Nearly half of all children born in Rhode Island in 2020 were children of color. And the health and well-being of those children and their birth mothers are “at risk,’’ according to a report released Monday afternoon by Rhode Island Kids Count. 

Racial and ethnic health disparities begin prior to conception with maternal insurance coverage and persist through pregnancy with higher maternal mortality rates nationwide, and higher risk factors for birth complications in Rhode Island, according to the report, Racial and Ethnic Disparities in Maternal, Infant, and Young Children’s Health in Rhode Island. 

Nationally, infant mortality has declined across all racial and ethnic groups, yet disparities remain. The Black infant mortality rate is the highest of any racial or ethnic group, the report said, even after controlling for risk factors such as socioeconomic status and educational attainment.

In Rhode Island, the Black infant mortality rate from 2016 to 2020 was 9.8 deaths per 1,000 live births – more than three times the white infant mortality rate of 2.7 deaths per 1,000 live births, according to the report.

“The health of Black and Brown mothers and babies are at risk in Rhode Island,” Paige Clausius-Parks, executive director of Rhode Island KIDS COUNT, said in a statement. “The story that this data tells is heavy and painful and should mobilize each and every person to call on our policymakers to act now.’’

Health care alone, however, only accounts for 10% to 20% of an individual’s overall health outcomes. Social determinants of health – the conditions and environments where people are born, live, learn, work and play - account for more than 80% of health outcomes, the report said.

Child health advocates and grassroots organizations, such as Sista Fire, a reproductive rights group, have been working for years to address these disparities in health outcomes, said Kaitlyn Rabb, policy analyst at Rhode Island Kids Count. And Rabb said the rest of the state needs to listen to them. 

“Can we have housing that's actually affordable in Rhode Island?’’ Ditra Edwards, director of Sista Fire, said during a Zoom discussion Monday about the report’s findings. “We are not at a place where we have a living wage. All of these things have implications on families and how they grow.”

If Rhode Island lawmakers “don't pay attention,’’ Edwards said, and “if we ourselves are not actively engaged in holding people accountable for what they say they’re going to do, we’re going to continue to struggle.”

Rhode Island has begun to address the health disparities with legislation in the FY 2023 budget to extend Medicaid coverage from 60 days to 12 months postpartum, and provide coverage regardless of immigration status; and restore the state policy of allowing all eligible low-income children enroll in the state insurance program RIte Care, among others.  

Rhode Island also was the first state in 2021 to reimburse doula services for both Medicaid and private insurance at a rate of $1,500 for all prenatal, labor, birth and delivery postpartum services.

But there is much more work to be done, the report said. The legislative recommendations include improving data collection - particularly of American Indian/Native American and Asian populations – by supporting “community-led data collection efforts that produce community-led solutions.” 

“We need to change not just how we do our programs, but how we invest in our communities,’’ Ana Novais, acting secretary of the state Executive Office of Health and Human Services, said during the discussion, so that we “serve women and support families and children in our state.” 

The report also recommends expanding access to reproductive health care, including abortions, for Rhode Islanders covered by Medicaid; and reducing barriers to doula care. 

Legislation was introduced in Rhode Island last year that would have required the General Assembly to include “equity impact statements,’’ similar to fiscal impact statements, to enable lawmakers to detect unforeseen ramifications of policies such as worsening racial disparities. But the legislation never made it out of committee.

The report said that nine states – Colorado, Connecticut, Florida, Iowa, Maine, Maryland, New Jersey, Oregon, and Virginia – have implemented mechanisms for developing such equity impact statements.

(Read the full report here.)

Health reporter Lynn Arditi can be reached at

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