Reducing Racial Disparities in Maternal Health
South Carolina has the eighth highest maternal mortality rate in the nation, fueled by the death rate among African-American women. In South Carolina, black women with Ph.D.s have worse health outcomes in pregnancy than white high school dropouts. Overall, black women are three times as likely to die in childbirth as white women in South Carolina and across the nation.
Health disparities like this are the heart of the issue for the Population Health Improvement committee for metro Charleston, co-chaired by Dr. Nancy Muller, director of the Lowcountry Graduate Center, for whom wellness is imbedded in its mission. “It’s just another way the LGC connects locally in support of both workforce development and community wellness to help make the Lowcountry an even better place to work and live,” Muller said.
Population Health Improvement Committee Tackles Maternal Mortality
The committee is part of the Tri-County Health initiative organized by Trident United Way, Roper St. Francis Healthcare and MUSC Health, which is focusing its work on five area priorities determined by surveying more than 5,000 individuals in Berkeley, Charleston and Dorchester counties. Maternal and child health is one of those priorities.
The committee has established a goal to reduce the disparity between black and white women by 10% by 2023. To accomplish that, they will need to tackle the myriad underlying issues associated with maternal morbidity. They include low income, distance from health providers, access to health care, increased incidence of cardiovascular disease and diabetes and the stresses of systemic racism.
Among the early stage action steps the committee is planning are enhancing public awareness of the existence of this divide in society and identifying organizations with best practices for closing the gap.
Seeking Best Practices
Victoria Manigault, a member of the First Baptist Church of James Island Health Ministry and the Maternal Child Health Program Manager for the SC Department of Health and Environmental Control Lowcountry Region, says programs like the Nurse-Family Partnership Program for mothers who qualify for Medicaid might be one of those best practices. Many first-time mothers know nothing about pre-natal care or the resources available to them and have little family support at home. The partnership connects them with a nurse to help them navigate the system, learn about nutrition and access available programs like WIC.
National research on the partnership, which exists in 40 states including South Carolina, has uncovered its value to mothers and their babies. Outcomes for babies include a 56% reduction in ER visits and a 50% dip in language delays by 21 months. Mothers stay employed longer and have fewer subsequent pregnancies.
As a first step, the Population Health Improvement committee will begin meeting with women in low-income and minority communities to hear their concerns. The first meeting has been established at Manigault’s church with subsequent meetings planned for Mt. Moriah Baptist Church and Royal Missionary Baptist Church, both in North Charleston.
“Many African-American women are astonished that they are so much more likely to die or have adverse effects than white women during childbirth or during the peri-natal period before and after childbirth” Manigault said.
Access to Health Care is Key
Members of the committee recognize that solving health care issues like this requires addressing other issues. The Healthy Tri-County initiative has set access to health as its number one priority, believing that it is a primary cause of most other health issues.
“Access to care is the number one priority because access is not just the traditional things we think about,” said Renee Linyard-Gary, director of health at Trident United Way. “We think about health coverage as the immediate access to care but don’t think about … transportation to get to medical services. People have other factors that are barriers to them getting into care.”
“This is a public health crisis. It doesn’t only affect African-American women; it affects the whole community because the burden is placed on the whole healthcare system, families and our society,” Manigault said. “It’s something that we all need to pay attention to and address.”