State programs and efforts by private organizations have reduced North Carolina’s infant mortality rate to its lowest ever, but the state still has a problem with high levels of black infant mortality. According to 2018 state statistics, black babies are more than twice as likely to die than white infants.
Overall improvements haven’t changed that. Indeed, the gap was wider in 2018, the most recent year for available statistics, than it was in 1999. An in-depth report by The News & Observer’s Lynn Bonner explored why this sad disparity persists.
Of the 806 infants who died in 2018, 43% were black babies, although blacks are only 22% of the state’s population. In some counties the gap is stark. In Pitt County in 2018, no white infants died in their first year while 11 black infants died before their first birthdays.
(Editor‘s note: In Alamance County, five white infants, five black infants and two Hispanic infants died in 2018, according to state records. The white and Hispanic mortality rates were 4.8 per 1,000 live births while the rate for black infants was 11.2 per 1,000 in Alamance. The county’s overall 6.1 mortality rate was lower than the state‘s 6.8 rate.)
State officials, researchers and health care providers say there are several reasons for the difference. A higher level of poverty among blacks is the major cause, but there are others: a lack of rural hospitals, doctors who don’t listen well to pregnant black women and the stress of racism that affects black women.
One necessary response is clear: expand Medicaid. A study published in the American Journal of Public Health concluded that “Infant mortality rate decline was greater in Medicaid expansion states, with greater declines among African American infants.”
This connection is not enough to move Republican lawmakers who are blocking Medicaid expansion under the Affordable Care Act. The federal government would pay 90% of the costs of making the insurance program available to half a million low-income North Carolinians. But Republicans who control the General Assembly think the state’s 10% state share would be too costly.
Medicaid expansion would close gaps in health care for women in a state where 15% of women ages 19-44 are uninsured, the 10th highest level in the nation. Without regular access to health care, some women are unaware of health problems that could affect developing babies.
The link between regular access to health care and healthy mothers giving birth to healthy babies is obvious. But some Republicans are still in denial. If Medicaid expansion opponents aren’t convinced, they ought to go to counties where mothers without insurance grieve for lost children. Otherwise, those lawmakers are turning a blind eye to what the state’s top health official rightly calls an atrocity.
Adapted from an editorial in The Charlotte Observer and The News & Observer of Raleigh
