Sheppard–Towner Act - Achievements - Infant Mortality

Infant Mortality

The overall U.S. infant mortality rate in 1922 was 76.2 death per 1000 live births. By the time that Sheppard-Towner was repealed in 1929, the infant mortality rate had fallen to 67.6. There was a net decrease of 9.6 decrease in deaths per 1000 live births. There was already a downward trend in infant mortality during the 1920s; not the entirety of the decrease was due to Sheppard-Towner.

States that spent one standard deviation of money on “child-life”, or approximately $27, reduced infant mortality on average by 2.8 deaths per 1000 live births. States that spent one standard deviation of money on health and sanitation, or approximately $188, reduced infant mortality on average by 6.27 deaths per 1000 live births. Home nurse visits reduced infant mortality on average by 1.8 deaths per 1000 live births. One standard deviation increase of the number of health centers decreased infant mortality on average by 2.25 deaths per 1000 people. An increase in 30 “prenatal letters”, letters that provided information on prenatal and well-child care, decreased infant mortality on average by 0.2 deaths per 1000 live births.

There were different effects on white and non-white populations of states that decided to participate in Sheppard-Towner. For whites, one standard deviation of spending on child life reduced 1.5 deaths per 1000 live births, and one standard deviation of spending on health and sanitation reduced infant mortality by 3.8 deaths per 1000 live births while for non-whites both had no statistically significant effect on reductions. Nursing visits reduced white infant mortality by 1.2 deaths per 1000 live births while non-whites with the same nursing visits had 8.7 decrease in infant mortality. With the health centers that were constructed, 1.9 deaths per 1000 live births were reduced for white infant mortality and 8.4 deaths per 1000 live births were reduced for non-white infant mortality. Finally for prenatal letters, white infant mortality was reduced by 0.2 deaths per 1000 live births and non-white infant mortality reduction was not statistically significant.

Overall mortality rate would have been 0.7 and 1.9 deaths per 1000 births higher without Sheppard-Towner. That would made up 9 and 21 percent of the decline of infant mortality during the enactment of the Act. Aggregate effect of Sheppard-Towner was driven primarily by the non-white populations. White infant mortality rate would have been 0.15 to 1.0 deaths higher whereas non-white rate would have been 9.9 to 13 deaths higher.

Federal appropriations for Sheppard-Towner was $776,676.54, suggesting that one infant death could be prevented for between $118 and $512 in federal expenditures.