The good news is that poor women are having healthier babies, which is particularly important for states such as South Carolina, which has pockets of heavy poverty and almost a fifth of its population without health insurance. (I don’t know how much that number has changed, if at all, since the implementation of the Affordable Care act given that we didn’t set up our own exchange and refused the Medicaid expansion.)
This is the type of trend everyone should want to see continued. The improvement is not a result of the ACA. Researchers say it is caused by a variety of policies (story below), but that access to better health care is making a difference. The ACA is increasing access to the health care system – particularly for the poor – so it doesn’t take a leap to believe that massive policy will make it more likely that poor mothers will have healthier babies for some time to come.
One more thing: I disagree vehemently with Gov. Nikki Haley’s decision to deny a few hundred thousand or maybe half a million poor people health insurance through the Medicaid expansion embedded in the ACA, funds that could also create 44,000 in South Carolina between now and 2020, according to a University of South Carolina study. She has denied the expansion for nakedly partisan reasons.
But Tony Keck, director of South Carolina’s Department of Health and Human Services, believes he can increase access to the health care system for the poor through means other than insurance. He told me that in five years we’ll see the results. Either way, it is bad that so many poor South Carolinians are being left behind now. But given the political environment in the state, a knee-jerk partisan opposition to everything President Obama touches, I pray Keck is right.
Even if he is and finds a way to improve health care access for the poor without increasing insurance, there are other factors that can mitigate its effectiveness – like violence and a harmful environment – if we don’t deal with those as well.
From the Washington Post report about this trend:
Experts say health interventions alone have had limited impact, in part because poor women face so many other pressures harmful to the health of a fetus, from pollution to stress to violence.
Women who make less than $25,000 a year, for instance, are
2½ times more likely to be victims of domestic violence, according to research. And being sent to the hospital as a result of domestic violence tends to cost a woman 5 ounces on her infant’s birth weight.
“If we’re really interested in improving birth outcomes, we have to look at the situation under which disadvantaged women find themselves — and that means violence in communities, violence in relationships, and a whole host of other factors,” said Lisa Dubay, a senior fellow at the Urban Institute.
Research has found that the big changes in infant health have come from a mix of policy and social trends. Programs such as food stamps and nutritional counseling have led to healthier outcomes. Declining rates in smoking, which is a factor in up to a fifth of unhealthy pregnancies, are thought to be a contributor. As are environmental regulations that have limited pollution from power plants. One study found that the installation of EZ-Pass booths in New Jersey and Pennsylvania reduced auto emissions and improved birth weights among women living in the area surrounding the tolls. A study has also suggested that policies that gave authorities less discretion in deciding when to prosecute men accused of domestic violence have helped.
Read more about poor women and their babies here.