Health Equity, Maternal & Rural Health, & COVID-19

Maternal Health and COVID-19

The COVID-19 pandemic is exacerbating concerns about maternal health in the United States, which has the highest maternal mortality rate of industrialized countries and is the only nation where the rate is rising. New studies highlight the pandemic’s impact on the physical and mental health of pregnant individuals.

• Black Maternal Mortality: Black women are three times more likely to die from pregnancy-related causes than White women. President Biden released a proclamation for Black Maternal Health Week, calling for recognition of the crisis of Black maternal mortality and morbidity.
• Policy Efforts: The U.S. Department of Health and Human Services announced plans to expand access to health care coverage and preventative care in rural areas to improve maternal health outcomes. Additionally, eight states joined the National Academy for State Health Policy’s academy aimed at improving access to quality care for Medicaid-eligible pregnant and parenting women.
• COVID-19: New research reports that pregnant people are at increased risk for severe illness from COVID-19. Fortunately, preliminary data does not indicate any vaccine safety concerns for pregnant persons and their babies. New research also shows that vaccinated mothers pass along anti-COVID-19 antibodies when they breastfeed.

Initiatives and Resources:

• The Centers for Disease Control and Prevention (CDC) has resources to combat maternal mortality through messaging, prevention, surveillance and state initiatives.
• The Blue Cross Blue Shield Association announced its National Health Equity Strategy, setting a goal to reduce racial disparities in maternal health by 50%.
• Doulas and midwives are a crucial, yet often unaffordable, resource in addressing postpartum depression for Black families.

Racism, Inequity and Public Health

The Director of the CDC, Rochelle Wallensky, MD, has announced that “racism is a serious threat to the public’s health.” She is calling on health leaders to “lean in and join her” in addressing the problem. Her statement comes as organizations nationwide are taking on the issue:

• Environmental Health: The American Lung Association’s 2021 State of the Air analysis reports people of color are “over three times more likely than whites” to be exposed to polluted air.
• Health Care: An Urban Institute analysis found Black adults were more likely to report discrimination in health care settings than White or Latino adults.
• Violence: The U.S. Senate passed an anti-hate crime bill to combat the current wave of violence against Asian Americans.

Initiatives and Resources:

• Anthem is working to eliminate health disparities by providing valuable resources to Black and Latino communities through the organization’s new Take Action and Taking Action websites.
• The Center for Health Journalism produced a webinar, “What Anti-Asian Hate Means for Mental Health, Safety and Justice.”
• Blue Cross and Blue Shield of Illinois has launched #VaccTogether, a campaign to boost COVID-19 vaccine access and education with a focus on seniors and the communities hardest hit by the pandemic.
• The Commonwealth Fund's The Dose podcast reports on the dual pandemic of COVID-19 and racism for Asian Americans.

Addressing the Social Determinants of Health

Initiatives and Resources:

• Mental Health: New Medicaid funding will support mental health crisis teams that will stand in for police. In the wake of George Floyd’s death, this is an attempt at a healthier and more equitable approach to helping people living with mental health issues in emergency situations.
• Non-Medical Drivers of Health: Blue Cross and Blue Shield of North Carolina is ramping up efforts to address factors that have a powerful impact on health and well-being, including access to healthy food and transportation.
• Food Insecurity: The BlueCross BlueShield of South Carolina Foundation is supporting the SC Roadmap to Food Security Learning Collaborative, a partnership of community-based organizations and medical providers that have come together to “forge new pathways toward creating greater food security for South Carolinians.”
• Equity: Anthem has “committed $2.45M over three years to increase equitable food access and food security in one Indianapolis community, with the goal of uncovering insights that could be applied more broadly.”
• Housing Insecurity: The Urban Institute has mapped the neighborhoods where low-income renters face the greatest risk of housing instability to help the community create the most equitable responses to COVID-19.

Rural Health and Vaccine Uptake

Rural America - with an older, sicker and poorer population - has faced significant health challenges and the coronavirus was no exception. Now, with the vaccination rollout well underway, many rural Americans remain reluctant to get the vaccine.

• Vaccine Hesitancy: Isolated pockets of low uptake could create little islands where the virus remains rampant. Experts are calling for targeted strategies to address vaccine hesitancy and renewed attention to the historical health challenges facing these communities.
• Rural Teens: A Kaiser Health News report discusses how the Pfizer vaccine is the only vaccine that has been approved for older teens and outlines the distribution challenges in rural America.

Initiatives & Resources:

• KFF’s COVID-19 Vaccine Monitor - Rural America dashboard outlines how the pandemic has impacted rural communities in the U.S. and provides an updated look at vaccine enthusiasm.
• The Public Health Communications Collaborative hosted a webinar on successful COVID-19 messaging in rural communities and released a list of tough questions on COVID-19, including on the J&J pause.
• Premera Blue Cross is investing $2.24 million through a partnership with the Washington State Department of Commerce to increase rural mental health crisis care capacity.
• Tradeoffs podcast released a new episode on how one rural town in Kansas dealt with losing its only hospital in an interview with Sarah Jane Tribble.
• The New York Times reported on the complexity of vaccine hesitancy in rural America.

COVID-19 Updates: Long-Haulers, India and Vaccines

As vaccinations wind down in the U.S., some countries are experiencing their worst death tolls from COVID-19 yet. New data reports on the global nature of the pandemic, concerns about the gap in vaccine access, and the experiences of long-haul COVID-19 patients.

• India: The U.S. pledged aid to India, where COVID-19 is overwhelming hospitals and running short of oxygen. India is the largest producer of COVID-19 vaccines, but only 1.4% of the population is vaccinated. High-income countries have secured 50% of the COVID-19 vaccine supply but are home to only 16% of the world’s population.
• Long-Haul COVID-19: Doctors are working to understand people's experiences with debilitating symptoms that linger after their initial COVID-19 infection. Thousands of COVID-19 long haulers have struggled to receive medical care for their symptoms.
• Vaccines: Almost 8% of people who received their initial Pfizer or Moderna shots missed their second doses, leaving them vulnerable to variants. According to Kaiser Health News, CVS and Walgreens have wasted more vaccine doses than states and federal agencies.

Resources:

• Learn about long COVID in this webinar “The Long Covid Nightmare” by NIHCM grantee the USC Annenberg Center for Health Journalism Digital.
• The new CDC mask guidance has raised a lot of confusion. Learn about experts’ concerns about the guidance, such as not being able to distinguish who is vaccinated, as more people unmask.