Infants and the Medicaid Expansion



we've covered infant mortality in a number of episodes and one of the questions we always get is what can we do about it we've also covered disparities in health care 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 needs to the research a new study just did JAMA Association of State Medicaid expansion 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 and difference and difference and difference in DIF models and I did not screw that up they compared these birth outcomes and infants and 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 one point five six million births and overall there was no significant difference 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 dropped more than 0.5 percent this analysis compared 17 states that didn't expand Medicaid to 17 states in Washington DC 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 that's a big deal 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 the 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 health care they also used to lose coverage two months after birth the expansion gave them Medicaid all the time and even raise the eligibility line to 138 percent of the federal poverty line and it appears that's associated with the big change it's important to remember the black infants have an infant mortality rate almost four times that of weight infants they also have more low birth weight and premature 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 of Medicaid we'd like to thank our patrons who helped make these kinds of videos possible especially our research associate Joe sevenths and of course our surgeon Admiral Sam find out more at patreon.com slash healthcare triage always helps if you liked the video and subscribe

12 Comments

  1. Some related viewing:
    1. Return on Investment in Medicaid: https://www.youtube.com/watch?v=vx1-X9wpUk4
    2. Is Medicaid Coverage Better or Worse than Private Insurance? https://www.youtube.com/watch?v=K0UdYZcCANY

  2. Do we know what causes the 4x black infant mortality?

  3. Bold of you to assume that the politicians responsible for rejecting the expansion don't consider the racial infant mortality disparity to be a good thing.

  4. You know what we already knows would improve outcomes for moms and babies? Midwifery care. Look into the work of midwife Jennie Joseph.

  5. As a dual national of two countries that have different models of universal healthcare, I find it absolutely stunning that US citizens and their representatives categorically refuse to invest in prevention and public health. There's the human cost of refusing to invest in antenatal and maternal care, as well as a huge economic impact.
    Even if you disregard the racial disparity, the US has terrible maternal and infant mortality rates for a developed country. That waste of life and the added morbidity should send even the most cynical selfish billionaire capitalist into a panicked frenzy (of course free market capitalism isn't as rational as it advertises itself).

  6. Next do abortion

  7. Do you think you can do a video on Japanese healthcare?

  8. Weird, a study published in AJPH found significantly higher figures, but reached the same conclusions.

  9. What can we do about it? Elect Bernie Sanders and pass Medicare for ALL.

  10. I'm getting an MA with a co-concentration in evaluation. We talk a lot about the importance of breaking down findings to ask "for whom does this work for." Thank you for providing this great example. A lot gets lost in aggregate.

  11. Access to health care is only a very small part of the racial disparity problem–Dr. Carroll should know that quadruple risk for premature and underweight babies carries across all socioeconomic levels for blacks. The major problem is that the vast majority of healthcare professionals are white, and many of them treat non-whites poorly, intentionally or not. If you really want equality in health, make sure minorities are able to get the education they need to provide these services back to people who know they can go to someone that is going to respect and believe them and give them the best health care possible.
    And, seriously? Half a percent is a huge drop? It really isn't and the fact you're making it out to be makes this seem even worse–like you, Dr. Carroll, a male white provider, can't even see what a "drop" in the ocean that is.

  12. Hi if you�re reading this. Please remember you�re beautiful , I hope you are having a wonderful day!

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