Building a Path Toward Health Equity
Apr 16, 2020
Angeline Sheets
Black pregnant woman

Across the nation, new data is illustrating a startling trend in the spread and impact of COVID-19: inequity. Between Illinois, North Carolina, South Carolina and New York alone, statistics are showing that African Americans are 74% more likely to contract the virus as compared with their total percentage of the state’s population.

While this new data is grabbing headlines and startling communities across the nation, inequities in healthcare outcomes are unfortunately not new news. As we observe Black Maternal Health Week (April 11-17), it is important to highlight that this is especially true for Black mothers, who are still roughly three times more likely to die due to pregnancy related causes.

The United States is facing serious challenges in how we care for expectant mothers and infants. A report in December of 2018 by the Commonwealth Fund found that American women have the greatest risk of dying from pregnancy complications among developed countries. (Munira Z. Gunja, n.d.)

Yet, California appears to be an outlier. California continues to perform better than the national average on maternal mortality with 11.7 deaths per 100,000 live births versus the national average of 17.4 deaths.

This was not always the case. Prior to 2006, the state’s maternal mortality rate had doubled in seven years – and black women were approximately four times more likely to die in childbirth than other ethnic groups.

In response, in 2006, Sutter Health leaders helped spearhead the creation of a multi-stakeholder organization, the California Maternal Quality Care Collaborative (CMQCC), to address maternal mortality and maternal health. The work done through CMQCC helped reduce California’s maternal mortality rate by 55% between 2006 and 2013.

Sutter’s partnership with the CMQCC and our work with their California Birth Equity Collaborative – a quality improvement initiative to improve birth care, experiences and outcomes for Black mothers – is helping to lower preventable maternal deaths or unexpected outcomes that have significant short, or long-term health effects on new mothers.

Sutter’s collaborative efforts have fostered real and much-needed progress, but there is still much more to do. We are committed to using robust data and collaborating with other providers and patients to make meaningful improvements to address equity gaps and improve patient-centered outcomes.

Building on this effort, two years ago Sutter created an ‘Advancing Health Equity’ team – led by Sutter’s Chief Medical Officer Stephen Lockhart, M.D., PhD – dedicated to identifying and addressing the issue through targeted, community-based programs. We are using innovative tools like the groundbreaking Health Equity Index that include analytic methods and dynamic applications of clinical and population data to measure outcomes of care among different patient populations. By reporting on these quality measures by race and ethnicity, we can identify previously unknown differences within populations, share best practices, and identify the need for targeted interventions and solutions.

Within Sutter’s own network, there is currently no inequity in race or ethnicity when it comes to maternal mortality. However, we know that 80% of what drives health outcomes happens outside the walls of our facilities. That is why it is so important that Sutter Health live up to our responsibilities as a national healthcare leader, and continue to research, innovate, and quantify the value of our integrated system of care for the benefit of other healthcare leaders throughout the state and the nation.

“I am so proud of Sutter Health’s long-standing commitment to improving health outcomes for our Black mothers, ” said Dr. Lockhart “COVID-19 reminds us more must be done to address health disparities and advance equity across the U.S. Everyone deserves the chance to live a healthy life.”

As long as inequities exist, the work will continue, but the successes we have seen and the initiatives that we are currently working on help to provide a clearer look at how we can do our part to advance health equity for all.

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