The United Health Foundation (UHF) recently released America’s Health Rankings® 2024 Health of Women and Children Report and America's Health Rankings® Maternal and Infant Health Disparities Data Brief, which offer an in-depth look at the health population that we serve through Babyscripts.
The reports were particularly revealing of the future of maternal health if solutions are not forthcoming, showing in many cases that younger women are experiencing poor outcomes at higher rates than earlier generations.
Here are a few of the key insights:
- The mental health crisis is worsening, and it is disproportionately targeting young women. According to the report, the prevalence of mental health distress increased by 18% -- a larger increase than last year's findings at 16%. Broken down by age group, the prevalence of mental health issues was 1.6 times higher among women ages 18-24 (29.4%) than those ages 35-44 (18.7%). To put that in a maternal health perspective: these rates show that the newest generation of mothers is at higher risk than ever from issues that already account for 1 out of 5 maternal deaths.
- Severe maternal morbidity (SMM), which includes serious and potentially life-threatening outcomes such as eclampsia, increased by 14% across all demographics. Although the highest incidents of SMM were in women age 35 and older (increasing from 127.9 per 10K births in 2020 to 142.7 in 2021), the greatest percentage increase occurred in women age 20 to 24, increasing by 15% from 2020 to 2021 (72.3 to 83.2).
- Additionally, the reports show that about 25% of women across the U.S. -- 1 out of 4 -- receive inadequate prenatal care, which is one of the most significant indicators of short and long-term health outcomes for women and children.
- Despite positive gains across some socioeconomic measures such as poverty and severe housing burden, disparities persisted and worsened for some of the most vulnerable, when stratified by education level and race/ethnicity.
Opportunities for Improvement
These reports and others from UHF provide an invaluable service, synthesizing publicly available population health data into actionable insights for stakeholders. They are extremely comprehensive: according to the website for America's Health Rankings (AHR), the reports pull data from over 80 publicly available databases and surveys, including the American Community Survey conducted by the U.S. Census Bureau, CDC's WONDER Online Database, the National Survey on Drug Use and Health (NSDUH), and the Pregnancy Risk Assessment Monitoring System (PRAMS).
However, even in their wide scope they highlight limitations -- most significantly around the postpartum period. Notably, there is no data available for postpartum visit attendance or postpartum depression. More than half of maternal deaths occur in the postpartum period, but this critical time period continues to be a black box for data collection.
Some sample sizes were too small to make reliable claims, and many of AHR's insights are tied to the measures determined on an individual state level, which vary widely.
These limitations reveal a need for standardized reporting measures across states, and some have called for a National Obstetrics Registry to better inform maternal health priorities. Digital health solutions can play a significant role in that aim -- if stakeholders can learn how to leverage the data collection infrastructure already at play, there is opportunity to gain a clearer picture of national maternal health trends and address critical needs.
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