Alabama infant mortality almost three times higher for African-Americans

From the article by Amy Yurkanin in AL.com:

Almost 500 babies born in Alabama in 2015 did not live to celebrate their first birthdays, and the tragedy of those deaths fell most heavily on African-American families.

The overall infant mortality rate in Alabama fell to 8.3 deaths per 1,000 births last year from 8.7 in 2014. The rate for white infants fell to a 10-year low of 5.2 as the rate for black infants rose to its highest rate in a decade, 15.3. The most recent infant mortality rate for the nation is 5.8 deaths in the first year for every 1,000 births.

About a third of the 59,651 babies born in Alabama last year were born to African-American mothers.

“The racial disparity between black and white infant birth outcomes continues to be of great concern,” said State Health Officer Dr. Tom Miller in a statement. “The black rate is almost three times the white rate in the state. There is much work to be done to address this ongoing challenge. We need to explore and transform social determinants of infant mortality in our population by addressing modifiable risk factors that contribute to unfavorable birth outcomes.”

“I think we’re heading in the wrong direction,” Thomas said. “We’re seeing the racial disparity widen and that is not the direction we want to be going. To be quite frank, it’s depressing.”

National researchers who study racial differences in infant mortality said much of the disparity can be tied to education, unemployment and other social determinants of health, Thomas said. Reversing those trends could take several years.

The top three causes of infant mortality in Alabama are congenital abnormalities, premature birth and sleep-related causes. The number of babies born before 37 weeks gestation has been dropping in Alabama for years.

Risk factors for infant mortality include poor maternal health, unhealthy lifestyles and short intervals between births. The health department said it will increase education about safe sleeping and contraception to decrease risk factors that can contribute to infant deaths.

Thomas said increasing education around sleeping could hopefully help reduce some infant deaths fairly quickly.

Babies with low birth weight, below 5 pounds 8 ounces, accounted for almost 70 percent of those who died during infancy, according to the Alabama Department of Public Health. Those babies are 20 times more likely to die during their first year than normal-weight newborns and account for about 10 percent of all births in the state.

Read the full article.

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Changing Access to Care for Women of Childbearing Age

In late October, the Health Reform Monitoring Survey (HRMS), released a policy brief exploring the changes in the levels of insurance coverage, access to care, and healthcare affordability for women of childbearing age. The researchers analyzed survey data from between summer 2013 (just prior to the implementation of the ACA’s major coverage provisions) and winter 2014-2015. The analysis showed:

  • The uninsurance rate among women of childbearing age decreased from 19.6 percent in summer 2013 to 13.3 percent in winter 2014–15, representing an increase in coverage for 5.5 million women.
  • Stability in access to care for low-income women between summer 2013 and winter 2014–15, both in the share with a usual source of care (64.5 and 63.3 percent, respectively) and the share with a routine checkup (55.7 and 57.0 percent, respectively).
  • A lower share of women reported problems accessing care in winter 2014–15 (21.8 percent, figure 4) than in summer 2013 (23.7 percent), and women were also less likely to report unmet need for care because of cost in the past 12 months (38.1 versus 42.9 percent in summer 2013).
  • Despite improvements, barriers to care were common among low-income women of childbearing age, particularly for services such as dental care and prescription medications (34.7 and 23.2 percent of low-income women, respectively, reported unmet need for these services because of cost).
  • The share of women who reported a problem paying family medical bills in the past 12 months decreased from 26.2 to 22.3 percent between summer 2013 and winter 2014–15.

Read the full policy brief.