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What can we do about infant mortality and disparities in health care? This week we take a look at a recent study in JAMA that may have an answer.

Related HCT episodes:
1. Return on Investment in Medicaid:
2. Is Medicaid Coverage Better or Worse than Private Insurance?

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We've covered infant mortality in a number of episodes. One of the questions we always get it is what can we do about it? We've also covered disparities in healthcare. People want to know what we can do about that too. A recent study in JAMA may have an answer for both questions. This is Healthcare Triage News.


To the research! A new study just hit JAMA: Association with State Medication Status with Low Birth Weight and Preterm Birth. This study wanted to explore whether the Medicaid expansion (which didn't occur everywhere) was associated with changes in the rates of low birth weight and preterm birth. They used data from the National Center for Health Statistics Birth Data Files from 2011 to 2016 to look at both difference-in-difference and difference-in-difference-in-difference models, and I did not screw that up.

They compared these birth outcomes in infants in Medicaid expansion states compared to non-expansion states, and also looked at changes in racial and ethnic minorities among those differences as well. The data covered more than 1.56 million births.

Overall, there were no significant differences in the rates of low birth weight or preterm births. But, there were significant drops in the relative disparities for black infants. Preterm birth dropped more than 0.4% and low birth weight more than 0.5%. This analysis compared 17 states that didn't expand Medicaid to 17 states and Washington, D.C. which did. Today, 37 states have accepted the expansion.

The bottom line here is that in the non-expansion states, the rates of prematurity and low birth weight infants pretty much stayed the same in black babies. But, in the expansion states, they dropped, and that's a big deals.

We've covered so many times the benefits of Medicaid. So, this isn't totally surprising, but it's worth exploring just a bit. You have to remember that pregnant women have always benefited from Medicaid, but it only kicked in for many of them when they got pregnant. So they may not have seen a doctor for years or received healthcare. They also use to lose coverage 2 months after birth. The expansion gave them Medicaid all the time, and even raised the eligibility line to 138% of the federal poverty line. And, it appears that's associated with the big change.

It's important to remember that black infants have an infant mortality rate almost four times that of white infants. They also have more low birth weight and premature births. That's the disparity. We should continue to watch this. States that continue to refuse the Medicaid expansion should also consider what that decision is costing them.


Hey, did you like this video? You might also enjoy this one on the return on investment in Medicaid. 

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