By Michelle the Sapiocrat
Dear America, we have a lot of work to do--and quickly.
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| Source: New American Media |
While lofty talks of comprehensive healthcare reform leave members of our current administration fighting at the dinner table, some of our nation’s most vulnerable populations are suffering at the hands of a healthcare system that is, quite literally, killing them. If I decided to tackle every aspect of the United States’ complex healthcare system, this submission could easily become a novel, so I’ll focus on the issue of maternal mortality rates today. According to the World Health Organization, maternal mortality is defined as “...the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy…”. Note: This should not be confused with maternal morbidity, which, according to the The World Health Organization is the measure of “health conditions attributed to and/or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing”. In a nutshell, maternal mortality is the measure of actual deaths that have occurred as a result of complications from pregnancy, and maternal morbidity is a term used to describe conditions such as diabetes, high blood pressure, etc. that worsen as a result of pregnancy. Still with me?
Now that we’ve gotten some of that public health jargon out of the way, let’s talk cold hard numbers, shall we? While 157 of 183 countries have reported steady decreases in maternal mortality rates in the wake of medical advances, expansion of hygienic practices, and spread of prenatal education, the United States is one of 8 countries (and the only developed country in this subset) to report an increase in maternal morbidity rate. According to most recent data on global maternal health outcomes, America is number 50. FIFTY. What’s the deal? In 2016, the United States spent almost $3.4 trillion on healthcare alone--which is roughly 18% of our national GDP. If we’re signing the checks for quality healthcare, where’s the return on our investment? I’d argue that it lies in the inherent inequality embedded within the fabric of our country’s social institutions.
If you’ve been paying attention to our current political climate, you’re likely aware that there are marginalized populations in the United States who experience a number of disparities (income, education, healthcare, etc.) that lead to poorer overall outcomes. When it comes to maternal mortality rates, African American, low-income, and rural mothers are among the most affected. To more accurately explore what these disparities reveal about our healthcare system, it is most helpful to view maternal health as a sort of marathon rather than than a sprint. When a woman discovers that she is pregnant, most physicians will ask for an extensive medical history in order to evaluate her diet, lifestyle choices, social support systems, and a number of other relevant criteria. In other words, the long term environmental, medical, and social conditions that a woman has been exposed to prior to conception are, for the purposes of this discussion, more relevant to the health of both mother and child than the changes made once a child is conceived. To put things into perspective: take a moment to consider how the pregnancy of a mother in rural south Georgia is likely very different from the pregnancy of a mother in Upper Manhattan. When you consider the two vastly different social, environmental, and economic circumstances under which these two women are experiencing pregnancy, you may begin to understand why these maternal mortality disparities tend to fall along socioeconomic fault lines.
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| Source: Preeclampsia Foundation |
The late Walter Cronkite, a broadcast journalist widely known for his 19 year tenure on CBS Evening News, once stated: “America’s healthcare system is neither healthy, caring, nor a system.” Although Mr. Cronkite’s take may seem a bit harsh, I think it holds merit. The state of the United States’ healthcare system is abysmal, considering the amount of resources that are allocated to this area. Our nation must double down on its efforts to reduce healthcare disparities among marginalized populations, and strive to ensure equitable, not just equal, outcomes for all. A recent bill brought before the U.S. House of Representatives has proposed that states and the federal government should work together to identify solutions that will reduce maternal mortality and assess the socioeconomic conditions that have contributed to poor maternal health outcomes. I believe that this is a step in the right direction. States that rank lower in maternal health outcomes, like Texas, for example, may even benefit from adopting changes that states with better maternal outcomes, like California, have implemented in the past.
What are your thoughts? Were you as shocked as I was to learn that the United States ranks so poorly in this area of healthcare? Let’s talk about it.
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