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Clark County’s birth rate drops 13 percent between 2013 and 2022

State report finds ‘persistent disparities’ in health care access, cost

By Chrissy Booker, Columbian staff writer
Published: November 7, 2024, 6:10am

Clark County’s birth rate per 1,000 residents dropped by 13 percent from 2013 to 2022, mirroring nationwide numbers that reached a historic low during the COVID-19 pandemic.

A recent report from the Washington Office of Financial Management revealed an overall decline in the birth rate, especially among people ages 15 to 34. From 2013 to 2022, the birth rate per 1,000 people in Washington dropped by 16 percent. The report also highlights the disparities in access to prenatal care, the high cost of postpartum care and how to improve access to maternal health services across the state.

“The results indicate that the state birth rate is declining, and there are persistent disparities in health care access and costs by race, ethnicity, age, and education, reflecting structural inequities in the state,” the report stated. “These disparities, particularly among BIPOC and low socioeconomic communities, underscore the need for urgent, focused interventions that eliminate institutionalized and structural racism, as well as address health care access and affordability.”

Each year, about 5,500 children are born in Clark County, according to the most recent data from Clark County Public Health.

“Some of the root causes of poor health outcomes for mothers and pregnant individuals are the same as the root causes for that declining birth rate. Health care access is one of them,” Public Health Project Coordinator Hayley Pickus said. “The fact is, it is declining. What is alarming is how uniquely unfriendly an environment we’ve created for families and pregnant parenting individuals.”

Mandy Stahre, a senior research analyst for the Office of Financial Management, said a number of factors could potentially be contributing to the decline. This includes the rising costs of child care and the lack of paid maternity leave, which forces families to consider the financial impact of taking time off work to have children.

“When you are in a position where you can’t take time off from work because you can’t afford to miss a paycheck, and paid maternity leave is not guaranteed, that really makes you sort of have to weigh the choices,” Stahre said.

The lack of access to prenatal and postpartum care and economic insecurity can also be a deterrent to having children, Stahre said.

In 2022, about 29 percent of people who gave birth in Clark County received inadequate prenatal care, according to Public Health.

This rate nearly doubled for the Pacific Islander community in Clark County, with 56 percent receiving inadequate prenatal care between 2018 and 2022, according to Public Health.

Swee May Cripe, a senior analyst who contributed to the state’s report, said researchers are working on collecting and analyzing race and ethnicity data to better understand the disparities across marginalized communities.

The state is also outlining ways to improve access to prenatal and postpartum care, which in turn could increase the birth rate. Those improvements include expanding the role of community health workers to provide wraparound support, ensuring Medicaid reimbursement for community-based services and offering flexible clinic hours and transportation assistance, Cripe said.

On a local level, Public Health also hopes to eliminate barriers to health care through community initiatives, such as the Nurse-Family Partnership and Raising Clark County.

Yasmina Aknin, program coordinator for Public Health, said the agency is working to improve referral pathways and increase existing prenatal and postpartum support resources, which includes conversations around mental health and the continuity of care.

“We know that prenatal care access for all parents is an issue. We were hearing folks were having a hard time finding an OB-GYN provider,” Aknin said. “And so for us, we thought, let’s take a look at the lay of the land here for Clark County and think about what are those specific populations that we need to focus on.”

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This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.

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