Overall and race-specific IMR ratios (RR) and 95% CIs for associations with structural racism indicators among the total county population and by urban–rural areas in the USA, 2013–2017
| Overall IMR | Black IMR | White IMR | ||||
| aRR | 95% CI | aRR | 95% CI | aRR | 95% CI | |
| All counties (n=1221) | ||||||
| Educational attainment | 1.00 | (0.96 to 1.04) | 1.02 | (0.97 to 1.08) | 0.94* | (0.90 to 0.98) |
| Median household income | 1.02 | (0.98 to 1.06) | 1.05 | (0.99 to 1.09) | 0.95* | (0.92 to 0.99) |
| Jail incarceration rate | 0.95* | (0.92 to 0.98) | 1.07* | (1.02 to 1.12) | 0.94† | (0.91 to 0.98) |
| Overall structural racism | 0.99 | (0.95 to 1.03) | 1.06† | (1.01 to 1.12) | 0.94† | (0.90 to 0.99) |
| Urban counties (n=775) | ||||||
| Educational attainment | 1.02 | (0.97 to 1.06) | 1.04 | (0.99 to 1.10) | 0.94† | (0.90 to 0.99) |
| Median household income | 1.01 | (0.97 to 1.06) | 1.08* | (1.03 to 1.14) | 0.96 | (0.92 to 1.00) |
| Jail incarceration rate | 0.93* | (0.89 to 0.97) | 1.07† | (1.01 to 1.13) | 0.94* | (0.90 to 0.98) |
| Overall structural racism | 1.00 | (0.96 to 1.05) | 1.09† | (1.03 to 1.16) | 0.94† | (0.89 to 0.99) |
| Rural counties (n=436) | ||||||
| Educational attainment | 0.98 | (0.91 to 1.06) | 1.01 | (0.89 to 1.14) | 1.00 | (0.90 to 1.12) |
| Median household income | 0.99 | (0.91 to 1.07) | 0.95 | (0.84 to 1.06) | 0.97 | (0.87 to 1.08) |
| Jail incarceration rate | 1.00 | (0.89 to 1.02) | 1.07 | (0.96 to 1.19) | 0.89* | (0.81 to 0.97) |
| Overall structural racism | 0.95 | (0.86 to 1.04) | 0.95 | (0.84 to 1.08) | 0.92 | (0.81 to 1.05) |
*P<0.01.
†P<0.05.
aRR, rate ratios adjusting for county-level poverty, population with a bachelor’s degree or higher, and county incarceration rate; CI, confidence intervals; IMR, infant mortality rate.