By Associated Press
Montgomery AL – Alabama babies whose mothers paid for their 2005 deliveries out-of-pocket were more than three times as likely to die in their first year than those whose mothers had private health insurance, according to a health department report released Tuesday.
Researchers at the department's Center for Health Statistics used birth certificate data from the 60,262 live births Alabama had in 2005 to create the four-page Method of Payment for Delivery" report.
Dr. Albert Woolbright, who started working on the study six months ago, said it unfortunately contained few surprises.
Among the findings: White mothers had more private health insurance than minorities, women with less than 12 years of education were more likely to be on Medicaid and 83.1 percent of mothers who were younger than age 20 used the federal insurance program.
It's about what you would expect," said Woolbright, a bespectacled 15-year veteran of the department.
The infant mortality, the low birth weight, the maternal morbidity is greater the poorer (and less educated) the woman," he said. If we can prevent teen births and try to move the child bearing pattern from the lower age groups to ages 25-35 so that the mothers can finish college," their birth outcomes would be so much better, he said.
Forty-eight percent of the 2005 deliveries were paid for by Medicaid, 48 percent were paid by private insurance and 4 percent were self-pay or other means.
The study found that babies whose deliveries were paid for by Medicaid were 40 percent more likely to be born at a low birth weight than those with private insurance. Babies covered by Medicaid were more than 60 percent more likely to die than those with private insurance, researchers found.
State Health Officer Don Williamson said that doesn't mean Medicaid doesn't provide good health care.
It's the other factors that make one eligible for Medicaid -- teenage moms, income, lower education status -- all of those are the drivers for infant mortality," he said. In that respect, Medicaid eligibility simply becomes a marker."
The study's authors recommend expanding Medicaid coverage from the present 133 percent of the poverty level to 175 or 200 percent to provide coverage to working mothers whose employers don't offer insurance.
They also suggest providing insurance through the Children's Health Insurance Program to mothers prior to delivery to cover the cost of their prenatal care.
Alabama's infant mortality rate had been falling since 1998, but health officials announced last year that it rose by 45 in 2005 with 561 baby deaths that year.
Williamson said the 2006 numbers should be released later this month and the department plans to start a long-awaited Infant Mortality Review board in the 2008 fiscal year.
The board will pull together researchers and health professionals to study infant deaths in order to prevent more in the future.
That really is one of our highest priorities," Williamson said. It's a long-term fix because what it does is look at all the factors in infant deaths and see how we can intervene in ways we don't currently know we should."
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On the Net:
Alabama Department of Public Health: www.adph.org