Report: Children in the Black Belt see worse health, education outcomes

Children raised in the Black Belt continue to see worse health and education outcomes than the state as a whole, University of Alabama researchers said at a press briefing on Monday.

In the 24 counties that stretch across the southern part of Alabama, children are likely to have higher rates of mortality, live in single-parent households and have fewer quality education resources compared to their counterparts, according to researchers.

“The Black Belt of Alabama is a historically underserved region and is no stranger to policy failures as it regards to the wellbeing of children and to the wellbeing of other citizens in these counties.” said Tessa Pickens, a graduate student at the University of Alabama Education Policy Center who led the media briefing.

The briefing highlighted a report from the Education Policy Center, part of an ongoing series to highlight various issues in the Black Belt region.

Alabama has long struggled with infant mortality. In 2024, Alabama’s infant mortality rate was  7.1 deaths per 1,000 live births, according to the Alabama Department of Public Health, versus 5.5 deaths per 1,000 live births for the United States.  There are major racial disparities in the rate. White Alabamians saw an infant mortality rate of 5.4 per 1,000 live births, while the rate among Black Alabamians was 11.8 per 1,000 live births.

That figure is worse for counties in the Black Belt, whose infant mortality rate is more than 9 deaths per 1,000 live births versus 6.5 deaths per 1,000 live births in non-Black Belt counties.

Butler County has an infant mortality rate of almost 30 deaths per 1,000 live births. Conecuh County’s infant mortality rate was 30.3 deaths per 1,000 live births. Wilcox County’s infant mortality rate was 31 deaths per 1,000 live births.

Researchers also said on Monday that a lack of access to health care for pregnant women plays a significant role in the disparities. According to the media briefing, only three counties in the Black Belt, Montgomery, Dallas and Escambia, have hospitals with obstetrics services targeted toward addressing the infant mortality rate, whereas 23 of the 43 counties in the non-Black Belt region have such services.

Dallas and Escambia counties have infant mortality rates that are 5.9 and 6.7 deaths per 1,000 live births, which places them in the upper third of the ranking among all counties in the state.

“Expectant mothers in most of these Black Belt counties are expected to travel outside of their county of residence to receive pregnancy-related healthcare,” Pickens said. “Barriers to transportation, as well as financial barriers, do prevent the utilization of services.”

Alabama’s refusal to expand Medicaid has also made it harder to sustain hospitals in rural areas like the Black Belt, according to Pickens.

The researchers also said that about 35% of households in the Black Belt are led by a single parent versus 23% in non-Black Belt counties. The statewide number is about 24%, which is higher than the national rate of 21%.

“Single-parent households are dependent on one income stream versus two,” Pickens said. “Single parents are more likely to have jobs with lower income potential and job security, and are more likely to face mental health issues, such as higher rates of depression and limited social support for helping to raise children.”

Researchers also said that fewer parents in the Black Belt enroll their children in childcare compared to parents who do not live in the region. Some of the barriers to enrollment could be affordability due to lower household incomes, or problems accessing transportation.

The report states that Lowndes County does not have any licensed childcare service providers, which forces parents to drive outside the area. The average occupancy rate for a childcare center in the Black Belt is about 73% but it is 79% for a childcare center that is not based in the Black Belt.

“This could indicate that families in the Black Belt are less likely to enroll their children in licensed childcare services, either turning to non-licensed options or choosing to not work to care for their children,” the report states.

This is problematic because childcare centers offer programming that could help put children on a successful path in school.

The Education Policy Center recommended expanding the Well Woman Program, provided by the Alabama Department of Public Health for women ages 15-55, which promotes healthy living and includes services such as preconception and/or inter-conception health planning.

Researchers also suggested expanding pre-kindergarten programs for children who are four years old.

“I believe the policy recommendations discussed at the briefing are great steps to address some of the needs of Alabama’s children,” said Katie Jeter, executive director of Children First, in a statement. “I would also like to add that it is imperative that children remain at the forefront of our minds as decisions are made for our state. Children are our future, and it is our responsibility to provide them with the opportunity to be successful in whatever endeavor they choose.”