Study Finds Medicaid Expansion May Reduce Infant Mortality Rate for Black Babies

The future generations of Americans could be impacted by healthcare policy now.

Access to health care translates to thousands of Black lives saved, according to a report released by JAMA this week.

States that expanded Medicaid health care coverage as part of the 2010 Affordable Care Act saw a decrease in disparities between Black and white infants of 7.7 percent, while non-expansion states saw an increase in disparity of 4 percent.

Researchers analyzed birth certificate data in 18 states plus Washington, D.C., that had expanded Medicaid coverage to include more low-income citizens from 2014 to 2016, and in 17 states that did not.

The 2.2 million Black infants in the study measuring preterm timelines and birthweights, out of the 15.6 million babies born from 2011 to 2016, were most impacted.

Black infants are about twice as likely to be born at low birth weight and 1.5 times as likely to be born prematurely than white infants.

Studies have continued to come out showing the disparity in healthcare between Black and white Americans, and show the Affordable Care Act has decreased barriers in access to care among Blacks and Latinos. But the Trump administration’s attack on the ACA works to undermine the progress.

As the American population shifts, with post-millennial generations already being the most ethnically and racially diverse in history, policies that increase healthcare disparities could threaten future generations.

By “providing women with continual health insurance, rather than giving them insurance for their [delivery] and then taking that insurance away, … you create healthier mothers and healthier babies,” says JAMA study coauthor Mick Tilford, a health economist at the University of Arkansas for Medical Sciences in Little Rock.

Related Story: Black Women Have Higher Rates of Life-Threatening Birth Complications

JAMA study authors hope this research can help create change in care for Black infants and Black mothers. 

“We believe that these findings should be considered in policymakers’ calculus of whether to expand Medicaid or not,” Tilford said.

The receipt of prenatal care in the first trimester is still low among Black women in both expansion states, at 67%, and non-expansion states, at 64%, compared with white women at 81% and 78%, respectively.

A recent study connecting racial discrimination, mental stress, and preterm birth rates, supports the concept of improving prenatal care for Black women. Not doing so endangers both groups lives.

Related Story: New Study Connects PTSD in Black Women to Preterm Birth, Recommends Action in Policy Equity

“Low birth weight and immaturity have such huge implications for the health and development of these children,” said pediatrician Consuelo Beck-Sagué of Florida International University in Miami, who was not part of the JAMA study.

Her previous research showed a 14.5 percent reduction in Black infant mortality between 2014 to 2016 — lowering the number of deaths from almost 12 to 10 for every 1,000 births in Medicaid expansion states.

For the Black infants, “these reductions potentially have large implications across the life course of Black infants,” said Clare Brown, an instructor of public health at the University of Arkansas for Medical Sciences, who was the first author of the study.


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