Overlooked Contributors to Rural Preterm Births in 200 Words
This World Prematurity Day, it’s important to acknowledge that many parts of rural America are facing troubling increases in preterm births. I often hear people linking this to the critical shortage of care for pregnant women – nearly half of U.S. counties have no obstetrician-gynecologists and labor and delivery units are closing in high-need rural areas. Access to care is absolutely part of the problem, but it’s not the sole source. Other root causes – social and environmental determinants – are often overlooked in rural settings:
- Environmental contamination: Rural areas often contain pesticides used for agriculture, chemicals resulting from hydraulic fracturing, and water and air pollution from mining, which contribute to preterm and low-weight births. Furthermore, low-income communities and communities of color are most likely to experience negative health effects resulting from these environmental justice issues.
- Poverty: Ninety-five percent of persistent poverty counties in the U.S. are rural. Poverty often increases with remoteness, and contributes to poor access to healthy diets, safe and stable housing, and chronic stress, all leading to increased preterm births for women in socioeconomically deprived areas.
- Behavioral health access: Rural communities have far fewer behavioral health providers, who are critical to addressing the growing opioid epidemic, providing addiction counseling and smoking cessation services for pregnant mothers, and working with mothers experiencing postpartum depression.
To address some of these causes, PolicyLab is exploring how home visiting programs work outside the delivery room to address broader social and environmental determinants ensuring healthy birth outcomes in Pennsylvania’s rural communities.
This post is part of our “____ in 200 Words” series. In this series, we tackle issues related to children’s health policy and explain and connect you to resources to help understand them further, all in 200 words. If you have any suggestions for a topic in this series, please send a note to PolicyLab’s Communications Manager Lauren Walens.