Wednesday, December 8, 2010

Edward Holifield: Florida's F grade on babies is hardly a surprise

Re: "Fla. gets an 'F' for premature birth rates" (news article, Nov. 17)
Published: November 28. 2010 in the Tallahassee Democrat

None of us familiar with Florida's abysmal record regarding maternal and children's health were surprised by this article in the Tallahassee Democrat. This record documents a history of contempt for poor children in general and black children in particular.

It places Florida in the company of other states with an F rating that typically have neglected their poor, such as Mississippi, Alabama and Louisiana. Even West Virginia was ranked ahead of Florida in the annual report compiled by the March of Dimes.

Reality is even worse than the Democrat article suggested. For example, the article reported that 13.8 percent of Florida's babies were born too soon in 2008. This was a "provisional" statistic. The actual statistic was worse, at 14.2 percent. Further, 19.4 percent of black babies were born preterm in Florida in 2008, compared with 12.8 percent for white babies.

Thus black babies in Florida have a preterm birth rate more than 2.5 times the national government's objective of 7.6 percent. The black preterm birth rate in Florida is the same as the overall preterm birth rate for Puerto Rico.

The racial disparities regarding maternal and child health issues are extraordinary. A preterm rate of 13.0 percent was reported for Leon County. This obscures the black preterm rate of 16.8 percent, compared with the much lower white preterm rate of 10.4 percent.

The Democrat article reported that the preterm birth rate in Leon County has "decreased over the past three years." However, that rate decreased only modestly, from 14.3 percent in 2006.

Meanwhile, there has been no statistically significant improvement in infant mortality in Leon County during the past 20 years, according to state epidemiologist Bill Sappenfield. Black infant mortality in Leon County at 11.3 per thousand live births remains embarrassingly high when compared with white infant mortality at 4.3 per thousand.

These dismal results were predictable. Medicaid is so dysfunctional that it is considered by some to be a risk factor for infant mortality. Medicaid "reform" has turned into Medicaid repeal.

A pregnant woman in Florida is banished from the Medicaid rolls only 60 days after she delivers her baby. Thus, a sick mother is expected to be able to care for her infant child.

In 2008, 42 percent of the births in Leon County were covered by Medicaid, which means that Medicaid must share the blame for such terrible birth outcomes, especially in regard to black infant mortality.

During years 2006 through 2008, one out of five black women in Leon County received no prenatal care during their first trimester of pregnancy. By comparison, 91 percent of white women in Leon County received prenatal care during their first trimester of pregnancy.

Only 68.5 percent of black women in Leon County initiated breast feeding following delivery, compared with 85.8 percent of white women.

The black maternal mortality in Florida is 33.8 per 100,000, which is more than three times the maternal mortality rate for white women at 10.7.

These problems exist largely because the political power structure does not care. Leon County Commissioner Bryan Desloge in 2007 used the racially pejorative term "million dollar crack babies" when speaking of black infant mortality. Mayor John Marks and the city of Tallahassee spent more money in 2007 on the St. Francis Animal Hospital than on the Bond Community Health Center.

Florida in 2005 left unused $20 million in federal money that could have been spent on KidCare.

The problem is not money. Rather, it is a lack of political will, coupled with babies who cannot vote.

See responses to this article:

Safety net can be a trap for poor women
Concerns about facts and infant mortality

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