New Study Exposes Racial and Ethnic Disparities in State-Level Maternal Mortality

Maternal deaths in the United States have more than doubled over the past two decades, and the devastating consequences have not been distributed equally. Black mothers have experienced the highest rates of maternal mortality, while American Indian and Native Alaskan mothers have seen the largest increases in deaths.

Moreover, certain states and specific racial or ethnic groups within them have fared worse than others. These alarming findings were revealed in a recent study published in the Journal of the American Medical Association, which examined maternal deaths between 1999 and 2019 for every state and five racial and ethnic groups. 

The study is a wake-up call, highlighting the importance of investigating the core causes of this calamity. The study emphasizes the role of systemic racism and discriminatory actions in increasing the risk of maternal death and other variables such as poor access to healthcare. Dr. Allison Bryant, Mass General Brigham’s senior medical director for health equality, emphasizes the need to tackle these challenges to improve maternal health outcomes. 

The United States has the highest maternal mortality rate among developed countries, defined as deaths occurring during pregnancy or within a year of giving birth. Most individuals die due to major internal bleeding, ailments such as heart disease and suicide, or drug overdoses. Researchers from Mass General Brigham and the Institute for Health Metrics and Evaluation at the University of Washington utilized a modeling approach informed by national vital statistics data on deaths and live births to estimate maternal mortality rates. 

Preexisting differences in maternal mortality were worsening, according to the statistics. In 2019, the South, the Midwest, and specific states such as Wyoming and Montana all had considerably higher maternal mortality rates than the national norm. 

The researchers identified the five states with the most significant increases in maternal death rates by comparing rates from the first to the second decade. Maternal death rates for American Indian and Alaska Native women grew considerably in Florida, Illinois, Kansas, Rhode Island, and Wisconsin, ranging from 100 to 162 percent.

White women’s mortality rates increased by nearly 135 percent in Georgia, Indiana, Louisiana, Missouri, and Tennessee. Hispanic mothers’ death rates climbed by more than 100 percent in Georgia, Illinois, Indiana, Minnesota, and Tennessee. Death rates for black women surged by 93% in Arkansas, Georgia, Louisiana, New Jersey, and Texas. Maternal mortality rates for Asian and Pacific Islander women soared by 83% in Georgia, Illinois, Kansas, Michigan, and Missouri. 

Dr. Karen Joynt Maddox, a health care and policy specialist at Washington University School of Medicine, was unsurprised by the findings. She emphasized that the United States has to expand its expenditure on social services, primary care, and mental health, all of which are areas where it falls behind other developed countries. Maddox stated that expanded access to Medicaid and other public health insurance may improve maternal health outcomes. 

In 2021, Arkansas commissioned a study that discovered Black women in the state were twice as likely as white women to die from pregnancy-related reasons. The Arkansas Department of Health’s medical director for family health, Dr. William Greenfield, admits the continuing gap but says it’s hard to determine what’s behind the state’s surge in maternal death rates among Black women. 

Despite early government statistics showing that maternal death rates declined in 2022 after hitting a six-decade high in 2021 due to the pandemic, maternal mortality rates in the United States are at their highest levels in decades. Identifying the gaps and the factors contributing to them is critical before adopting community-based solutions and the necessary resources. 

Aside from well-known approaches such as telemedicine, the state of Arkansas is actively working on alternative measures to improve access to treatment. The state has formed a “perinatal quality collaborative,” which is a group of doctors and nurses working together to reduce the number of maternal deaths and birth injuries caused by unnecessary cesarean sections and other medical interventions, as well as to manage hypertensive disease complications better.