Confronting The Nation’s Racial Health Disparities in Maternal Health
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Last month, Blue Cross Blue Shield Association announced its National Health Equity Strategy as part of its ongoing efforts to improve the health of America. Furthermore, the strategy was put in place as a means to confront the nation’s crisis in racial health disparities. In response to the findings from a recent Blue Cross Blue Shield, The Health of America Report®, both BCBSA and Blue Cross Blue Shield have committed themselves to reducing racial disparities in maternal health by 50% in five years.

“There is an urgent maternal health crisis in our country,” said Kim Keck, president and CEO of BCBSA. “It is unconscionable that women of color face a greater risk of childbirth complications compared to white women. We must confront health disparities across the board to change the trajectory.”

Severe Maternal Morbidity:
According to the new BCBSA study measured by the CDC’s Severe Maternal Morbidity Measure (SMM), the rate of childbirth complications were higher for women in marginalized communities than majority white communities in 2020, specifically amongst Black and Hispanic communities. Furthermore, the study concluded that women from predominantly Black communities and are under the age of 35 were more likely to experience severe childbirth complications than their counterparts from majority white communities.

SMM is a unit of measurement of an expected outcome between conception to childbirth that may result in severe short or long-term consequences for the birth mother’s overall health. The Center for Disease Control and Prevention (CDC) categorizes SMM by 21 variants of indicators, and without treatment or diagnosis, SMM can lead to death. Within majority Hispanic communities, the SMM rate increased by 19% between 2018 and 2020, making it the biggest growth of the three groups studied.

Black Maternal Health Crisis:
The crisis in Black maternal health is no secret.  Black women are nearly twice to three times more likely to die from pregnancy and childbirth complications in the U.S. than white women. Thanks to recent research – with the database of claims for births among women with commercial BCBS health coverage about those specific complications and risk factors – Blue Cross Blue Shield has been able to identify top SMM indicators and risk factors, and quantify the disparities.

Following a survey conducted by BCBSA, Black and Hispanic women revealed that they are fearful of not receiving the necessary care and reported difficulty completing recommended prenatal visits due to transportation and scheduling conflicts. “The cumulative disadvantage of racism and chronic stress throughout life take a toll on the body and is bringing Black women into pregnancy at less than optimal health. This then affects the health of their babies,” said Dr. Rachel Hardeman, Blue Cross Endowed Professor of Health and Racial Equity.

Dr. Hardeman, who also serves as the Founding Director of Center for Antiracism Research for Health Equity University of Minnesota, School of Public Health continued: “As the Covid-19 pandemic illustrated, all policy is health policy. We must meet the urgency of the moment and insist that for the health of Black mothers and the health of women across the nation, we address the social, economic, political, legal, educational and health care systems that fuel the devastating maternal health disparities they face.”

Programs For The Ultimate Care Experience:
In support of the health of Black women amidst research findings and prior knowledge of healthcare disparities, BCBS companies has curated programs and is initiating national focus on improving the care for expecting mothers. Research suggests that working with a doula can reduce serious complications among women of color during childbirth, and a number of BCBS companies have begun to include doula coverage in their members’ plans, donating to doula organizations that focus on marginalized communities and funding training programs to increase the number of doulas of color.

Blue Cross and Blue Shield of North Carolina assisted with March of Dimes’ launch of its national Breaking Through Bias in Maternity Care program in North Carolina. As a response to healthcare workers attempting to identify and address their own implicit biases, maternal care providers across North Carolina are free of charge. The program’s curriculum covers structural racism in the U.S., strategies to mitigate bias in maternity care and approaches to building a culture of equity in workplaces and communities.

Additionally, BCBS Mississippi is partnering with OB/GYN doctors to train in managing chronic conditions, like hypertension and diabetes, so women of all race and ethnicity can receive necessary care in one place and OB/GYNs are more aware of developing risk factors.  BCBS Mississippi is also facilitating training for maternity hospitals that want to implement nationally-vetted “safety bundles,” or evidence-based practices for responding to childbirth emergencies like eclampsia or hemorrhage for all women.

BCBS companies acknowledges that they can’t make these changes alone in order to protect Black women and give them the care they need during pregnancy. With the assistance of a national advisory panel of distinguished doctors, public health experts and community leaders, BCBS will be focusing on specific efforts for a more diverse and equitable future.

The Blue Cross and Blue Shield Association is a national association of independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.