1 infant mortality rate per 1,000 live births ARE FLORIDA'S CHILDREN BORN HEALTHY AND DO THEY HAVE HEALTH INSURANCE? Too Many of Florida's Babies Die at Birth, Particularly African American Infants In the US, the infant mortality rate, the rate at which babies less than one year of age die, has continued to steadily decline over time, dropping from 26.0 per 1,000 live births in 1960 to 6.75 per 1,000 live births in 2007 (i.e. 29, 153 infants died). i In Florida, the infant mortality rate has also dropped over the past few decades, however, since 1994 the rate has only declined from 8.1 per 1,000 live births to 7.2 per 1,000 live births in 2008 (i.e. 1,667 infants died) and the state's rate of infant mortality is higher than the national rate. ii The trend in the US and Florida between 1995 and 2007 is illustrated in the following graph. 7.8 Infant Mortality Rate - US and Florida, iii US Florida Similar to the national pattern, there are significant disparities in infant mortality that exist among various racial and ethnic groups in Florida where the problem is particularly prevalent among African Americans. iv Infant mortality among African There are significant disparities in infant mortality that exist among various racial and ethnic groups in Florida where the problem is particularly prevalent among African Americans. 1
2 infant mortality rate per 1,000 live births Americans is typically more than double the rate among other racial and ethnic groups as illustrated in the following graph. Infant Mortality Rate by Race and Ethnicity US and Florida Linked Files v US Florida Non-Hispanic Whites Non-Hispanic Blacks 0 American Indian Asian or Pacific Islander Hispanic Low Birth Weight Infants are at Risk of Premature Death or Developmental Problems. Florida's Rate of Low Birth Weight Infants is Worse than the National Average and is More Prevalent Among African Americans Infant size at birth is an important predictor of short-term complications and long-term developmental and health problems. Smaller infants, especially those born at less than 1,500 grams (i.e. very low birth weight), are at the greatest risk. For example, research conducted in 2006 found that 24 % of the babies born with very low birth weight in the US died in the first year of life compared with 0.2 % of infants born at 2,500 grams and higher. vi As was noted in the discussion of infant mortality, the rate of low and very low birth weight babies is also higher in Florida than national trends. In addition, although the rate of very low birth weight babies has remained fairly constant, the rate of Low Birth Weight babies has increased somewhat over time as shown in the following graph.
3 % low birth weight % low birt weight Percent Low Birth Weight LBW) Infants US and Florida US - LBW 7.00 Florida - LBW African American infants are more likely than those in other racial or ethnic groups to be born with low birth weights nationally and in Florida. African American infants are more likely than those in other racial or ethnic groups to be born with low birth weights nationally and in Florida. The following chart illustrates the prevalence of low birth weight babies in 2008 among the various racial and ethnic groups. Percent Low Birth Weight Infants by Race and Ethnicity - US and Florida in % 12.9% % 7. 5% 6.9% 7.3% US 6 Florida Non-Hispanic White Non-Hispanic Black Hispanic
4 % receiving prenatal care One factor of importance linked causally to this trend is the proportion of births that received early pre-natal care. In Florida, only 78% of the births in 2009 received early pre-natal care. vii Given the high rate of low birth weight babies (and infant mortality) among people who are non- Hispanic Black, they would by comparison also not receive prenatal care at levels similar to other racial/ethnic groups. National data clearly shows such a pattern as illustrated in the following figure. viii An earlier study found that in 2006 the percentage of mothers who began prenatal care in the first trimester by racial/ethnic group was 76.1% among non-hispanic White, 61% among non-hispanic Black, and 66.2% among Hispanic mothers. ix Prenatal Care Participation Rate by Race and Ethnicity Selected States, All Races and Ethnic Groups non-hispanic White 50 non-hispanic Black American Indian or Alaska Native Asian Hispanic 0 Prenatal Care in First Trimester Late or no Prenatal Care A Large Portion of the Nation s and Florida s Children, Especially African American and Hispanic Children, Lack Adequate Health Insurance - A Contributing Factor to Poor Birth and Health Outcomes for Children and Youth In 2010, more than 49 million people under the age of 65 in the United States lacked health Insurance. x Who are these people? They are: xi More than three-quarters are in working families, Most are from low and moderate-income families (78% less than 250% of Federal poverty level), and
5 More adults (persons under age 65) are uninsured than children because of specific programs (Medicaid, etc.) that target children (16% less than age 19). The following table reports the percentage of children (less than age 19) lacking health insurance by selected states: Health Insurance Coverage of Children by Selected State xii State Ranking Percent Children Uninsured HIGH TEXAS 17% LOW HAWAII None xiii U.S. AVERAGE 10.1% FLORIDA 16.2% Florida s uninsured population becomes even starker when race is considered. While current data does not differentiate race by age, it is important to note that in Florida, the smallest percentage of uninsured persons are the 65 years and older group (1.3% uninsured), with the age group being the highest percentage of uninsured at 26.6%. xiv In the middle at an uninsured percentage of 14.8% are children under the age of 18. However, when race is considered, regardless of age, significant differences arise. Florida Health Insurance Coverage Status xv Race/Ethnic Origin Total Uninsured Percent Uninsured White 14,040,265 2,665, % Black/African American 2,787, , % American Indian and Alaska Native 56,494 20, % Asian 440,450 97, % Native Hawaiian/Other Pacific Islanders 8,872 2, % Some Other Race 507, , % Two or More Races 351,464 69, % White alone, Not Hispanic or Latino 10,805,125 1,590, % Hispanic or Latino (of any race) 3,943,669 1,347, % As would be expected and shown in the table below, income level has a direct relationship to insurance coverage, (or uninsured).
