Maternal and Child Health Disparities Across the U.S.

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Between 2000 and 2014, the U.S. maternal mortality rate increased by more than 25%. Though some states have seen decreases, others have seen significant increases. Black women are at particular risk during pregnancy, illuminating stark disparities in maternal health care.

To learn more, check out the infographic below created by the Ohio University Online Master of Public Health program.

 

How public health programs and the work of professionals can combat maternal and child health disparities.

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Statistics of Maternal and Child Health in the U.S.

The Centers for Disease Control and Prevention defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Unfortunately, ethnic disparities are prevalent among mothers and infants in the U.S.

Maternal Health Statistics

Each year, more than 700 women die from causes related to pregnancy or childbirth. The maternal mortality rate among Black women is 3 times higher than that of white women. From 2011 to 2015, there were an average of 42.8 deaths among Black women per 100,00 live births, and 32.5 deaths among American Indian/Alaska Native women per 100,000 live births. The per-100,000 live birth rate for Asian/Pacific Islander, white, and Hispanic women were under 15.

According to the CDC, the highest causes of pregnancy-related deaths between 2011 and 2015 were other cardiovascular and other noncardiovascular medical conditions, which caused 15.1% and 14.3% of deaths, respectively. These were followed by infection or sepsis at 12.4%, hemorrhage at 11.2%, and cardiomyopathy at 10.8%.

Studies also indicate maternal mortality is the sixth-most common cause of death among American women ages 25 to 34. Studies also indicate maternal deaths are on the rise. Unfortunately, studies reveal more than 60% of maternal deaths could have been prevented.

Infant and Child Health Statistics From the CDC

CDC data indicates 11.4% of the 2016 deaths per 1,000 births were Black, followed by American Indian/Alaska Natives at 9.4% and Native Hawaiians or other Pacific Islanders at 7.4%. 2017 data indicates maternal pregnancy complications, preterm birth, sudden infant death syndrome, injuries, and birth defects as leading causes of infant death. It also indicates Asians had the highest percentage of children in excellent health, and that 18.5% of children and adolescents 2 to 19 years of age are obese.

Health Determinants for Mothers and Children

Health disparities among minority mothers and infants are exacerbated by factors like poverty, poor preconception health, and a lack of social support.

Some of the key factors in health disparities include poverty, environmental dangers, inadequate access to health care, education inequalities, and individual and behavioral factors. Some of the factors affecting pregnancy and childbirth include social support, access to health care at various stages, preconception health status, age, resource availabilities, and socioeconomically driven opportunities. Factors affecting infant and child health include education, breastfeeding, family and home environment, family income, and the physical and mental health of parents and caregivers.

Potential Causes of Rising Mortality Rates

Several theories pertain to the increase in mortality rates. One potential cause relates to older mothers, some of whom may have more complex conditions. Another cause is thought to correlate to higher rates of cesarean deliveries, which can increase the risk of complications. The opioid epidemic is also listed as a potential cause, as is an increased prevalence of chronic conditions like obesity, diabetes, and heart disease. Finally, it’s thought that the rise in mortality rate could be a product of improved record keeping.

Taking Steps Forward

Government programs and the efforts of private institutions are helping to identify trends in maternal mortality, develop strategies to improve maternal and infant health, and increase access to health care and other resources that would help decrease health disparities among mothers from ethnic minorities.

Closing the Gap

One of the methods that could improve maternal and infant health is State Title V programs. According to the Association of Maternal & Child Health Programs, “State maternal and child health (MCH) programs have been authorized by Title V of the Social Security Act to provide maternal and child health services for more than 80 years.” Title V programs help drive improvement in areas such as preconception health services, newborn screening programs, and efforts to promote breastfeeding.

Another means of improvement is through the Preventing Maternal Deaths Act. This bill, which was signed into law on December 21, 2018, provided states with $12 million in funding to review maternal mortality data. Public-private partnership have also been effective in California, as they’ve helped decrease in-state maternal mortality rates by 55% over the course of seven years.

Careers Dedicated to Supporting Public Health

Community health coordinator and epidemiologist are two careers that contribute to advancing public health.

Community health coordinators discuss health concerns with the local community, educate individuals about health and preventative care, and plan and execute outreach programs. Epidemiologists plan and coordinate studies of public health issues to identify prevention strategies, collect and analyze data to identify the cause of diseases, and oversee public health programs.

Conclusion

The success seen in California has inspired other states to adopt a data-driven approach in addressing maternal mortality. Reducing health disparities will likely require greater collaboration between public and private institutions in finding effective solutions for a variety of health issues.

 

Sources

Association of Maternal & Child Health Programs, “The Power of Prevention for Mothers and Children”

California Maternal Quality Care Collaborative, Who We Are

Centers for Disease Control and Prevention, Childhood Obesity Facts

Centers for Disease Control and Prevention, Health Disparities

Centers for Disease Control and Prevention, Infant Mortality

Centers for Disease Control and Prevention, Pregnancy Mortality Surveillance System

Centers for Disease Control and Prevention, Summary Health Statistics: National Health Interview Survey, 2017

HealthAffairs, “Beyond the Preventing Maternal Deaths Act: Implementation and Further Policy Change”

HealthAffairs, “The United States Maternal Mortality Rate Will Continue to Increase Without Access to Data”

The JAMA Forum, “Why Is US Maternal Mortality Rising?”

National Geographic, American Women Are Still Dying at Alarming Rates While Giving Birth 

Office of Disease Prevention and Health Promotion, Maternal, Infant, and Child Health

U.S. Bureau of Labor Statistics, Epidemiologists

U.S. Bureau of Labor Statistics, Health Educators and Community Health Workers