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The Blue Cross Blue Shield Association has released data showing that women of color are at higher risk for pregnancy-related complications, regardless of whether they have commercial health insurance or Medicaid.
Instead, the numbers suggest that US maternal health inequalities are likely the result of broader health care systems and societal challenges, including underlying chronic medical conditions, racial inequalities, and likely bias within the health care system itself.
Pregnancy-related complications have worsened 9% since 2018, with a significant increase during the COVID-19 pandemic, with some women of color having an almost 70% greater risk of pregnancy-related complications than white women.
The study, Racial and Ethnic Disparities in Maternal Health, examined the rate of birth complications in nearly 11 million U.S. births to women with either commercial insurance or Medicaid, as measured by the Centers for Disease Control and Disease Severe Maternal Morbidity Measure (SMM). prevention.
WHAT IS THE IMPACT
The analysis found that Black, Hispanic, and Asian women had higher rates of SMM than white women, regardless of age or type of health insurance. Pre-existing health conditions such as high blood pressure, diabetes or asthma prior to delivery are strongly correlated with higher SMM and worse pregnancy complications, increasing the likelihood of risky delivery or postpartum challenges.
While women aged 35 to 44 have been identified as most likely to have an SMM event across all populations, black women in this age group have a 66% higher rate of SMM and experience more pregnancy-related complications than white women, the researchers said data showed.
dr Adam Myers, senior vice president and chief clinical transformation officer at BCBSA, said inequalities are largely caused by implicit bias and systemic racism in healthcare — ingrained issues that need to be addressed.
“To achieve better outcomes, we must ensure that pre-pregnancy care is easily accessible and equitable for all women, in addition to robust prenatal care and ongoing postpartum care to ensure the safety of future pregnancies,” Myers said.
The BCBSA is trying to make headway in this regard and launched its National Health Equity Strategy last year. The strategy outlines a plan to reduce racial disparities in maternal health by 50% over five years.
Components of this strategy include: working with lawmakers to strengthen and scale policies that make care more equitable; Creating incentives and training for providers to provide sensitive care and eliminate unconscious bias; addressing social drivers of health, with a focus on root causes; and working with industry partners to standardize data collection and analysis to better understand gaps in care and design interventions to address them.
BCBSA has also developed a list of 10 actions organizations can take to improve maternal health and make a measurable difference in health disparities.
THE BIGGER TREND
The federal government is also making a push to address racial and ethnic differences. In late August, the Department of Health and Human Services, through the Health Resources and Services Administration, announced investments of more than $20 million to reduce disparities in maternal and birth outcomes.
The funding will help expand and diversify the pregnant and postpartum workforce, improve access to midwifery services in rural communities, and help states address maternal and child health inequalities.
Black women in this country are three times more likely to die from a pregnancy-related cause than white women, according to HRSA Administrator Carole Johnson.
These investments are part of the implementation of the White House Blueprint for Addressing the Maternal Health Crisis released in June.
In November 2021, HHS announced that more than 200 hospitals signed a new program, Perinatal Improvement Collaborative, an agreement with Premier. The program assesses how pregnancy affects the general health of the population by linking inpatient data from newborns to their mothers.