6 Florida s Uninsured by Income Groupings xvi Income Number Uninsured Percent Uninsured Under $25,000 1,093, % $25,000 to $49,999 1,342, % $50,000 to $74, , % $75,000 to $99, , % $100,000 and over 273, % As the above data shows, having (or not having) health insurance coverage is likely a product of one s race/ethnicity and/or level of income. Poor people of color are less likely to have insurance than white people. Poor people of color are less likely to have insurance than white people.
7 i "Infant Mortality Statistics from the 2007 Period Linked Birth/Death Data Set," Matthews, T.J. and MacDorman, Marian, National Vital Statistics Reports, Vol. 59, Number 6. ii Kids Count Data Book, iii Kids Count Data Book, 2011 and "Infant Mortality Statistics from the 2007 Period Linked Birth/Death Data Set," Matthews, T.J. and MacDorman, Marian, National Vital Statistics Reports, Vol. 59, Number 6. iv Center for Disease Control Prevention: - 2 v "Infant Mortality Statistics from the 2007 Period Linked Birth/Death Data Set," Matthews, T.J. and MacDorman, Marian, National Vital Statistics Reports, Vol. 59, Number 6. vi. Infant mortality statistics from the 2006 period linked birth/infant death data set. National vital statistics reports; Mathews TJ, MacDorman MF vol 58 no 17. Hyattsville, MD: National Center for Health Statistics. vii Kids Count Data Book, viii "Expanded Data from the new Birth Certificate," Osterman, Michelle, Martin, Joyce, Mathews, T.J. and Hamilton, Brady, National Vital Statistics Reports, Volume 59, Number 7, July ix Kaiser State Health Facts. x The Kaiser Commission on Medicaid and the Uninsured. Pg 6 xi Ibid., pg 6 xii Ibid. xiii Identified coverage totals 97.3%; unidentified balance is within standard error of estimate. Next lowest state was Massachusetts at 3.4% uninsured. xiv U.S. Census bureau, American FactFinder, FLORIDA S2701 Health Insurance Coverage Status xv Ibid. xvi Ibid.
8 % obese TO WHAT EXTENT IS OBESITY AND FOOD INSECURITY AN ISSUE FOR FLORIDA'S CHILDREN? Obesity is a Major Problem Among Florida's Children and Adolescents, Particularly Among Mexican-American Boys and non-hispanic Black Girls Childhood obesity (i.e. body mass index at the 95th percentile) is a growing problem and can lead to harmful long-term effects including; high blood pressure, diabetes, respiratory problems, musculoskeletal distress, and social and psychological problems. Nationally, in % of the country's children aged 2 to 19 were obese and the rate has tripled since xvi Not only has the rate of obesity increased, but it varies significantly among different racial and ethnic groups as shown in the following graph. xvi Obesity is particularly prevalent among Mexican American boys and non-hispanic Black girls with rates of 26.8% and 29.2% in respectively. Prevalence of Obesity in US Children and Adolescents by Race and Ethnicity
9 In Florida among adults eighteen or older, 27.2% of them were considered obese in xvi A higher rate was determined for youth aged 10 to 17, reaching 33% in xvi A survey of high school students in Florida found that 10% were obese in xvi A greater rate of obesity among non-hispanic Black and Hispanic persons was also found in Florida, where 25.2% of White, 42.7% non-hispanic Black, 29.2% Hispanic people over the age of 18 were obese in The Rate of Food Insecurity Among Florida's Children is Also Worse than the National Average On the opposite side of the coin, households are considered "food insecure" when the adults report that, during several times of the year, there was "reduced quality, variety, or desirability of diet with little or no indication of reduced food intake." xvi The prevalence of food insecure households nationally has climbed from 10.47% in 2000 to 14.51% (17.2 million) in xvi Considering race and ethnicity, 10.8% of non-hispanic White, 25.1% of non-hispanic Black, and 26.2% Hispanic households experienced food insecurity in 2010 in the US. Higher rates of health and behavioral problems are found in children who live in food insecure households. Among the country's food insecure households in 2010, there were 7.9 million or 20.2% with children under the age of 18 and there were almost 4 million or 21.8% with children under the age of six. xvi A comparison of the average prevalence of food insecure households in the US and those in Florida between 2008 and 2010 reveals that our state is above the national rate by a little over 10%. The US averaged 14.6% compared to 16.1% in Florida. xvi Looking at households with children over the period , the rate in Florida (16.5%) was also higher than the national average (16.2%).