1965 US Voting Rights Act Impact on Black and Black Versus White Infant Death Rates in Jim Crow States, 1959-1980 and 2017-2021.

Abstract

<b>Objectives.</b> To investigate the impact of the US Voting Rights Act (VRA) of 1965 on Black and Black versus White infant deaths in Jim Crow states. <b>Methods.</b> Using data from 1959 to 1980 and 2017 to 2021, we applied difference-in-differences methods to quantify differential pre-post VRA changes in infant deaths in VRA-exposed versus unexposed counties, controlling for population size and social, economic, and health system characteristics. VRA-exposed counties, identified by Section 4, were subject to government interventions to remove existing racist voter suppression policies. <b>Results.</b> Black infant deaths in VRA-exposed counties decreased by an average of 11.4 (95% confidence interval [CI] = 1.7, 21.0) additional deaths beyond the decrease experienced by unexposed counties between the pre-VRA period (1959-1965) and the post-VRA period (1966-1970). This translates to 6703 (95% CI = 999.6, 12 348) or 17.5% (95% CI = 3.1%, 28.1%) fewer deaths than would have been experienced in the absence of the VRA. The equivalent differential changes were not significant among the White or total population. <b>Conclusions.</b> Passage of the VRA led to pronounced reductions in Black infant deaths in Southern counties subject to government intervention because these counties had particularly egregious voter suppression practices. (<i>Am J Public Health.</i> 2024;114(3):300-308. https://doi.org/10.2105/AJPH.2023.307518).