The United States has the highest gross domestic product and one of the highest standards of living in the world,[i] yet its maternal mortality rate is one of only 13 in the world that is higher than it was 25 years ago.[ii] The numbers are worse among black women in America, who are three to four times more likely to die from pregnancy-related causes than their white counterparts, while black infants are more than twice as likely to die as white infants. What’s more, these disparities transcend income and level of education.[iii]
“Infant and maternity mortality rates are regarded as measures of the health of a society. The racial and ethnic disparities in our current rates reflect longstanding biases that challenge our very basic capacity to offer fair and ethical health care,” said Dr. Lenaye Lawyer, an OB-GYN and one of the market chief medical officers for AmeriHealth Caritas, a national leader in Medicaid managed care and other healthcare solutions for those most in need. “The provider community should be aware of these disparities and recommendations for reducing them.”
According to the National Partnership for Women & Families, there are broader problems in the health care system and in the delivery of maternal care which disproportionally affect black women.[iv] For example, a survey conducted by the Robert Wood Johnson Foundation found that 22 percent of black women report discrimination when going to the doctor or clinic.[v]
In 2016, the Council on Patient Safety in Women’s Health Care issued recommendations for reducing peripartum racial and ethnic disparities. These recommendations include, but are not limited to:[vi]
- Health care providers establishing a “culture of equity,” including implementing quality improvement projects that target disparities in health care outcomes, access, and treatment.
- Providers establishing systems and staff-wide education programs for collecting race, ethnicity, and language data, and how to use that information to improve patient care.
- Health care providers training staff on racial and ethnic disparities and their root causes, as well as implicit bias.
- Engaging in shared decision making between providers, patients, and family members.
Dr. Lily Higgins, another AmeriHealth Caritas market chief medical officer, added that improving health literacy and self-advocacy skills can also help more black women have healthy pregnancies, deliveries, and babies.
“If the health care system can foster a culture of health equity, literacy, and advocacy, we will take a big step towards eliminating maternal health disparities in this country,” said Dr. Higgins.
[i] GDP (current US$). The World Bank, 2017. https://data.worldbank.org/indicator/ny.gdp.mktp.cd?view=map&year_high_desc=true
[ii] Villarosa, L. Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis. New York Times Magazine, 11 April 2018. https://www.nytimes.com/2018/04/11/Magazine/black-mothers-babies-death-maternal-mortality.html
[iv] Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities. National Partnership for Women & Families, April 2018. http://www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html
[v] Discrimination in America: Experiences and Views of American Women. Robert Wood Johnson Foundation, December 2017. https://www.rwjf.org/content/dam/farm/reports/surveys_and_polls/2017/rwjf441994
[vi] Reduction of Peripartum Racial/Ethnic Disparities. Council on Patient Safety in Women’s Health Care, 2016. https://safehealthcareforeverywoman.org/wp-content/uploads/2016/11/Reduction-of-Peripartum-Racial-and-Ethnic-Disparities_FINAL-11.7.16.pdf