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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 whether they have commercial health insurance or Medicaid.
Instead, the numbers indicate that maternal health disparities in the United States are likely the result of broader health care system and societal challenges, including underlying chronic diseases, racial inequalities and likely biases within the healthcare system itself.
Pregnancy-related complications have worsened by 9% since 2018, with a marked increase during the COVID-19 pandemic, with some women of color at almost 70% higher risk of pregnancy-related complications than white women .
The study, Racial and Ethnic Disparities in Maternal Health, examined the rate of childbirth complications in nearly 11 million U.S. births to women with commercial insurance or Medicaid, as measured by the Centers for Disease Control and Prevention’s Severe Maternal Morbidity Measure (SMM).
WHAT IS THE IMPACT
The analysis found that black, Latina, and Asian women have higher rates of SMM than white women, regardless of age or type of health insurance. Pre-existing health conditions, such as hypertension, diabetes or asthma before delivery, are strongly correlated with higher SMM and more serious pregnancy complications, increasing the likelihood of an unsafe delivery or postpartum difficulties.
While across populations, women aged 35-44 have been identified as the most likely to have an SMM event, black women in this age range have a 66% higher rate of SMM and are more more likely to suffer from pregnancy-related complications than white women, the data showed.
Dr. Adam Myers, senior vice president and director of clinical transformation at BCBSA, said the disparities are largely caused by implicit biases and systemic racism in health care – deep-rooted issues that need to be addressed. resolved.
“To achieve better outcomes, we need to ensure that pre-pregnancy care is easily accessible and equitable for all women, in addition to strong prenatal care and ongoing postpartum care to ensure future pregnancies are safe,” said said Myers.
BCBSA is trying to make progress in this regard, launching its national health equity strategy last year. The strategy lays out a plan to reduce racial disparities in maternal health by 50% over five years.
Among the components of this strategy: working with legislators to strengthen and scale policies that make care more equitable; create incentives and training for providers to provide sensitive care and eliminate unconscious bias; tackling the social drivers of health, focusing on root causes; and collaborate with industry partners to standardize data collection and analysis to better understand gaps in care and create interventions that will address them.
BCBSA has also developed a list of 10 actions that organizations can take to improve maternal health and make a measurable difference in health disparities.
THE GREAT TREND
The federal government is also working to address racial and ethnic disparities. 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 child outcomes. the birth.
The funding will help expand and diversify the workforce that cares for pregnant and postpartum women, increase access to obstetric care in rural communities, and help states address health inequities. maternal and child health.
According to HRSA administrator Carole Johnson, black women are three times more likely to die from pregnancy-related causes in this country than white women.
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 had signed a new program, Perinatal Improvement Collaborative, a contract with Premier. The program assesses how pregnancy affects the overall health of the population by linking inpatient data from newborns to their mothers.
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