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Anerudh Praveen

Anerudh Praveen

FeaturedHealth

The Racial Health Disparity in Maternal Mortality

by Anerudh Praveen February 23, 2023
3 mins read

Maternal mortality, defined as the death of a woman during pregnancy, childbirth, or within 42 days of delivery, is a significant public health issue in the United States. Despite medical advancements, maternal mortality rates in the U.S. are among the highest in developed countries. Moreover, black and Indigenous women are disproportionately affected by this issue, and the gap between these communities and white women continues to widen.


According to the Centers for Disease Control and Prevention (CDC), black women are three to four times more likely to die from pregnancy-related complications than white women. In 2018, the maternal mortality rate for black women was 37.1 deaths per 100,000 live births, compared to 14.7 deaths per 100,000 live births for white women. The disparity is even more significant for Indigenous women. The CDC reports that Indigenous women are 2.3 times more likely to die from pregnancy-related complications than white women.


Several factors contribute to this racial health disparity. Structural racism, which includes historical and current policies that create and maintain racial inequalities, is a significant factor. For example, black women are more likely to live in impoverished communities with limited access to quality healthcare, healthy food, and safe housing. Moreover, they are more likely to experience racism and discrimination in healthcare settings, which can lead to mistrust and reluctance to seek care.


Other factors include underlying health conditions, such as hypertension, obesity, and diabetes, which increase the risk of pregnancy complications. Socioeconomic status, education, and access to healthcare also play a role.


The U.S. government has taken steps to address this issue. In 2018, Congress passed the Preventing Maternal Deaths Act, which provides funding to states to establish maternal mortality review committees. These committees investigate maternal deaths to identify gaps in care and develop strategies to prevent future deaths. Additionally, the CDC has launched the Hear Her campaign, which raises awareness about maternal mortality and encourages women to seek care when they experience warning signs.


In conclusion, the racial health disparity in maternal mortality is a complex issue that requires comprehensive solutions. Addressing structural racism and improving access to healthcare and resources can help reduce the disparity and ensure that all women have safe and healthy pregnancies and births. 





References:


Centers for Disease Control and Prevention. (2021). Pregnancy Mortality Surveillance System. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm


National Partnership for Women & Families. (2021). Maternal Health: Women of Color. https://www.nationalpartnership.org/our-work/resources/health-care/maternal-health/women-of-color.html


February 23, 2023 0 comment
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Featured

Disparities in End-of-Life Care in the US

by Anerudh Praveen January 29, 2022
3 mins read

The COVID-19 pandemic has focused the spotlight on many disparities in America, with higher rates of infections and deaths among lower-income populations and communities of color. Infection and mortality rate are not the only disparities apparent in America though. There are many differences in end-of-life care that patients receive based on ethnicity, race, social status, and economic status. While efforts to increase equality should focus on mortality prevention, policymakers and clinicians should also seek to eradicate inequities in end-of-life care. 



End-of-life care takes on many forms depending on socioeconomic class and race. Medicare and Medicaid are the two biggest corporations in end-of-life care for low-income populations. Hospice and palliative care are frequently unavailable to American Indians and Alaska Natives for a variety of reasons. Poverty and geographic isolation are major factors in indigenous communities’ limited access to end-of-life care services, which mirrors greater inequities among rural patients of all races. Many tribal health institutions are also unable to meet the numerous Medicare and Medicaid standards for hospice treatment, leaving patients to rely on outside hospice programs that are typically oblivious to tribe culture and norms about end-of-life care.

 

Most alarming, research shows that disparities in access to hospice and palliative care result in negative outcomes for lower-income populations and racial/ethnic minorities with serious advanced illnesses. Another factor contributing to this pattern is that hospice and palliative care has traditionally focused on cancer, whereas other illnesses, such as end-stage kidney disease, which has significantly higher rates among racial minorities, can cause symptoms as severe as cancer, but patients with these illnesses are less likely to receive key elements of high-quality end-of-life care.



What can be done? First and foremost, financial access to health-care services must be enhanced. States should eliminate prescription drug caps that prevent proper end-of-life symptom management, and Congress should designate hospice as an essential service required in state Medicaid systems. A road to affordable coverage for undocumented immigrants is also necessary to ensure that they have access to meaningful health care throughout their lives. Second, unlike Medicare, Medicaid’s long-term care function opens up the possibility of extending access to inpatient hospice, a place that provides superior family-reported end-of-life care than hospitals and nursing homes. Because of its long-term care component, Medicaid might possibly assist hospice usage to a higher extent than other programs, given that lack of proper help at home is a key obstacle for many families contemplating hospice. Third, initiatives to make hospice and palliative care more accessible in underprivileged institutions and communities are crucial. The quick deployment of telemedicine during the COVID-19 epidemic indicates a new approach for sending palliative care professionals to rural locations.

January 29, 2022 0 comment
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