If we look back on 2020 as the year that thrust racial inequities into the national consciousness, 2021 may be the year we see the tide start to turn.
We’re starting to see efforts to address health equity progress across the healthcare ecosystem.
Anthem, the largest of the Blue Cross Blue Shield affiliates, announced in August the creation of a health equity database, to support collaborative efforts. The database includes programs and organizations in Anthem’s central Indiana home base that are working to improve social determinants of health.
Seattle-based Providence, among the country’s largest health systems, recently released a progress report on its health equity initiatives. The system touted, among other accomplishments, its COVID vaccination, testing and outreach efforts to underserved communities.
In a recent meeting of health plan executives sponsored by Blue Health Intelligence®, leaders from across the country discussed the progress they had been making around health equity. As the group discussed reachable targets for improving equity and addressing racial disparities, the conversation turned to maternal health.
Rich Snyder, MD, senior vice president and chief medical officer at Independence Blue Cross, shared some startling statistics:
- Compared to Whites, 1.4 times as many African American women did not receive prenatal care in the first trimester. (See Table 100 of the Centers for Disease Control and Prevention, Pregnancy Nutrition Surveillance.)
- Pregnancy-related mortality for American Indian and Alaska Native women and Black women is two and three times higher, respectively, than for White, Hispanic, and Asian/Pacific Islander women.
- Non-Hispanic Black women are more likely to enter pregnancy with chronic hypertension, are more likely to develop preeclampsia and more likely to have low-risk cesarean deliveries than women from other races and ethnicities.
Snyder indicated that maternal health among minorities is a common concern for health plans – including at his employer, Independence. Programs to address maternal health disparities are spreading across the country.
“Plans are looking at data to identify unwarranted access and utilization of care as well as underlying causes of variation in maternal health outcomes, and how to motivate better prenatal and postnatal care,” Snyder said.
Quality of maternal care seems to be related to where the people studied get their care, Snyder said. Underserved populations in many inner-city areas, for instance, regardless of race or ethnicity, are getting poorer outcomes.
As health plans analyze their data and report their results, we’ll all learn what interventions are working and who’s successfully closing the gaps in minority population health.