More data on race could improve maternal outcomes, Health Affairs finds

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Understanding the disparities faced by various racial and ethnic groups is key to addressing preterm births and low birth rates, which should spur action from payers, providers and lawmakers, finds a recentstudy in Health Affairs.

Specifically, the authors said that state and local lawmakers wield considerable influence in reducing disparities in maternal health outcomes, since many originate from historically inequitable local policies.

One possible means of addressing the issue would be the development of surveys with disaggregated race and ethnicity data that's specific to a given community, though authors cautioned that it's a fine line between reducing health inequities and intensifying them through racial targeting.

WHAT'S THE IMPACT

Using National Center for Health Statistics data from 2016 to 2020, researchers found a significant variation in low birth weights and preterm births among racial subcategories. Under broader categories of race, such as non-Hispanic Asian, they further broke those categories down into more granular categories – into Korean, Filipino or Japanese, for example.

Breaking those categories down into subcategories revealed some notable differences, such as rates of low birth weights that varied about 2.3-fold among the non-Hispanic multiple race category, and preterm birth rates varying twofold in the Asian category.

The racial subcategories revealed numbers that varied statistically from the broader categories. For instance, the broad category of Hispanic had five subcategories, and rates of low birth weight ranged from 5.4% for people of Cuban descent to 7.7% for those of Puerto Rican heritage. Asian subcategories saw even greater variation, from a low birth weight rate of 4.5% among Chinese Americans to 8.7% for Filipino Americans. 

The takeaway for researchers is that improving maternal health equity can greatly be benefitted by understanding patients' specific race and ethnicity, and suggested that a more fine-toothed comb should be used when considering the data.

For payers specifically, the authors said, population health outreach efforts can be greatly benefitted by having access to this micro-level information, especially since many payers don't collect racial information in the first place.

THE LARGER TREND

The link between race and maternal health has received increased attention in recent months. In September, for example, the Blue Cross Blue Shield Association released data showing evidence that women of color are at higher risk of pregnancy-related complications, regardless of having commercial health insurance or Medicaid.

Instead, the numbers indicate U.S. maternal health disparities are likely the result of broader health system and societal challenges, including underlying chronic conditions, racial inequities, and likely biases within the healthcare system itself.

The federal government is also making a push 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 birth outcomes.

The funding will help expand and diversify the workforce caring for pregnant and postpartum individuals, increase access to obstetrics care in rural communities and support states in tackling inequities in maternal and infant health.

Black women are three times more likely to die from a pregnancy-related cause in this country 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.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com