For nearly a decade, the annual County Health Rankings have shown that where we live makes a difference in how well and long we live.

This year’s County Health Rankings, however, show that health gaps persist not only by place, but also by race and ethnicity.

These gaps are largely influenced by differences in opportunity—from a lack of access to quality health care to a lack of safe, affordable housing—and these differences disproportionately affect people of color. From high rates of children living in poverty to increasing rates of low birthweight babies, this year’s analyses show troubling trends that stand in the way of good health.

Of these trends, the one that alarmed me is that after nearly a decade of improvement, we are seeing more babies born at low birthweight (8.2% in 2016, a 2% increase from 2014). And this trend is even more worrisome when broken down by racial and ethnic group. Compared to White babies, Black babies are twice as likely to be born at low birthweight and about twice as likely to die before their first birthday. As seen in the below figure, in all 50 states, the percentage of low birthweight babies born to Black mothers (orange dots) is worse than in the typical bottom performing county in their state (green bars).

As a Black woman, this data has been especially hard to digest. I don’t have children, but these numbers provide a sobering lens for what is supposed to be a joyous time. This time is for celebrating milestones of growth like first steps, first words and first birthdays. Healthy markers often signify a healthy life to come, and that is what a mother dreams for her children. But, too often, barriers put some babies at a disadvantage from the start. 

These barriers and this trend should not just alarm me. They should alarm us all.

Low birthweight is a critical measure of health and quality of life—for both mom and baby. It indicates a healthy start to life, and we know that kids who start behind often stay behind. Low birthweight babies have elevated lifetime risks of diabetes, heart disease and high blood pressure, and are also likely to have learning impairments. The failure to address the percentage of babies born at low birthweight has lifelong implications for the health and well-being of children, families and the nation.

The good news is we can work together to ensure all moms and babies have the same opportunities to grow up healthy, regardless of where they live and the color of their skin. Everyone deserves a healthy start and a fair and just shot at a healthier life. The Rankings are a call to action to come together and address these barriers to good health and well-being, including low birthweight.

Visit County Health Rankings to learn more about what’s happening in your community, and explore the Take Action to Improve Health resources for policies and strategies to consider.