›› The Right Start 2004

February 5, 2004

EXCESS HOSPITALIZATION COST OF LOW BIRTHWEIGHT BABIES IS $166 MILLION

COLUMBIA--Hospital discharge records in South Carolina show that the excess cost of one year of hospitalization for low birthweight newborns is $166 million.

Dr. Baron Holmes, Project Director for South Carolina Kids Count, said, "Over 60% of the excess cost is paid for by the South Carolina Medicaid program. The 9.6% of babies with low birthweight account for 57% of all newborn hospitalization cost; over three-fifths (62%) of low birthweight cost is very low birthweight babies under 3.3 pounds whose births cost an average of $101,889 each."

Holmes added, "The additional healthcare, school, and institutionalization costs in subsequent years will add substantially to this excess cost of low birthweight and prematurity. The Medicaid program, other insurers, state agencies, and school districts will pay most of these additional costs. We can save ourselves a lot of money by getting our babies off to the right start. Most important is preventing the unnecessary consequence of disabilities and chronic health problems affecting too many children".

The Right Start Report shows that during the 1990s South Carolina and the nation have made improvements on many measures of healthy births to caring, prepared parents. Overall, the problem rates for South Carolina reported in The Right Start declined by 9% between 1990 and 2001. This should come as no surprise in South Carolina, since recent governors have made healthy births a priority and enlisted the collaborative efforts of state and local organizations. There is much to celebrate and much still to accomplish.

The good news is:

Indicator	Rate Change 1990-2001
Fewer births to teens;	-15%
Fewer second births to teens;	-13%
Fewer births to undereducated mothers;	-12%
Fewer births with little or no prenatal care;	-44%
Fewer births to mothers smoking during pregnancy.	-35%

The bad news is:

Indicator	Rate Change 1990-2001
More births to unmarried mothers;	+23%
More low birthweight babies;	+10%
More premature (pre-term) births.	+13%

South Carolina Rank:

	1990	2001
Births to teens	43	43
Births to teens already moms	43	39
Births to unmarried mothers	42	47
Births to mothers without high school education	35	35
Late or no prenatal care	44	39
Mothers smoking while pregnant	21	20
Low birthweight	47	47
Pre-term births	43	46
Average:	40	40

South Carolina's ranking failed to improve because other states have made similar progress. During the 1990s, South Carolina improved its ranking significantly only for repeat births to teen mothers and for late or no prenatal care. However, South Carolina ranked 43rd or worse on 4 of the 8 indicators in 2001, with an overall average rank of 40th. We are not keeping up with our neighbors, North Carolina and Georgia, which improved their overall rankings to 35th and 33rd respectively. Georgia made dramatic progress. It was tied for 40th with South Carolina in 1990 but improved its performance substantially in prenatal care, smoking, pre-maturity, and low birthweight.

South Carolina's progress has been achieved through hard work by many dedicated persons. Some highlights have been:

• Strong public-private partnerships to improve access to prenatal care and increase the number of medical homes for children.
• Increased enrollment of children in the Partners for Healthy Children health insurance and Medicaid programs.
• Effective community-based adolescent pregnancy prevention programs and family planning services.

In order to continue our progress and to overcome the increasing problems with low birth weight and pre-term births, we must:

• Promote healthy lifestyles among women during pregnancy and pre-conception periods by:
  • Avoiding smoking, drugs, alcohol, and infections
  • Reducing stress and depression
  • Achieving appropriate weight gain during pregnancy
• Improve mothers' access to early, risk-appropriate prenatal care and nutrition programs.
• Encourage the formation of strong, viable families who deeply want and are committed to raising healthy, successful children and who avoid stress, violence, and anxiety during pregnancy.
• Reducing the number of fertility-induced multiple births which are more likely to be premature and low birthweight.

Holmes said, "The current state fiscal crisis and budget cuts endanger our noteworthy progress over the past decade. Elected officials and other decision-makers should do everything in their power to sustain South Carolina's progress in assuring the right start for every baby born in the state. Continuing to invest in this effort is fiscally and morally responsible."

Also provided at www.sckidscount.org are tables for each county showing the improvement required to reach the national average on each of The Right Start indicators. With appropriate state-level support, our local communities across South Carolina must strengthen their partnerships to promote healthy births through the actions listed above. South Carolina's ranking will improve only when decisive action occurs in each community with support from state-level organizations.

South Carolina Right Start State and County Profiles
South Carolina Right Start County Rankings for Each Indicator
Appendix: South Carolina Data on Very Low Birthweight and Prematurity
South Carolina Right Start Contacts