New data from the Centers for Disease Control and Prevention show another increase in the nation's maternal mortality rate, and a Minnesota expert says there are several underlying factors.
The report, released last week, covers data from 2021. That year, deaths of pregnant women or new mothers in the U.S. went up by nearly 40% over the previous year.
The agency says it follows gradual increases leading up to the pandemic as well.
Dr. Stephen Contag is an associate professor in the Maternal-Fetal Medicine division at the University of Minnesota Medical School. He said improved reporting is playing a role.
But he added that there are other issues at play.
"Disparities in transportation," said Contag. "Getting to health care. Or differences in the number of obstetricians or health providers that can provide that care to patients in certain parts of the country."
The findings show that Black women are especially affected by this issue. The maternal mortality rate for this population rose by nearly 70%, compared with nearly 25% for white women.
Some health experts say COVID-19 likely played a role in the 2021 spike, and that the big jump may have peaked. But there's concern the other factors will keep pressure on these rates.
The maternal death disparities have been documented in Minnesota as well. Contag said he sees hope in reversing trends, including changing how the state's Maternal Mortality Review Committee works.
The panel is now operating under a mandate.
"Now that we have that mandate," said Contag, "it's much easier to obtain the information that we need to review these cases in a fair manner."
He suggested that will lead to more recommendations that get to the root causes of these deaths.
And earlier this year, a new Minnesota law took effect, expanding postnatal care by requiring public and private health plans to cover a series of care visits for up to 12 weeks after a baby is delivered.
Two of those visits would have to involve comprehensive care.
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Breast cancer is the leading cause of cancer death in Utah women.
According to the Utah Women and Leadership Project at Utah State University, Utah is among the three lowest-ranked states in the country for mammography screening rates in women aged 40 or older. According to the group, The Utah Department of Health and Human Services was unable to meet its goal of 76% of Utah women, aged 40 years and older, to be screened for breast cancer in 2020.
Chloe Bhowmick, clinical psychologist and research fellow for the Utah Women and Leadership Project, said a lot of the challenges inhibiting mammography rates are "financial and systemic."
"Having lack of insurance, not having insurance coverage through their job, not being able to get time off," Bhowmick outlined. "Those are all, I think, pretty important factors that we found or at least we surmised in being pretty significant."
Bhowmick noted other factors which have negatively affected screening rates include lack of affordable child care, discrepancies between mammography guidelines as well as varying levels of health literacy. Only 62.7% of Utah women aged 40 years and older reported having a mammogram in the last two years. The national average for U.S. women in the same group was 69%.
Bhowmick emphasized it is also important to not forget because of the COVID-19 pandemic, medical centers are still catching up on the backlog of mammography appointments, which can further delay preventive services.
Bhowmick added while the Beehive State is currently sitting 6.3% below the national average, local and state systems can take steps to increase screening rates, including having insurance systems building patient advisories into electronic record systems, tracking how often providers remind individuals of preventive care and employers implementing initiatives such as wellness programs and policies.
"I think having systems that support women, women will be able to both realize that this should be a priority with certain age groups, but also they have the freedom to go," Bhowmick explained.
The Utah Department of Health and Human Services has a goal of 81% of age-eligible Utah women receiving a mammogram by 2030. Bhowmick stressed education and advocacy from community groups can help the state reach its goal.
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To wrap up Women's Health Week, doctors are urging women to take stock of their mental health.
Dr. Sharon Eloranta, medical director at the Washington Health Alliance, said COVID-19 was hard for everyone and led to a drop in health screenings.
She said with the worst of the pandemic over, some women may need to consider how to prioritize their health.
"Women experienced more anxiety and stress during the time of the pandemic," said Eloranta, "and I think that may have been reflective of the fact that they worry not only about their own health, but about health of the people in their families and others. And that can be a hill to climb if you're trying to get back into taking good care of yourself."
For Women's Health Week - which runs through Saturday - the Centers for Disease Control and Prevention is asking women to schedule regular checkups, exercise and eat a healthy and balanced diet.
CDC data show a disturbing trend in mental health, with the rate of young girls saying they attempted suicide twice that of young boys.
Dr. Donna O'Shea, an OB/GYN and chief medical officer of Population Health at UnitedHealthcare, said parents need to be on the lookout for symptoms of depression and anxiety in adolescent girls.
"Especially after COVID," said O'Shea. "We found that 57% of high school girls have experienced persistent feelings of sadness in the last year. Ten years ago, that number was only 36%."
Eloranta said it's important for people to pay attention when they aren't feeling normal.
"'I'm just down, and nothing that usually makes me happy tends to change it.' Then that's time to reach out and try and find some support," said Eloranta. "And again, it can be through your employer, it can be through your primary care. You can always call a friend and see if they have any referrals for you to go and get some assistance."
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Two groups are working to create equal opportunities for Black and Latina women in the trucking industry.
The Truist Foundation has pledged $1.5 million to the Accion Opportunity Fund to support the Down Payment Assistance Program, which aims to empower minority women by helping them become first-time truck owners and entrepreneurs.
Luz Urrutia, CEO of the Accion Opportunity Fund, said the step is crucial in bridging the equity gap for underrepresented groups.
"America is in the midst of an entrepreneur boom with record numbers of small businesses, and they're led by women and people of color," Urrutia pointed out. "At the same time, there is a $130 million financing gap for small businesses who need less than $100,000 in this country."
Urrutia noted since 2010, Accion Opportunity Fund has invested $360 million in the trucking industry, providing crucial support to more than 6,000 first-time truck buyers through loans.
Nicole Ward, president of the African American Women Trucking Association and a trucking entrepreneur from Georgia, has firsthand experience with the challenges faced by women of color breaking into the trucking industry.
Despite encountering setbacks when trying to purchase her first truck, Ward persevered and now advocates for others in her community to do the same.
"I thought it would be as easy as purchasing a car, but I didn't realize that entering the industry you are looked at as a weaker link because it's a male-dominated industry," Ward explained. "Instead of jumping into the transportation industry I had to crawl in because I didn't have a certain financial support that was needed."
Ward hopes the Accion Opportunity Fund Program sets a precedent for other financial institutions in ensuring equitable access to funding for entrepreneurs of color.
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