Black Maternal Health Week: Disparities in Healthcare and the Importance of Representation Among Providers | $name

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Black Maternal Health Week: Disparities in Healthcare and the Importance of Representation Among Providers

Thu, Apr 4, 2024  -  Comments (0)  -   Posted by The Center for Health Affairs

Health disparities, including the increased presence and severity of certain diseases and poorer health outcomes, continue to impact people in racial and ethnic minority groups in the U.S. Let’s look at some of the challenges facing pregnant Black women and their infants, and discuss what can be done to address these disparities.


Maternal Health Inequalities

What does the data tell us? Black women face a higher risk of dying from pregnancy complications than white women. The Centers for Disease Control and Prevention (CDC) states “Black women are three times more likely to die from a pregnancy-related cause than White women. Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias.”


The CDC goes on to report that more than 80% of pregnancy-related deaths are preventable. The agency’s Maternal Mortality Review Committees collected data from 36 states and determined that the leading cause of death for Black birthing people were cardiac and coronary conditions. The CDC also states that 22% of pregnancy-related deaths happened during pregnancy, 25% occurred on the day of delivery or with seven days, and 53% occurred between seven days to one year after pregnancy.


Healthcare providers have suggested increasing the number of postpartum visits in an attempt to catch any warning signs and encouraging pediatricians to offer health services for birthers during their child’s visits. In some states, postpartum care has seen an increase thanks to the American Rescue Plan Act of 2021, which made a change to Medicaid coverage for low-income pregnant and postpartum women by giving states the option to extend the postpartum coverage from 60 days to a full year.


According to John Hopkins’ Bloomberg School of Public Health, states that have agreed to extend the postpartum period have seen lower rates of maternal deaths, particularly for Black women.


In Ohio, the most recent data report from the Ohio Department of Health’s Pregnancy-Associated Mortality Review committee indicates that Ohio Black mothers are 2.5 times more likely to die from a cause related to pregnancy or childbirth than a white mom. Between 2008 and 2016, 186 mothers died in Ohio from pregnancy complications or causes. The graph below shows the proportion of deaths that occurred among Black women (34%) far exceeded their representation among the population of women giving birth (17%) in Ohio.


The committee was created to assess the causes and factors that contribute to maternal deaths and provide recommendations to prevent future deaths. Their recommendations include:

  • Optimize the treatment of pregnant postpartum women with substance abuse disorder, including alcohol.
  • Work to recognize disparities at both the personal and systems level.
  • Ensure mental health screening for all pregnant women and treatment for those with a positive screen.
  • Work to recognize disparities at both the personal and systems level.


You can read PAMR’s report and full list of recommendations, here.


Infant Mortality

Infant mortality rates are higher as well for Black babies. In 2021, overall infant mortality in the United States was 5.4 deaths per 1,000 live births. As illustrated in the CDC’s graph below, non-Hispanic Black infants saw a death rate of 10.6 compared to 4.4 for non-Hispanic white infants.


A study by the Proceedings of the National Academy of Sciences indicates that Black newborn babies in the U.S. are more likely to survive childbirth if they are cared for by Black doctors, but three times more likely than white babies to die when looked after by white doctors. This underscores the importance of diversity and representation among healthcare providers and indicates a need to see an increase in the enrollment of minorities in the medical field.


Representation Among Healthcare Providers

According to the Association of American Medical Colleges (AAMC), only 5.7% of physicians identify as Black or African American, despite the demographic making up 13% of the U.S. population. Additional research provided by the AAMC indicates that racial concordance can improve communication, trust, and adherence to medical advice.


In the past few years, there has been a glimmer of hope. The American Medical Association (AMA) released a report in 2022 that indicated a significant rise in enrollment for historically marginalized racial and ethnic groups with more than a 20% increase in first-year medical student enrollment among Black medical students. This increase is clearly an improvement, yet AMA indicates this would need to be the beginning of a large trend to reverse the problem of physician representation.


The Impact of Social Determinants of Health (SDoH)

Social determinants of health can be defined as the nonmedical factors that influence health outcomes. These are conditions in which people are born, grow, work, live and age. These forces and systems include economic policies and systems, development agendas, social norms, social policies, racism, climate change and political systems.


SDoH have prevented individuals from racial and ethnic minority groups from accessing fair opportunities for economic, emotional and physical health. This leads not only to a negative impact on the health of the mother and child, but on individuals seeking to enter a career in healthcare.


What is being done to fix this problem?

In Cleveland, Case Western Reserve University’s Clinical and Translational Science Collaborative of Northern Ohio will host its first summit dedicated to Black Maternal Health Equity on April 14. Created in 2007 as a collaboration between Cleveland Clinic, MetroHealth System, University Hospitals, Louis Stokes Veterans Administration Medical Center, Northeast Ohio Medical University, and the University of Toledo, the Collaborative continues to advance health equity through translational science with an aim to get more minority communities involved and interested in research with a goal of leading to better treatment for all Northeast Ohioans. Attendees will hear stories from local mothers, a keynote address from author Deirdre Cooper Owens, PhD, and have an opportunity to apply their learnings and shared insights during action tables. Register here.


Another local organization making an impact on Black maternal health, First Year Cleveland is dedicated to helping all babies celebrate their first birthdays. Providing direct funding, support and training to local organizations and care providers, they work in partnership with communities to identify and advocate for policy and system changes centered in racial and social justice to ensure equity and accountability. Understanding the challenges faced by pregnant Black women, the organization offers resources and guidance for all stages of pregnancy and postpartum.


At the national level, in 2023, the Biden-Harris Administration announced more than $103 million in new funding to address the maternal health crisis. This included funding to expand access to maternal healthcare, form a new task force to address maternal mental health conditions and co-occurring substance use disorders, and launch a new campaign to provide information and combat stigmatization associated with this significant public health issue.


The U.S. Department of Health and Human Services (HHS) directed this funding through Health Resources and Services Administration (HRSA) to the following areas:

  • Expand and diversify the perinatal workforce: HRSA is investing $12.5 million to expand the maternal health workforce by supporting nurse midwifery programs at 10 universities.
  • Increase access to maternal health services: Investing $34 million to increase access to maternity care in underserved and rural communities. This includes more than $24 million to establish maternal health task forces to improve maternal health service delivery.
  • Invest in maternal health research: Nearly $10 million will be spent to establish a new research network to support minority-serving institutions of higher learning to study the disparities in maternal health outcomes and identify effective methods and strategies for addressing them.

These areas of funding combined with enacting measures to improve cultural competence — the ability to collaborate effectively with individuals from different cultures — are important steps toward alleviating healthcare disparities, improving pregnancy and postpartum care, and saving lives.


This week in Cleveland, OH, there will be two screenings of American Delivery, a documentary which highlights MetroHealth’s dedication to maternal and infant health as it examines the nation’s maternal mortality crisis and the nurses working to solve it. Tickets for the screening on April 6 and April 7 can be purchased here


To learn more about Black Maternal Health Week, visit
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