators and to allow disaggregation by race and ethnicity.

To read the full State of Babies Yearbook: 2020, including state-specific results, visit


ZERO TO THREE works to ensure all babies and toddlers benefit from the family and community connections critical to their well-being and development. Since 1977, the organization has advanced the proven power of nurturing relationships by transforming the science of early childhood into helpful resources, practical tools and responsive policies for millions of parents, professionals and policymakers. For more information, and to learn how to become a ZERO TO THREE member, please visit,, or follow @ZEROTOTHREE on Twitter.

About Think Babies™

ZERO TO THREE created Think Babies to make the potential of every baby a national priority. When we Think Babies and invest in infants, toddlers, and their families, we ensure a strong future for us all. Learn more at or follow @ZEROTOTHREE on Twitter.

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