The Mississippi Department of Health recently declared a public health emergency in response to rising infant deaths in an unusual move to help speed up efforts to cover gaps in care.
Lowering the state’s infant mortality rate won’t be easy, health experts warn, and will potentially be made trickier by the ongoing overhaul of the federal public health system.
“This declaration by Mississippi is a bold and necessary step to elevate infant mortality to the level of urgent crisis response,” said Michael Warren, chief medical and health officer for the March of Dimes. “Declaring a public health emergency shines a spotlight on the severity of this crisis.”
The overall infant mortality rate in Mississippi rose to 9.7 deaths per 1,000 live births in 2024, according to the state’s Department of Health, the highest it’s been in more than a decade.
Since 2014, more than 3,500 babies in the state have died before turning 1.
Mississippi’s public health crisis reflects a wider trend, and other states like California and New Jersey have launched initiatives to address maternal and infant health.
Mississippi, however, has had the highest infant mortality rates in the nation since 2017, data from the Centers for Disease Control and Prevention (CDC) show. The most common causes of infant death in the state are congenital malformations, low birth weight, and accidents, according to state health data shared with The Hill.
Mississippi State Health Officer Dan Edney declared a public health emergency to expedite plans the agency already had in the works to mitigate infant deaths, according to a spokesperson.
Some of those plans included educating families on safe sleep practices to reduce preventable infant deaths, while others focus on pregnant women’s health, like a plan to prepare county health departments to offer prenatal and postpartum services in communities without obstetric or gynecologic services.
“Improving maternal health is the best way to reduce infant mortality,” Edney said in a statement. “Healthy women of childbearing age are more likely to have healthy pregnancies, which in turn lead to healthier babies.”
Joia Crear-Perry, an OB-GYN and the founder and president of the National Birth Equity Collaborative, agrees that investing in maternal health is a direct way to improve infant health.
“The United States has the worst maternity health outcomes of any high-income nation and what happens to mom also happens to baby,” she said.
Health experts said the impacts of abortion restrictions on fetal death rates cannot be overstated.
Infant deaths have gone up in states that enacted abortion bans in the months following the 2022 overturning of Roe v. Wade, according to two studies published earlier this year.
One of the studies found a rise in deaths among Black babies and infants due to congenital anomalies — the most common cause of infant deaths in the U.S. — in those states.
Alison Gemmill, a perinatal epidemiologist at Johns Hopkins Bloomberg School of Public Health and author of the study, said the data and anecdotal evidence show that abortion bans are forcing some people to carry “doomed pregnancies” to term.
“People get that diagnosis in pregnancy and usually they would have an option to terminate, and that option is no longer there,” she said.
The most common cause of infant death in Mississippi between 2022 and 2024 was congenital abnormalities, according to state health data. A total of 172 infants died because of congenital malformations, deformations or chromosomal abnormalities during that time.
Health experts said they believe Mississippi officials may be able to knock down the infant mortality rate, but that recent changes within the federal Department of Health and Human Services (HHS) might make the process challenging.
Mass layoffs at HHS have gutted divisions within the Centers for Disease Control and Prevention dedicated to improving the health of pregnant people and infants.
One of the impacted programs was the Pregnancy Risk Assessment Monitoring System (PRAMS), which collects state-level data on maternal and infant death. The Trump administration indefinitely suspended the survey early this year and then placed the entire staff overseeing the program on administrative leave in April.
Health experts stressed that the survey examines a wide range of factors that could influence maternal and infant health outcomes, like insurance coverage, income, and prenatal care, and that it is essential to figuring out where high-risk maternal groups are located. State and local governments have used PRAMS data to develop or implement changes to policies meant to help maternal or infant health.
The Senate Committee on Appropriations approved a provision in a 2026 appropriations bill that includes a $3 million increase in the CDC’s Safe Motherhood program, which helped pay for agency programs aimed at improving maternal and infant health outcomes and surveillance.
But the Trump administration has not expressed an interest in bringing fired CDC employees back, leaving the future of maternal and infant health work at the agency up in the air. Even if the administration wanted to replace fired employees, it would be difficult to undertake.
“You can’t replace the knowledge that those staff had,” one former CDC employee told The Hill. “It takes decades to build up that comprehensive understanding of the interplays between sociodemographics and the health care system and local and state and national health departments.”
Health experts also noted that forthcoming Medicaid changes will also make it challenging to combat rising infant mortality, especially in states that heavily rely on the program, like Mississippi.
Nearly 24 percent of Mississippians received their health insurance coverage through Medicaid in 2023, according to the health care policy nonprofit KFF. That same year, Medicaid covered about 57 percent of births in the state.
The Trump administration’s enormous tax and spending package is projected to cost the federal government $3 trillion, which will be offset in part by nearly $1 trillion in cuts to Medicaid.
More than 12 million low-income Americans could lose their health insurance coverage by 2034 as a result, according to an analysis from the Congressional Budget Office. Medicaid cuts would force states to make difficult decisions on how to offset reductions and choose to make cuts to their Medicaid programs by “reducing coverage, restricting benefits, or lowering provider reimbursement rates,” according to KFF.
Decreased coverage and reimbursement rates could also lead to rural hospital closures, reducing access to OB-GYNs and other maternal health care providers in states like Mississippi.
“The vast majority of infant mortality events are because of social factors and maternal health conditions, not just health care itself,” said the former CDC employee. “And the people who know that are the people whose jobs have been cut.”
An HHS spokesperson said the CDC “stands ready to assist” all states with public health emergencies to “safeguard the health and wellbeing of Americans.”
