A study from researchers at the U of M School of Public Health (SPH) has been selected by editorial staff at the prestigious Women’s Health Issues journal as its Editor’s Choice selection for the November/December 2022 edition.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health at George Washington University. In a statement announcing the selection, Editor-in-Chief Karen McDonnell said the study provides policymakers with critical new information.
“This study’s findings emphasize the key role Medicaid can play in advancing equity,” said McDonnell. “State and federal policymakers should consider ways to make the Medicaid program an even stronger tool for ensuring all pregnant and birthing people have access to high-quality, equitable care.”
The SPH study focused on the uneven distribution of maternal illness and death in the U.S., with some populations bearing substantially greater risk, including Medicaid-insured individuals, rural residents and Black and Indigenous patients. Key findings of the study include:
Rates of severe negative maternal health outcomes were greater for Medicaid-funded births compared to privately-insured births for both rural and urban residents and for all race and ethnicities
- Rural Indigenous Medicaid beneficiaries had the highest rate of severe maternal morbidity and mortality, compared to urban, white privately insured births
- 40% of morbidity and mortality cases among Indigenous rural residents were due to the interaction of insurance type, race and rurality
- Among Black and Hispanic births, significant negative maternal outcomes due to the interaction of race and ethnicity with insurance type was largely among urban, rather than rural, residents
Lead researcher Julia Interrante, an SPH doctoral candidate and graduate research assistant in the SPH Rural Health Research Center, and colleagues used data on more than 6 million childbirth hospitalizations from 2007-2015 and identified those with severe maternal morbidity.
“I’m pleased that our study is receiving this additional exposure,” said Interrante. “Examining the intersection of people’s identities, rather than only looking at isolated segments, tells us so much more about how structural factors such as racism, urbanism, socioeconomic status and other social determinants of health have an impact on and compound the risk for negative health outcomes.”
As an Editor’s Choice selection, the article is available free of charge on Women’s Health Issues’ website.