America still has a premature birth problem, a report from the nonprofit March of Dimes has revealed, especially among minorities.

On Tuesday, the organization released its annual Premature Birth Report Card — and the verdict was not so great. Analyzing data from the National Center for Health Statistics, the report found that the total rate of premature births in 2015 was 9.63 percent, an increase over 2014’s 9.57 percent and the first jump seen in eight years. Among black women, the rate had risen by 48 percent, and among American Indian/Alaska Native women, 15 percent, when compared to white women. Seven states, including Connecticut, Utah, and New Mexico, saw their grade drop down from last year, while three others — Alabama, Louisiana, and Mississippi — got an outright F. As with previous years, the country overall earned a grade of C.

“The 2016 March of Dimes Report Card demonstrates that there is an unfair burden of premature birth among specific racial and ethnic groups as well as geographic areas,” said Dr. Jennifer L. Howse, March of Dimes president, in a statement. “The March of Dimes strives for a world where every baby has a fair chance, yet we see this is not the reality for many mothers and babies. Babies in this country have different chances of surviving and thriving simply based on the circumstances of their birth.”

The premature birth rate has undergone a roller coaster ride over the past few decades. Between 1990 to 2006, it rose over 20 percent to reach a recorded high of 12.8 percent of all births in 2006. Since then, however, it steadily dropped. Some, but not all, of this general trend has been to tied to more women having children at an older age or having multiple children at once; both are more possible with the advent of new treatments aimed at increasing fertility.

Yet these newfangled technologies do little to explain the higher rates seen in minority women, since many aren’t shelling out the money to use them. Instead, they reflect the lower standards of prenatal health care women of color have compared to white, generally wealthier, women. In light of that, the organization also evaluated each state by the level of racial and ethnic disparity women there faced, ranking Maine first and Hawaii dead last.

“Americans lead the world in medical research and care, yet the U.S. preterm birth rate still ranks near the bottom of high-resource nations,” said Dr. Edward R.B. McCabe, March of Dimes Chief Medical Officer. “We can do better by mobilizing resources and driving best practices and policies to ensure that no mother or baby falls through the cracks.”

One particular practice cited by McCabe, and implemented by the organization in Missouri, would be to discourage early deliveries that aren’t medically necessary.

Referencing research from the National Academy of Medicine, the organization pointed out that premature births rack up $26 billion in preventable medical and societal costs every year. And children born prematurely are known to face a laundry list of increased health risks, both in their earliest years and even into adulthood.