....How Hospital Closures and Structural Inequality Are Fueling a National Maternal and Child Health Emergency!
By Norris R. McDonald, DIJ, CRT @sulfabittasnews
New national data from the United Health Foundation and the America’s Health Rankings project confirm what Black, Indigenous, and poor communities have warned for generations: systemic racism remains deeply embedded in U.S. healthcare and continues to shape who receives quality care, who struggles, and who dies prematurely.
The 2025 Health of Women and Children Report finds that race can be a stronger predictor of health outcomes than income or education. That reality is reflected in rising maternal mortality, worsening infant and child death rates, and growing mental health distress among women and children. Behind these trends lies a dangerous convergence of structural racism, economic inequality, and collapsing healthcare infrastructure.
This is not a temporary setback. It is a slow-moving national emergency.
Racism as a Public Health Threat
Black women in the United States are roughly three times more likely to die from pregnancy-related causes than white women. Black infants face significantly higher mortality rates. These disparities persist even when controlling for income, insurance status, and educational attainment.
Public health researchers describe a “weathering effect,” in which chronic exposure to discrimination, economic insecurity, and social stress accelerates biological aging and weakens immune and cardiovascular systems. Over time, this cumulative burden increases the risk of pregnancy complications, hypertension, diabetes, and maternal death.
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| The fight for healthcare justice is a moral imperative! |
Structural racism also determines where people live—and therefore what healthcare they can access.
Residential segregation has concentrated many communities of color in areas with fewer hospitals, fewer prenatal clinics, and limited specialty care. Geography, shaped by decades of policy choices, becomes destiny.
America’s Vanishing Maternity Wards
One of the most alarming forces intensifying these disparities is the rapid disappearance of maternity wards across the United States.
Since 2018, approximately 300 maternity units have closed nationwide. More than 100 rural hospitals have stopped delivering babies since 2020 alone. Today, fewer than half of rural hospitals still offer labor and delivery services.
Hospitals cite financial losses, chronically low Medicaid reimbursement rates, staffing shortages, and declining birth volumes as reasons for shuttering obstetric units. Maternity care is often treated as a money-losing service line rather than essential infrastructure.
The result is the expansion of what public health experts call “maternity care deserts”—regions where pregnant people must travel long distances for prenatal visits, delivery, and postpartum care.
In many rural counties, one in three residents now live without local access to an OB-GYN.
Closures are occurring nationwide, with heavy concentrations in the South and in rural regions. Even metropolitan areas are not immune. South Florida has seen maternity units close at facilities such as North Shore Medical Center, Jackson West, Holy Cross Health, and Hialeah Hospital, further straining already overcrowded systems.
For low-income families, the consequences are severe. Long travel times increase the risk of missed prenatal appointments, delayed emergency care, preterm births, and maternal death. Transportation costs, time off work, and childcare barriers compound the danger.
When maternity wards disappear, preventable deaths rise.
Rural Collapse, Racial Impact
Women in rural areas experience higher rates of chronic illness and face steeper access barriers than their metropolitan counterparts. When race and rurality intersect, the risks multiply.
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| Since 2018 over 300 units have been closed throughout America which worsens the plight of poor Black, Hispanic Native Americans and other minority women. |
These conditions are not accidental. They reflect decades of underinvestment in rural hospitals, privatization of healthcare, and policy decisions that prioritize corporate profitability over community survival.
Children Paying the Price
Child mortality has worsened alongside maternal outcomes.
Rising housing costs, food insecurity, and medical debt force families into impossible trade-offs—rent versus groceries, utilities versus prescriptions. When pregnant people are undernourished and overstressed, infants face higher risks of low birth weight, developmental delays, and early death.
There have been modest gains in early childhood education enrollment and slight declines in smoking during pregnancy. But these improvements are fragile and easily overwhelmed by broader structural forces.
A nation cannot claim to value children while tolerating conditions that shorten their lives.
A Mental Health Emergency
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| America's poverty induced mental health crisis is worsening! |
At the same time, fewer women report having a dedicated healthcare provider, weakening continuity of care and early intervention. Minority and rural communities face acute shortages of mental health professionals, long wait times, and limited culturally competent services.
Mental health struggles do not emerge in a vacuum. They grow from material conditions—poverty, instability, discrimination, and chronic uncertainty.
Policy Choices, Not Inevitable Outcomes
The report outlines clear, evidence-based priorities:
* Permanent Medicaid expansion in all states.
* Debt relief and financial incentives for providers who work in underserved areas.
* Sustained investment in rural hospitals and maternity units.
* Expanded support for Black and Indigenous midwives and doulas.
These solutions are feasible. What is lacking is political will.
The Bottom Line
America’s worsening outcomes for women and children are not mysterious. They are the predictable result of policy decisions that allow inequality to harden into infrastructure.
Systemic racism is not merely a social problem. It is a public health crisis measured in graves.
Health equity is not charity. It is justice!
