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On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

Kansas premature birth rate reflects racial disparities, but state nears goal for 2020

By Meg Wingerter | November 04, 2016

Kansas premature birth rate reflects racial disparities, but state nears goal for 2020
Photo by March of Dimes

Black and Native American babies in Kansas are far more likely to be born early than other babies, putting them at risk of a host of complications.

The March of Dimes reported about 8.8 percent of all Kansas babies were born prematurely in 2015, still slightly above the organization’s goal of 8.1 percent by 2020. 

Kansas is “on a better track” to reach the goal than many states, said Jennifer Robinson, spokeswoman for the March of Dimes south central region, which includes Kansas. But not all families are benefiting, she said. Kansas came in 41st out of the 50 states and the District of Columbia when it came to racial and ethnic disparities, according to March of Dimes.

“Some counties show a much higher preterm birth rate than others, and the racial disparity index for Kansas is among the worst in the country,” she said.

Kansas 2015 premature birth rates

  • Hispanic: 8.2 percent
  • White: 8.6 percent
  • Asian/Pacific Islander: 8.8 percent
  • Native American/Alaskan Native: 12.1 percent
  • Black: 13.1 percent

Source: March of Dimes 

In Kansas, black babies were the most likely to be born prematurely, with 13.1 percent arriving before the 37th week of pregnancy. Native American babies also were disproportionately likely to be born early, with 12.1 percent classified as premature.

Babies born before the 37th week of pregnancy are at a higher risk for problems with their lungs, hearts, digestive systems and immune systems. Some also experience bleeding on the brain, anemia, jaundice, low blood sugar and difficulty maintaining their body temperature, according to Mayo Clinic

Some premature babies don’t experience long-term consequences, but others have cognitive delays or physical disabilities such as cerebral palsy, impaired vision or difficulty hearing.

Hispanic babies were the least likely to be born prematurely, with 8.2 percent arriving too early. They were closely followed by white babies, with 8.6 percent premature, and Asian babies, with 8.8 percent premature.

Rachel Hardeman, an assistant professor at University of Minnesota’s School of Public Health who studies birth outcomes in black families, said race can affect a woman’s risk in multiple ways. Policies in the past to segregate black people from certain neighborhoods and careers resulted in lower average incomes and educational attainment and less access to health care.

Socioeconomic conditions aren’t the only factor that results in worse birth outcomes for black women, however, Hardeman said. Black women with high levels of education still often experience more stress than their white counterparts, she said. Excessive levels of stress hormones over time increase the odds of negative health outcomes like premature birth.

“Black women with a professional degree … were still at a higher risk than white women who hadn’t finished high school of having a preterm birth,” she said.

It isn’t clear why Hispanic women didn’t have the same negative outcomes, but some researchers have suggested that recent immigrants are healthier because their lifestyles are more like those in their home countries than the average American lifestyle, Hardeman said.

The odds of being born prematurely also varied geographically. March of Dimes released data for the six Kansas counties with the highest number of births. Riley and Johnson counties already met the goal of less than 8.1 percent of births being premature as of 2014. Wyandotte County had the highest rate, at 9.8 percent, and Sedgwick, Shawnee and Douglas counties all had rates higher than 9 percent.

Kansas was in the lower half of states when it came to overall premature birth rates. Vermont had the lowest rate, with 7.3 percent of babies born premature. Mississippi had the highest rate, at 13 percent. The highest rates clustered in the Southeast, and the lowest rates were in New England and Pacific Northwest.

Nationwide, the premature birth rate increased slightly in 2015, from 9.57 percent to 9.63 percent.

Women who are pregnant with multiple babies or who have a health condition such as high blood pressure or diabetes are more likely to give birth early, according to the Centers for Disease Control and Prevention.  Those who give birth before age 17 or after age 35 also have an elevated risk. Almost two-thirds of pre-term births have no known risk factors, however, according to March of Dimes

While disparities in birth outcomes haven’t been easy to change, some research with black women has shown better results when the women go through their prenatal preparations as a group, Hardeman said. She also is researching whether black women who use a birthing center with care geared toward their culture have better outcomes than those who give birth at a traditional hospital.

“Building that community into the model has been very successful,” she said.