Card Shines Spotlight On The Health Of Moms And Babies In Hawaii

Hawaii Earns "D+" for preterm birth rate; Report finds too many U.S. babies are born too soon for the 5th year in a row

Systemic racism, access to care, poverty and preexisting conditions are helping fuel the U.S. maternal and infant health crisis

News release from March of Dimes, Nov 16, 2020

March of Dimes, the nation's leader in the fight for the health of all moms and babies, has issued its 2020 Report Card amid the coronavirus pandemic and calls for racial justice, shining a spotlight on factors that contribute to maternal and infant health across the U.S. and in Hawaii. The U.S. remains among the most dangerous developed nations for childbirth and it's even more dire for women and babies of color. In Hawaii the preterm birth rate in 2019 was 10.6%, earning the state a "D+" grade. Preterm birth is a leading cause of infant mortality, which has slowly declined nationally over the past few years. Yet, in the U.S., two babies die every hour, and two women die from pregnancy complications every day. The Report Card found that in Hawaii, 115 babies died before their first birthday in 2018.

Preterm birth and infant mortality rates are worse for moms and babies of color. The Report Card shows significant racial disparities that cut across maternal and infant health. In Hawaii, Black women had the highest rates of infant mortality at 14.6 per 1,000 live births.

"Although there has been some incremental progress in advancing policies that will address better maternal and infant health care, this progress is not happening quick enough, and is tempered by increasing racial/ethnic health care disparities in preterm birth," said Stacey D. Stewart, President and CEO of March of Dimes. "At a time of racial awakening in our nation, we must amplify our efforts to decrease deaths and health challenges facing our nation's moms and babies and enact new policies that support health equity." 

The Report Card grades the U.S., 50 states and Puerto Rico on rates of preterm birth. This year's Report Card found that nationally the preterm birth rate has increased for the 5th year in a row to 10.2% of births, earning the nation a "C-" compared to last year's "C" grade. Additionally, the Report Card grades the 100 largest cities based on birth in the U.S. on their preterm birth rates. Honolulu, city and county received a "D+" grade, with a rate of 10.5% for preterm birth. 

While there is no single cause to this complex maternal and infant health crisis in the U.S., contributing factors include maternal health and management of preexisting conditions. They also include social determinants of health such as being uninsured, living in poverty and having inadequate prenatal care – which the Report Card shows most often affect women of color. In Hawaii, 21.2% of women receive inadequate prenatal care; 4.8% of women ages 15-44 are uninsured; and 10% of women ages 15-44 are in poverty. Systemic challenges with health care and deeply entrenched structural racism are fueling this health equity gap.

"A priority for March of Dimes is to close the health equity gap across the country," said Dr. Rahul Gupta, Chief Medical and Health Officer, Senior Vice President, and Interim Chief Scientific Officer at March of Dimes. "Using the concrete, detailed evidence in the 2020 Report Card, we can identify common-sense steps to reverse the alarming trends. A part of this work, we recognize a lack of uniform reporting and inconsistent access to real-time maternal and infant health data is impeding progress. Particularly during a pandemic, we need access to robust, uniform data sharing to inform evidence-based strategies that can be implemented across public and private sectors to address the specific needs of this crisis." 

March of Dimes works every day with individuals and organizations across the country to combat the maternal and infant health crisis through research, education, advocacy and programs. This includes advocating for federal legislation that prioritizes the health of our nation's moms and babies, such as the Helping MOMS Act of 2020, Maternal Health Quality Improvement Act of 2020 and Black Maternal Health Momnibus Act of 2020. State and local legislation is also needed to fill the gaps associated with access to maternity care for women in rural and underserved communities. Just as important is education and implicit bias training to equip health care professionals with the tools they need to eliminate institutional racism in our health care system and provide more culturally competent care no matter where they practice. The Report Card includes policy and program recommendations that can help states address disparities and allow women greater access to preventative and essential care and resources during and post pregnancy.

Through the #BlanketChange movement, March of Dimes is urging policymakers and political candidates to protect and improve maternal heath by taking immediate action on series of policies to address equity, access and prevention. To learn more about the #BlanketChange agenda, visit BlanketChange.org.

Learn more about the 2020 Report Card and actions you can take to support moms and babies at marchofdimes.org/ReportCard.