271: Minnesota Eyes Maternal Disparities

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Tuesday, September 27th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

BROOKE CUNNINGHAM:

We've been reviewing maternal deaths for a while, but this is the first report that we've released.

JOHNSON:

The voice of Brooke Cunningham, assistant commissioner for health equity at the Minnesota Department of Health. She's talking about a report that examined maternal deaths from 2017 until 2018. Cunningham says the report shows the state's overall maternal mortality rate is much lower than the national average, but reveals many disparities.

CUNNINGHAM:

While Black Minnesotans represent 13% of the birthing population, they made up 23% of pregnancy-associated deaths. Similarly, American Indians represent 2% of the birthing population, but made up 8% of pregnancy related deaths and almost 70% of deaths.

Pregnancy was not an aggravating factor. In many cases, those individuals died from motor vehicle accidents or poisoning or overdose. 10% of those deaths had violence as a contributing factor. And we know of those that were pregnancy related, 100% were actually deemed preventable. And so, there's a lot of opportunity for intervention there.

JOHNSON:

Cunningham says her department is using the report and other data to understand disparities in the state and how to solve them.

CUNNINGHAM:

We know when we think about disparities and when we think about racialized minorities, often they have worse pre-conception health, right—even before people get pregnant, right? For example, Black women experience higher rates of chronic disease, cardiovascular disease, diabetes, hypertension that are linked to maternal morbidity and mortality.

JOHNSON:

She says Medicaid expansion would help as would a focus on maternal care deserts that impact rural areas. Whatever the approach, Cunningham says public health leaders can make a difference.

CUNNINGHAM:

Even though public health professionals might not be in the doctor's office, we are often very close partners with our healthcare provider community, with our hospital systems, and we know that much work does have to happen within the healthcare system. So, how can we be that partner? Encourage screening for depression, encourage screening for substance use.

JOHNSON:

You can read the Minnesota report using the link in the show notes.

Also, a new ASTHO blog article explains how states and the federal government have taken steps to improve health outcomes for pregnant people. It examines extended postpartum insurance coverage policies that allow doula services and initiatives to increase diversity in the workforce and reduce bias impacting clinical decisions. You can read it using the link in the show notes.

Public health emergencies can impact pregnant people and infants. ASTHO has a new report to help you plan and prepare for their needs before, during, and after a crisis.

This is ASTHO's Maggie Davis.

MAGGIE DAVIS:

So in the preparedness phase, the report's really looking at mechanisms for reporting new diseases that might be emergent or outbreaks that could affect this population. It also has some considerations for specifically tracking birthing parent and infant diets, which is a way to see any sort of long-term effects from disease or infection that might occur during pregnancy, just to see if there's any long-term effects.

JOHNSON:

Davis says the evaluation phase is another critical aspect of emergency response addressed in the report.

DAVIS:

So, the biggest thing is to have an assessment of what were some of those emergency policy changes that worked well, and are there ways to build that into the system moving forward. For example, we learned a lot during the COVID-19 pandemic about the necessity of allowing supportive partners with a person accessing care.

JOHNSON:

You can download the document using the link in the show notes.

Finally today, state primary care offices are helping to expand access to healthcare and improve health equity. ASTHO examines the value of these offices in a conversation with Alisa Druzba, chair of the Primary Care Office National Committee. You can read her interview using the link in the show notes.

Also, make sure to follow us on your favorite podcast player. It's the best way to get every newscast delivered to your mobile device at 5:00 a.m. weekday mornings.

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.