LUMBERTON — Almost one out of three Robeson County women who are of child-bearing age don’t have health insurance.
What that means for Robeson County mothers and their babies is detailed in new report, out this week from advocacy group NC Child.
The report looks at women statewide who fall in the health insurance “coverage gap,” meaning they earn too little to pay for private insurance, and too much to qualify for Medicaid, which North Carolina elected not to expand in 2014.
One in five North Carolina women of reproductive age — ages 19 to 44 — are uninsured, the report says, and more then half of those women fall in the coverage gap.
“Healthy births start with healthy moms,” said Michelle Hughes, executive director of NC Child. “If we want to reduce infant mortality, we need to do a better job providing their mothers with access to health insurance before they get pregnant.”
According to the report, uninsured women are more likely to have health issues that are going untreated, such as chronic illnesses, mental health and substance abuse that can increase their risk of birth complications — most notably, premature births and low birthweight.
According to the report, in 2014, 12.1 percent of Robeson babies were born at a low birthweight, and 14.5 percent were born premature.
Dr. Brandon Locklear, with Southeastern Women’s Healthcare, sad low birthweight and premature birth can have a lasting effect on a child’s health. Babies born early may have issues with brain development, or suffer from digestive, lung or even eye problems.
“The difference between a 25- or 26-week baby and even a 30- or 32-week baby is gigantic,” he said. “Every day we can keep the baby in mom is important.”
According to the report, North Carolina’s infant mortality rate, defined as the number of babies who die before age 1 per 1,000 births, has plateaued. In 2013, the infant mortality rate was 13.4 in Robeson County, about twice the statewide rate.
“Over the past two decades, North Carolina’s infant mortality rate has dropped by more than 40 percent as a result of improved clinical practices and smart public policy. But North Carolina’s progress has plateaued and lags behind the rest of the nation, ranking 42nd for infant mortality. For every 1,000 babies born alive in North Carolina, seven die in their first year of life,” the report says.
The report also notes racial disparities when it comes to infant health. Black and American Indian babies are 2.5 and 1.8 times more likely, respectively, to die before their first birthdays than white babies. The report attributes this not only to high poverty and low insurance rates, but also to discrimination; expectant mothers may internalize experiences with racism, raising their stress levels and increasing the likelihood of complications.
“The difficult truth in this data is that babies of color are more likely to die before their first birthday than white babies,” said Laila A. Bell, director of research and data at NC Child and author of the report. “But we can implement evidence-based policies and programs to address this disparity, including closing the health insurance coverage gap for women of child-bearing age.”
According to the report, closing North Carolina’s health insurance coverage gap would provide about 175,000 women of reproductive age with health insurance.
But Locklear said most expectant mothers in Robeson County can qualify for Medicaid if they take the initiative and seek out the resources to do so. He suggests visiting the Robeson County Health Department or a social worker with Southeastern Health for help.
“Once we get their Medicaid they can get just about anything they need for their pregnancy,” he said. “Medicaid is really the key for these uninsured patients.”
Sarah Willets can be reached at 910-816-1974 or on Twitter @Sarah_Willets.