Georgia Drops In Health Ranking For Women And Children

A recent report ranks Georgia 40th among states on the health of women and children, down three spots from its 2018 ranking.

The 2019 United Health Foundation report said among Georgia’s challenges are its high percentage of uninsured women, its low rate of prenatal care before the third trimester, and its low percentage of high school graduation. The state also has high rates of infant mortality and low-birthweight babies.

As in similar rankings on health measures, several Southern states were rated in the bottom 10 in the report.

The Southeast “tends to have more poverty,’’ Dr. Michelle Bucknor, chief medical officer for UnitedHealthcare of North Carolina, said Tuesday when asked about the rankings. “We know that living in poverty creates all sorts of issues,’’ including lack of access to food, shelter and health care, Bucknor said.

Mississippi ranks as the state with the most health challenges for women and children, followed by Arkansas (No. 49), Oklahoma (No. 48), Louisiana (No. 47) and Nevada (No. 46).

The regional factor was even more striking at the top of the rankings. Rhode Island is the healthiest state for women and children, the 2019 report said. It was followed by four other New England states: Massachusetts, New Hampshire, Vermont and Connecticut.

The United Health Foundation also publishes rankings on states’ overall health and senior health.

Nationally, teen suicide and child mortality rates have increased sharply, according to the report, released last month.

The U.S. teen suicide rate increased 25 percent for adolescents ages 15 to 19 since the 2016 report, rising from 8.4 to 10.5 deaths per 100,000 adolescents. In Georgia, teenage suicide increased 40% over that time, to 9.5 deaths per 100,000 adolescents ages 15-19.

The suicide increase “is very concerning,’’ Bucknor said. “There’s more stigma in the South over mental health and substance abuse disorders.’’

“There are a lot of social pressures on kids,’’ including from social media, she added.

And nationally, maternal mortality was found highest among African American mothers at 63.8 deaths per 100,000 live births.

Georgia’s maternal mortality rate is at or near the bottom of states. That’s the number of women who died during pregnancy or childbirth or in the weeks afterward.

Michelle Nelson, professor of nursing at Georgia State University, pointed out that the state has “way too many counties that don’t have providers, with no obstetric care.’’

“Lack of insurance is extremely problematic,’’ Nelson said Tuesday. “We have not had Medicaid expansion in the state. It’s inhibiting access to care.’’

Nelson, who is president of United Advanced Practice Registered Nurses of Georgia, says full practice authority for these advanced nurses “would be an immediate fix’’  for much of Georgia’s medical provider gaps.

Experienced Advanced Practice Registered Nurses, Nelson said, “should be able to practice without restriction in rural areas.’’

She says Georgia is the most restrictive state in terms of allowing APRNs to practice without supervision.

The women-and-children report said that among Georgia’s strengths are a low prevalence of excessive drinking among women, low cost of infant child care, and low prevalence of substance use disorder among adolescents.

Nationally, the report said the U.S. has made improvements to decrease the rates of teen births and smoking, and to increase the rate of flu vaccinations among women.

The report said the rankings’ goal is to “create widespread awareness of where states stand on important public health measures.’’

The rankings are based on 55 measures of health. Five categories of health comprise the rankings model: behaviors, community & environment, policy, clinical care and health outcomes.

Andy Miller is editor and CEO of Georgia Health News.