Restoring the Infant Mortality Rate as a Measure of Societal Health and Well-Being

( N Engl J Med . 2025;393:609-614. doi: 10.1056/NEJMms2415762) In 1899, Boston activist Josephine St. Pierre Ruffin addressed local African American women’s clubs, noting the stark reality: African American infants in Boston were dying at far higher rates than white infants. At the time, half of African American infants and one-third of white infants did not survive their first year of life. Although some commentators blamed these disparities on supposed innate racial differences, early social scientists and physicians, most notably W.E.B. Du Bois, argued that these patterns reflected unequal social, economic, and political conditions rather than biology. Du Bois emphasized that high infant mortality was a marker of broader social distress, not a racial trait.