Racial Disparities in Florida Threaten Infant Health

Florida's high rate of premature births is alarming experts who warn of an infant health crisis in the state and the U.S. as a whole.

In its latest infant health report card, the March of Dimes found that Florida's preterm birth rate was 10.6 percent of all live births in 2019 — meaning more than one in ten babies in Florida was born prematurely. In Miami-Dade County, the preterm birth rate was 9.7 percent; the national rate was 10.2 percent.

Preterm births are one of the top causes of infant deaths, which is one reason the March of Dimes gave Florida a D+ on its report card.

"The report card found that in Florida, 1,339 babies died before their first birthday. This is unacceptable," the nonprofit said in a press release.

March of Dimes CEO Stacey D. Stewart tells New Times that high preterm birth rates in Florida are driven by a number of factors affecting the health of mothers, including the large number of women who are uninsured, the lack of Medicaid coverage for maternity care, and the number of Florida counties that lack birthing-care centers.

The situation is even worse for women of color, according to the March of Dimes report. From 2016 to 2018, 13.9 percent of Black babies in Florida were born premature, compared to 9.1 percent of white babies and 9.1 percent of Hispanic babies.

Stewart says wealth disparity and systemic racism make Black mothers more vulnerable to health issues.

"A lot of women in poverty are at higher risk — they face more social determinants that don't help them to be healthy," Stewart says. "When we look at racial disparities, systemic racism has exacerbated these inequities."

According to the National Partnership for Women & Families, Black women in Florida working full-time are on average paid $20,862 less than white, non-Hispanic men; Hispanic women are paid $21,200 less. (White women are paid $9,691 less than their white male counterparts, on average.)

Stewart says because women generally earn less than men (and women of color in particular), they often can't afford medical insurance and avoid seeing doctors altogether. Florida has a far higher rate of uninsured women at childbearing age than much of the U.S., with 18.8 percent of women between the ages of 15 and 44 in Florida living without insurance, compared to an average of 11.9 percent of women in the U.S.

"For some women, when they find out they're pregnant might be first time they see a doctor at all," Stewart says.

If Florida wants to improve the lives of mothers and babies and ensure the health of newborns, Stewart adds, it will take institutional change — which the March of Dimes is pushing for.

"The biggest thing we can do is push for policy change. Millions of women are uninsured, and we stand out as a country that leaves people to fend for themselves," Stewart says. "We need to expand Medicaid, offer high-quality healthcare irrespective of how much you make, and not just cut women off once they give birth."

Other changes, she says, should be aimed at tackling systemic racism in healthcare to address the disparity with women of color having more preterm births.

"We've heard from women of color that they feel unheard and disrespected by healthcare providers. Any healthcare provider with implicit bias should not have that bias interfere with their ability to deliver healthcare," Stewart argues.