Inequities in newborn screening: Race and the role of medicaid☆

Newborn Screening (NBS) is a State-run program that mandates all newborns to be screened for a panel of medical conditions to reduce infant mortality and morbidity. Medicaid is a public health insurance program that expanded access to care for low-income infants. NBS mandates and Medicaid rolled out state-by-state in the 1960s, 70s, and 80s, which are considered significant programs that improved infant health in the latter half of the 20th Century. This article utilized variation in States’ timing of NBS mandates and Medicaid implementation to examine changes in infant mortality rates among white and African American infants associated with NBS, Medicaid, and their interaction. The analyses used data from birth and death certificates in the US Vital Statistics from 1959 to 1995. We find that the implementation of NBS mandates alone was not associated with significant declines in infant mortality and coincided with increases in within-state racial inequities. States experienced mortality declines and reduction in racial inequities after implementing Medicaid with NBS mandates.