Washington state has made tremendous gains in recent years to make sure more kids and families have greater access to health insurance. In 2007, the Washington State Legislature passed the Cover All Kids law, creating affordable, comprehensive Apple Health for Kids coverage. Since then, the number of Washington children without health coverage has dropped to its lowest level on record. Yet despite reaching historically high rates of insurance coverage, racial gaps in health outcomes persist and must be addressed.
For KIDS COUNT in Washington’s new “Getting All Kids Off to a Healthy Start” brief (a part of the State of Washington’s Kids 2018 series), we asked local health leader Michelle Sarju, “What would it take to make sure young kids have a healthy start?” She noted that it begins with the quality of care an expectant mother receives – because women with low incomes experience the worst features of our public systems, which includes our health care system. Mistreatment at the hands of medical providers is a disincentive to seek further care, says Sarju. “Who wants to show up to a doctor’s appointment to be treated poorly?”
Even when socioeconomic differences are erased, race still matters. Black women are three times as likely to die from pregnancy and childbirth-related causes as white women, according to the U.S. Department of Health and Human Services. “For African American and Native American women, midwifery and doula care are two of several evidence-based strategies for improving maternal-child health outcomes,” says Sarju. “If you have a well-trained and licensed provider, you have much better outcomes. Midwives and doulas are strategic resources.”
In Washington state, women of color have a greater likelihood of dying from pregnancy-related causes. And infants of color – particularly Black, American Indian, and Pacific Islander babies –experience higher rates of infant mortality and preterm births and are more likely to be born at a lower birthweight.
In order to make systemic improvements to address these poor outcomes, decision makers must thoroughly assess quality of care for women and families of color. Policymakers, community health leaders, health care practitioners, and other individuals who influence health care and public health systems should also take other necessary steps to implement the following recommendations to help improve health outcomes for mothers and young children:
- Identify interventions to address the adverse effects of structural and institutional racism on health outcomes;
- Promote culturally relevant forms of health care, such as midwifery; and
- Prioritize socioeconomic supports that advance the well-being of families, including Apple Health coverage, Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance for Needy Families, two-generation approaches to parent-child support like home visiting, and the full implementation of the state’s new paid sick and family leave laws.