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While infant mortality fell for decades across the U.S., the situation only seems to be getting worse in Detroit. According to a recent report, 15 out of every 1,000 babies born in Detroit die. That’s more than any American city and a rate higher than in China, Mexico and Thailand. Experts say that staggering statistic is propelled by rates of premature birth and maternal mortality. reports:

Detroit’s crisis is a foot on the neck of women and children. Mothers’ obesity, diabetes, poverty-related stress and poor nutrition can harm infants even before they are born.

While the raw number of births declined with the population, children have grown more likely to be raised in female-headed households, in high-poverty neighborhoods and to rely on public assistance, according to a 2012 report from the Skillman Foundation, which seeks to improve the well-being of the city’s youth.

Health isn’t determined just by poverty, but by race, which plays a disproportionate role in Detroit. Blacks composed 84 percent of residents in 2010, according to the census.

Black babies in neighborhoods with the lowest poverty level are more likely to die than white infants in neighborhoods with the highest poverty, according to a state report last year. In 2010, non-whites made up 21 percent of Michigan’s population but 43 percent of infant deaths.

“Reducing these disparities requires an explicit focus on the role of race,” the report said. Read more.