“Equality of Opportunity in Action: Addressing Maternal Healthcare Disparities" Andrew Taber, Impact Investing Analyst, Edited by William Michael Cunningham

On July 28, 2021, the U.S. Chamber of Commerce held  a webinar titled “Equality of Opportunity in Action: Addressing Maternal Healthcare Disparities”, discussing racial gaps in maternal health outcomes and the proposed Black Maternal Health Momnibus Act. 

Maternal mortality rates are critically high in the United States, and problematically, higher for minority groups due to various social and structural inequities. Research from the Centers for Disease Control and Prevention (CDC) shows that Black women are much more likely to die from a pregnancy-related cause than white women. In fact, if childbirth as a Black woman were an occupation, it would be the 5th deadliest job in America. 

The first part of the webinar featured Congresswoman Lauren Underwood, a nurse instructor and Representative with a background in healthcare policy. She emphasized that the majority of maternal deaths are preventable, but that this persistent and withstanding crisis has been problematically ignored. Direct and targeted policy solutions are required. Representative Underwood sponsored the Momnibus Act and it’s twelve bills, which focus on addressing the social determinants of these disparities, including climate change, nutrition, and mental health support. 

Specifically, the Momnibus Act seeks to use data to inform policy choices and drive effective solutions. Crucially, there is a role for the private sector to play. Not only can companies provide invaluable information and data to the government to help save lives, they can design products that would help solve the crisis. 

In fact, Creative Investment Research proposed the Maternal Mortality Reparation Facility for Black Women, described below. The Facility is a set of legally binding agreements, modeled on the agreements used by the Federal Reserve to direct trillion in support to large corporations and financial institutions during the Covid crisis. The facility will purchase up to $500 billion of short- or medium-term notes directly from U.S. cities, states, counties and private sector entities (issuers) with innovative, effective and efficient programs that lower Black maternal mortality

The rest of the U.S. Chamber of Commerce’s webinar examined the current state of maternal healthcare. The panelists included Dr. Alan Fishman, a Specialty Medical Officer for Maternal Fetal Medicine for the Mednax National Medical Group; Nadia K. Primus, RN, MSN, a Manager of Quality and Safety Improvement for Hackensack Meridian Health, New Jersey; Trashaun Powell, MA, a member of the Preeclampsia Foundation’s Racial Disparity Taskforce; and Dr. Juliet M. Nevins, the Clinical Solution Medical Director for Aetna (A CVS Health Company). Their discussion centered on  solutions to negative maternal health outcomes, both at-large and specifically related to racial disparities. 

In addition to a more thorough and human approach to maternal health, reducing trauma was a key factor for the panelists, as introduced by Ms. Powell. Described through personal testaments, many face trauma giving birth. Unfortunately, not enough attention is given to the mental health of maternal patients due to structural and logistical issues. This is particularly harmful as trauma is long-lasting and can likely lead to many other complications. Hence, leadership and a voice is required in this dimension.

Additionally, access remains a problem for many mothers given socioeconomic differences; this necessitates technological innovations. Telehealth was a growing and effective option for many people during the pandemic, although socioeconomic disparities exist there as well. 

A final method to improve maternal healthcare according to the panelists, involves greater utilization of data. Data can be used to improve program creation, reduce informational fragmentation, and prevent patients from slipping through the cracks. An interesting aspect emphasized by the panelists was carefully using but not relying on data; medical experts need to be able to trust their own expertise. Hence, an equilibrium ought to be reached where approaches are data-driven but patients and their doctors are still treated like humans. 

Altogether, the U.S. Chamber of Commerce’s event was extremely interesting, informative, and important. The United States has among the worst maternal health in the industrial world. Innovative and cooperative solutions are required to tackle this complex crisis and it’s racial dimension. 

Hopefully, the Black Maternal Health Momnibus Act, if passed, will help focus on the root causes of negative maternal health outcomes through both the public and private sectors and lead to a healthier and more equitable healthcare system for all.

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