Babies born in Flint, Michigan, were about half as likely to die in their first four weeks of life in 2025 as in the four years before, according to a research letter published Nov. 2 in JAMA Pediatrics. The year 2025 was the first full year of Rx Kids, a program that gives cash to expectant mothers and new parents in the city.
The neonatal death rate, which counts deaths in the first 28 days of life, fell from 10.2 per 1,000 live births in 2021 through 2024 to 5.1 in 2025. Over the same period, the rate in the rest of Michigan stayed nearly flat, at 4.0 and then 3.9 per 1,000.
The numbers are small, and the study design cannot prove the program caused the drop. The findings were first shared in June in a paper that had not yet been peer-reviewed and have now been published in the journal.
Before-and-After Numbers in a Small City
The researchers used statewide Michigan birth and death records from January 2021 through December 2025. In the earlier period, Flint recorded 41 neonatal deaths among 4,036 births. In 2025, it recorded five deaths among 980 births.
From 2021 through 2024, Flint’s newborns were more than twice as likely to die in the neonatal period as babies elsewhere in Michigan, a statistically significant gap. In 2025, the difference between Flint’s rate of 5.1 and the rest of the state’s 3.9 was no longer statistically significant, meaning the remaining gap could reflect chance.
Deaths in the first week of life showed an even sharper change. Flint’s early neonatal death rate dropped from 7.9 per 1,000 births to 2.0, a 74% decline, with two deaths in 2025. The rate in the rest of Michigan was 3.3 in both periods.
«When it comes to the health of newborns, this is the end-all-be-all outcome,» Rx Kids co-founder Luke Shaefer said in a July Michigan State University release on the findings.
Rx Kids launched in Flint in January 2024. There, it gives $1,500 during pregnancy and $500 a month through a baby’s first year, with no conditions on how families spend the money. About 98% of eligible families took part, according to the study.
Evidence Check on a Five-Death Year
The research letter is a descriptive comparison, not a clinical trial. It compared Flint with the rest of the state over time, but the researchers could not yet link individual birth and death records, which would have allowed a stronger analysis of whether trends in Flint differed from those elsewhere.
Neonatal deaths are uncommon, so the rates are sensitive to small changes. Flint averaged about 10 neonatal deaths a year before 2025 and recorded five in 2025, so one or two deaths more or fewer would shift the rate noticeably. The 2025 figures are also provisional. In addition, the comparison period included 2024, when the program was already running.
The authors call the findings preliminary. The study was written by researchers who lead or evaluate the program, including Dr. Mona Hanna, the Flint pediatrician known for exposing the city’s lead water crisis and now director of Rx Kids. It was funded by the W.K. Kellogg Foundation and the Michigan Department of Health and Human Services (MDHHS). The study says the funders had no role in its design, analysis, or writing, though MDHHS reviewed the manuscript.
In a written statement, Hanna said the program «may be helping more babies survive their earliest days,» Michigan Public reported. The authors point to earlier Rx Kids findings on housing, prenatal care, smoking during pregnancy, preterm birth, and low birth weight as a plausible pathway.
Earlier peer-reviewed research points in the same direction. A study published this spring in The Lancet Public Health estimated that, compared with similar Michigan cities, Rx Kids was associated with 18% fewer preterm births, 27% fewer low-birth-weight babies, and about 29% fewer NICU admissions in Flint, according to the University of Michigan.
«Being born too soon or too small can mean the difference between life and death in a baby’s first month,» said Dr. Sumit Agarwal, a University of Michigan physician and health economist who co-wrote the new study.
Families and Communities With the Most at Stake
Infant mortality remains a major problem across Michigan. In 2024, 629 infants died before their first birthday, a rate of 6.3 per 1,000 live births, according to state vital records. Babies born to Black mothers faced about three times the risk of an infant death as babies born to white mothers.
«For generations, Flint families have carried the burden of some of the highest infant mortality rates in our state,» said Flint Mayor Sheldon Neeley. «Seeing that gap narrow is a powerful reminder that when we invest in families, we can change outcomes.»
The program has grown far beyond Flint. Michigan lawmakers approved $270 million in the state’s 2025-26 budget to expand it, Spectrum News reported. By July 2026, Rx Kids had reached nearly 50 Michigan communities and more than 13,000 families, according to MSU. Detroit joined in February and the Upper Peninsula in March. Some Republican lawmakers have criticized the program over how families spend the money, Michigan Public reported.
Expecting parents in participating communities can check eligibility through Rx Kids. Michigan’s Medicaid and CHIP programs also cover eligible people for 12 months after pregnancy, an extension federal regulators approved in 2022.
Key Questions Answered
What did the study find? Flint’s neonatal death rate fell from 10.2 per 1,000 live births in 2021 through 2024 to 5.1 in 2025, Rx Kids’ first full year.
What is Rx Kids? A program that, in Flint, gives $1,500 during pregnancy and $500 a month through a baby’s first year, with no strings attached.
Did the program cause the drop? The study cannot prove that. The numbers are small, the 2025 data are provisional, and the design only compares rates before and after.
How does Flint compare with the rest of Michigan? Flint’s rate was more than double the rest of the state’s before 2025. In 2025, the remaining difference was no longer statistically significant.
Where is Rx Kids available? In Flint and nearly 50 other Michigan communities as of July 2026, including Detroit and the Upper Peninsula.
Published by Medicaldaily.com
