Almost every section of this report illustrates a reproductive health crisis for Black and Hispanic women in Ohio. The racial inequality in reproductive health access should function as a lens for interpreting the entirety of the report. This section draws out some particularly problematic numbers that demonstrate a real emergency. The unique challenges Black and Hispanic women face span the spectrum of reproductive health needs and issues, starting at a very young age. The teen birth rate has decreased across the board for all young women and girls in Ohio over the past decade, however the teen birth rate remains substantially higher for Black and Hispanic teens. In 2013 the teen birth rate, births per 1,000 females age 15 to 19, was 49 for Black teens, 43 for Hispanic teens and 22 for white teens (National Kids Count, 2014). This disparity in teen birth rates suggests a resource gap for Black and Hispanic teens that impacts their ability to advance in their education, careers, and communities.
Affordability of contraceptives is a major issue for planning family size and avoiding unintended pregnancy. The Affordable Care Act makes access considerably easier for women with insurance coverage; however not all women are insured. In 2013 19% of white women, 18% of Black women, and 34% of Hispanic women who were in need of publicly supported contraception were uninsured (Frost, Frohwirth and Zolna, 2015). According to these numbers Hispanic women in Ohio appear to be disadvantaged in terms of need for contraception and insurance coverage to attain those services.
During and after pregnancy Black and Hispanic women in Ohio face obstacles accessing care. Access to adequate and affordable prenatal care is essential to continuing a healthy pregnancy and assisting women in controlling their reproductive lives. According to Amnesty International, 19.3% of women of color in Ohio in 2010 did not receive prenatal care or their prenatal care was delayed (Amnesty International, 2010). For the same year 12.2% of all women in Ohio including white women did not receive or delayed prenatal care (Amnesty International, 2010). Unfortunately, the 2010 numbers are the most recent data tracking the accessibility of prenatal care based on race and ethnicity. Analysis of the statistics available shows it is more difficult for women of color in Ohio to obtain the same level of prenatal care as white women. Delaying or not having prenatal care influences pregnancies from the beginning, impacting the health status of woman and their infants. Black infants consistently have the highest rates of low birth weights in Ohio, in part due to the racial disparity in prenatal care access. Low birth weight is defined as a live birth weighing less than 2,500 grams or 5.5 pounds. In 2013, 13.3% of Black infants born in Ohio had a low birth weight compared to 7.4% of the white infants, who consistently have the lowest rate of low birth weights (National Kids Count, 2014). The trend of Black women and Black infants facing the worst issues in pregnancy and delivery continues with infant mortality. Ohio is known for having particularly high infant mortality rates in the United States, nationally ranked 44th (United Health Foundation, 2016). However for Black infants the rate is double the state average. In 2014 the infant mortality rate, calculated as the number of deaths per 1,000 births within the first year of life, for white infants was 5.3 while for Black infants it was 14.3 (Ohio Department of Health, 2015). The racial disparity in these numbers reveals a clear and devastating health inequality between white residents and Black residents in Ohio. The reasons for this disparity are varied and complex. It is evident that comprehensive policy reform is necessary to address this reproductive health crisis for Black women in particular.
Rates of cancer and sexually transmitted infections are also key indicators of the state of choice in Ohio. The reproductive health inequality for Black and Hispanic women continues into these health indicators as well. According to the Ohio Cancer Incidence Surveillance System, “Hispanic women have more than twice the risk of developing cervical cancer compared to non-Hispanic white women, and African American women have 1.5 times the risk of non-Hispanic white women” (OCISS, 2014). These differences indicate potential barriers to screening and treatment that Hispanic and Black women face that white women do not. Those disparities in prevention, screening, and treatment also impact upon disparities in the rate of sexually transmitted infections. In 2014 the rate of diagnosis of HIV (defined as the number of infections per 100,000 females) for white women was 0.9, for Hispanic women it was 4.6 and for Black women it was 10.9 (Ohio Department of Health, 2015). Although the HIV infection rate for Black women has decreased, it remains consistently higher than the rate for women of other racial and ethnic backgrounds. These numbers are troubling because they illustrate that Black women in Ohio are facing greater threats to their reproductive health and wellbeing. While the causes of these threats to Black and Hispanic women’s reproductive safety are multifaceted, it is clear that Ohio must allocate more resources to focus on the needs of these women.
Conclusion and Suggestions for Change
Although there are some positive trends in the state of choice for Ohio, extensive policy change is required to grapple with the substantial obstacles and complex problems that women, particularly Black and Hispanic women, in Ohio face. The data, and in some cases lack of data, examined in this report also point to issues requiring further investigation. What is clear is that across the entire spectrum—from abortion and contraception, to prenatal care and birth outcomes, to the ineffective response from law enforcement to domestic violence and sexual assault—Black and Hispanic women face a unique health crisis. Now is the time for local, state, and federal policymakers to dedicate the resources necessary to effectively address these issues. Now is the time for bold change. We must implement sweeping policy changes that can effectively address the structural issues that are at the root of these systemic and near-universal disparities.