NC Infant Mortality Hits Historic Low as Drug Deaths Drop 34% in 2024
State achieves record-low infant death rate of 6.3 per 1,000 births while drug overdose fatalities plummet more than one-third in a single year.
RALEIGH, NORTH CAROLINA — North Carolina achieved a historic low in infant mortality during 2024 while also recording a dramatic decline in drug overdose deaths, according to new data released by the state Department of Health and Human Services.
The infant death rate dropped from 6.9 deaths per 1,000 births in 2023 to 6.3 deaths per 1,000 births in 2024, marking an 8.7% decline. State health officials attributed the improvement to Medicaid expansion, which took effect on December 1, 2023.
Drug overdose deaths fell more than 34% from 2023 to 2024, outpacing the national decline of 26.2% reported by the Centers for Disease Control and Prevention.
Medicaid Expansion Shows Impact
As of March 2, 2026, expanded Medicaid covered more than 720,000 North Carolinians, according to DHHS data. Research studies have found that states that expanded Medicaid showed greater declines in infant mortality than states that did not expand the program.
Those improvements were attributed to declines in Black and Latino infant death rates in previous studies. In North Carolina, white, Black and Latino infants were all more likely to survive their first year in 2024 compared to 2023.
Racial Disparities Persist Despite Progress
While all racial groups saw improvements, Latino babies showed the greatest decline in mortality rates. Deaths among Latino infants dropped from 6 per 1,000 births in 2023 to 4.4 per 1,000 in 2024, representing a 26% decrease.
However, the overall improvement did not significantly narrow the gulf between Black and white infant death rates. Black babies born in North Carolina remained about 3 times more likely to die before their first birthdays compared to white infants.
In its news release, DHHS called the disparity “unacceptable” and said it is working to narrow the gap between racial groups.
Statewide Health Improvements
The dual improvements in infant mortality and drug overdose deaths represent significant public health victories for North Carolina. The state’s progress in reducing fatal overdoses exceeded national trends, suggesting targeted interventions may be having measurable effects.
Health officials noted that continued monitoring and intervention programs will be necessary to maintain these positive trends and address remaining disparities in health outcomes across different populations.
