Disparities in Pennsylvania’s maternal healthcare have been on the rise in recent years, but a new report is shining light on just how big those disparities are.
According to a new report by Blue Cross/Blue Shield as part of its Health of America Report series, severe maternal morbidity (SMM) rates in Philadelphia are nearly 190 percent higher for Black women compared to white women.
“Maternal health disparities in our region are among the highest in the nation,” Dr. Richard Snyder, executive vice president of Facilitated Health Networks and chief medical officer at Independence Blue Cross said. “We cannot and should not accept these gross disparities, especially in one of the most advanced regions for health care. We must address these issues immediately to ensure that women of all races experience healthy pregnancies and babies.”
SMM is defined by the Centers for Disease Control and Prevention as “outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.” The United States has seen an increase in SMM in recent years, affecting 50,000 people as of 2014, according to CDC data.
In Philadelphia, Black women had nearly a percentage point higher prevalence of cardiac disease – a risk factor for developing SMM – than whites, 2.4 per 100 people, compared to 1.5 per 100. Black women also had a much higher rate of anemia than white women, 26.1 per 100, compared to 10.6 per 100.
In April, the Capital-Star reported that Non-Hispanic Black Pennsylvanians accounted for 23 percent of pregnancy-associated deaths in the commonwealth, despite only making up 14 percent of births during the same time period.
The report found that women in majority Black communities have a 63 percent higher rate of SMM than women in majority white communities. Women in majority Hispanic communities have a 32 percent higher rate of SMM than women in majority white communities.
“These rates are higher across all age groups and nearly all indicators examined,” the report noted. It also found that Black and Hispanic women have a substantially higher prevalence than white women of the most common risk factors that put women at risk of SMM, including hypertension, preexisting diabetes, bleeding disorders and anemia.
While women ages 35-44 had higher rates of SMM than those younger than 35, women in majority Black communities under age 35 had SMM rates that were higher than women in majority white communities ages 35-44.
Indicators of SMM
The study found that SMM indicators varied by race and ethnicity, as well.
Among women in majority Black communities, acute renal failure was the most common SMM indicator. While rates of pulmonary edema/acute heart failure showed the widest racial disparity, being nearly three times as prevalent among women in majority Black versus majority white communities.
Hysterectomies were the most common SMM indicator among women in majority Hispanic communities. Rates of adult respiratory distress syndrome showed the widest racial/ethnic disparity, being more than twice as high as women in majority Hispanic versus majority white communities, according to the report.
By Risk Factor
Anemia was the most prevalent risk factor for SMM in women in majority Black communities, occurring nearly twice as often as in women in majority white communities.
In women in majority Hispanic communities, preexisting diabetes was 38 percent more common compared to women in majority white communities.