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Real Threat to South Dakota Kids: Infant Mortality. Expand Medicaid Now!

No children have been shot and killed in our schools recently, but or Legislature is gunning to take action to arm teachers and janitors to save children from that overhyped threat.

Meanwhile, no legislator yet has filed a bill this session to address the much more clear and present threat of South Dakota's unusually high infant mortality rate. Governor Dennis Daugaard has been beating the drum on this issue since the beginning of his term. His wife Linda leads the Governor's Infant Mortality Task Force:

"It was disheartening to learn that an average of 79 babies die before their first birthdays each year in South Dakota," said the First Lady. "The death of even one South Dakota baby is one too many" [Governor Daugaard's infant mortality webpage, downloaded 2013.01.22].

Infant mortality is an even worse problem in South Dakota than in neighboring states:

Since 2000, 877 South Dakota infants have died before their first birthday, an average of 80 a year, [Linda] Daugaard said. South Dakota’s infant mortality rate in 2000-2010 was 7 for every 1,000 live births, slightly higher than the national average of 6.8.

South Dakota’s infant mortality rate also was higher than the neighboring states of North Dakota (5.9), Minnesota (5), Iowa (5.2), Nebraska (5.9) and Montana (6), Daugaard said.

The infant mortality rate among American Indians was twice that of white women, Daugaard said [Chet Brokaw, "SD First Lady Says States Must Reduce Infant Deaths," AP via Native American Times, 2012.01.26].

Note that saying that our infant mortality rate is higher than the national average is saying something pretty serious, since the United States' infant mortality rate is already alarmingly higher than that of other industrialized countries.

Since that 2012 report, the First Lady's task force has made numerous concrete efforts to help new moms keep their babies healthy, though we're still waiting for data showing fewer babies are dying.

Expanding access to pre-natal care, especially on the hospital-sparse reservations; teaching safe sleep practices; distributing cribs and car seats; raising public awareness—all of these are worthwhile practical actions by the Governor's task force. But the Governor and the Legislature are still balking at the policy elephant in the room: expanding Medicaid. Medicaid has been associated with lower infant mortality among the uninsured; states that have already expanded Medicaid have reduced mortality in general. If the Governor himself says that helping more people get access to care can save infants' lives, and if expanding Medicaid will expand access to care, then buying into the PPACA Medicaid expansion that the federal government is offering should be a no-brainer.

Keep those cribs and car seats coming, Linda. Tell the Legislature to make a real difference in saving kids lives by trading its silly gun legislation for more practical policies. And tell your husband to back you up by expanding Medicaid.

9 Comments

  1. larry kurtz 2013.01.22

    Hickey: "The state has a duty to revoke the driving privilege of people who persist in driving dangerously." RT @ArgusMontgomery

  2. WayneB 2013.01.22

    Cory,

    Good focus on a worthwhile topic. A couple of considerations, though:

    1) How much can the state do without infringing upon tribal sovereignty? I'm all for helping American Indians reduce infant mortality, but what barriers might exist in the tri-partate relationship between tribal, state, and federal governments?

    2) Will expanding Medicaid really help with infant mortality? The paper you cite is from 1998, and discusses the level of medicaid we have currently. Can we find some information showing expanding medicaid coverage to single adults will help improve outcomes?

    2a) I guess I don't know the answer to a question - does a woman have access to medicaid prior to giving birth (i.e. does medicaid kick in to help deliver pre-natal care)?

    The Medicaid expansion may well have positive health outcomes for our state, but I wonder how much it'll move the needle on infant mortality over current trends.

  3. WayneB 2013.01.22

    Answered 2a - apparently not. SB140 seeks to remedy that, however.

  4. Michael Black 2013.01.22

    What's the infant mortality rate on the reservations compared to Sioux Falls?

    If the reservation numbers are higher and the government provides healthcare guaranteed by treaty via Indian Health Services, does that mean that we will see the same level of care in the rest of the state when Medicaid is expanded?

    http://online.wsj.com/article/SB10001424052970203706604574376981533298534.html

    "The IHS spends about $2,100 per Native American each year, which is considerably below the $6,000 spent per capita on health care across the U.S. But IHS spending per capita is about on par with Finland, Japan, Spain and other top 20 industrialized countries—countries that the Obama administration has said demonstrate that we can spend far less on health care and get better outcomes."

    "Unfortunately, Indians are not getting healthier under the federal system. In 2007, rates of infant mortality among Native Americans across the country were 1.4 times higher than non-Hispanic whites and rates of heart disease were 1.2 times higher. HIV/AIDS rates were 30% higher, and rates of liver cancer and inflammatory bowel disease were two times higher. Diabetes-related death rates were four times higher. On average, life expectancy is four years shorter for Native Americans than the population as a whole."

  5. Bill Dithmer 2013.01.22

    The only thing that will help the native population is a better outlook on life,"jobs."They are not only victims of their own circumstances they are victims of the IHS as well. There is no way you can compare the IHS to what might be if PPACA Medicaid expansion were to take place.

    "But IHS spending per capita is about on par with Finland, Japan, Spain and other top 20 industrialized countries—countries that the Obama administration has said demonstrate that we can spend far less on health care and get better outcomes."

    Again Michael you are comparing two completely different things. What they don't have in common is industry. That one thing could change the death rate on the reservation all the way from infant to old man.

    Being poor causes bad habits, drinking drugging, eating bad, and not caring what well you get your drinking water from, or where you have to take a dump. All the things most of us take for granted they don't have. When that changes then the mortalities will come down but until that happens no amount of IHS money will fix what is broken.

    Look at it this way. Its like giant slum that is a hundred miles across that has little islands of population that are doing a little better then the rest. No jobs, no money, no life to look forward to, and I'm sure most think "who the hell cares."Lets get drunk and try to forget about this crap.

    The Blindman

  6. Douglas Wiken 2013.01.23

    "Being poor causes bad habits, drinking drugging, eating bad, and not caring what well you get your drinking water from, or where you have to take a dump. All the things most of us take for granted they don't have. When that changes then the mortalities will come down but until that happens no amount of IHS money will fix what is broken. "

    Millions of dollars have been put into reservation water systems. Being poor is not a justification for wasting what resources you have on alcohol or drugs. Having illegitimate children at age 15 is not a recipe for good care or prevention of infant mortality.

    Natives get better care in hospitals than whites because every hospital has a phone number to report discrimination based on race to the federal government. Native Americans make demands that no whites would think about demanding.

    Natives that want to work can work. There are dozens working in Winner; but there are hundreds doing nothing but praising the wonders of a stone age culture and blaming whites and ancestors who never set foot in Dakota Territory for the reservation system. There are educational opportunities. They require work and study.

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