Nancy Gin, MD, FACP, leads a vibrant panel discussion for The Permanente Journal on the evolution, merits, and challenges of value-based care.
Maternal health equity among Black women remains a serious, unresolved issue. Black women die from pregnancy-related complications at a rate 3 times higher than white women in the U.S. Even the wealthiest Black women have the same mortality rates as low-income white women, indicating the crisis is in part fueled by racism, unconscious bias, and health disparities.
In a recent op-ed published by MedPage Today, Nkem Chukwumerije, MD, president and executive medical director of The Southeast Permanente Medical Group, provided his perspective on ways to reverse this trend and advance health equity for Black mothers and their babies. In the article, Dr. Chukwumerije, who also serves as executive sponsor and national physician lead for Equity, Inclusion, and Diversity for the Permanente Medical Groups, recommends a multifaceted, multidisciplinary approach to improve Black maternal care:
- Look for and recognize personal bias. Research has shown people have biases toward other races and ethnicities based on stereotypes that then inform their behavior towards that population. Most of the time, people are unaware of these biases. One of the first steps in advancing health equity is to identify personal biases and the ways those biases may lead to harm.
- Practice cultural humility. It is impossible to know all the nuances and intricacies of every culture. However, practicing cultural humility acknowledges this fact and shows a respectful willingness to learn.
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- Commit to improving diversity in health care. Furthering health equity requires a workforce that looks like the population it cares for. Addressing this issue is not the responsibility of any one physician, but every physician can serve as a powerful advocate for action.
- Improve access to quality care. Access to quality primary care is always important to detect, treat and monitor medical issues, but it’s particularly essential immediately before, during, and after pregnancy.
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- Take social determinants of health into account. Up to 70% of a person’s health is driven by things like access to food, housing, and transportation. Physician leaders can address these social determinants of health by ensuring their teams screen perinatal patients for unmet needs and connect them to social services that can help.
- Focus on systemic factors that contribute to pregnancy-related morbidity and mortality. Gaps in coverage and access to high-quality care are primary drivers of health inequity. Fortunately, more than 30 states have already begun to extend the Medicaid postpartum coverage period from just 60 days postpartum to 12 months. Additional efforts can do more to address disparities in care.