Bladen County leads the Cape Fear region in terms of the rates of fetal death and infant mortality, according to a recent study.
Earlier this month, N.C. Child released a report looking at infant and fetal mortality, as well as insurance coverage among women of childbearing age in all 100 N.C. counties. The study concludes that North Carolina needs to address its “persistently high” mortality rate among fetuses and newborns.
According to the report, Bladen County ranks near the top in a state that rates 39th in the country. In the Mother County from 2012 to 2016, 10 of roughly every 1,000 fetuses die prior to birth, and only 11 other counties have higher rates. When it comes to infant deaths, Bladen County again rates high, with 10.7 out of every 1,000 live births ending in mortality. Only 10 other counties fare worse. The statewide fetal mortality rate during the same time was 6.9, and the statewide infant mortality rate was 7.2.
As part of the study, its authors examined the link between infant and fetal mortality and insurance coverage.
“Without access to health insurance, it’s incredibly difficult to manage chronic conditions that can adversely impact birth outcomes,” said Whitney Tucker, research director with NC Child and author of the report. “That’s why it’s critical for North Carolina legislators to close the health insurance gap.”
The insurance gap exists, the report says, at least in part because North Carolina has not taken advantage of a provision federal legislators wrote into law. When the Affordable Care Act was passed in 2010, funding was designated to allow states to expand Medicaid coverage to adults earning up to 133 percent of the federal poverty level, but the ACA provision has yet to be realized in the Tar Heel State.
“Because North Carolina has not yet expanded income eligibility for Medicaid under the ACA provisions, many women of childbearing age fall in the ‘coverage gap,’ earning too much to qualify for Medicaid and too little to afford private insurance,” according to the report.
In Bladen County, more than 27 percent of women ages 18 to 44 do not have health insurance, putting it in the top one-fifth in terms of N.C. counties without insurance.
“By utilizing available federal funding to expand access to affordable health care for women of childbearing age, the state can influence both fetal and infant mortality simultaneously, effectively doubling the positive impact for North Carolina families,” said Tucker.
Introduced in April 2017, H.B. 662, also known as Carolina Cares, would expand insurance to adults between 100 and 133 percent of the federal poverty level. As it is currently written, the proposal contains premiums and work requirements for enrollees.
“Whether it’s ‘Carolina Cares’ or a different bill, the legislature should act quickly to close the health insurance coverage gap and support healthy pregnancies and healthy babies,” said Tucker.
H.B. 662 remains in a House subcommittee.
“Fetal and maternal health begins far ahead of conception,” the reports’ authors say. “Women are more likely to give birth to healthy babies when they are healthy themselves, and North Carolina should not miss the current opportunity to promote safer births statewide.”
Chrysta Carroll can be reached by calling 910-862-4163 or emailing firstname.lastname@example.org.