Disparities in maternal and infant health

For the brief, researchers analyzed 14 measures associated with maternal and infant health. The measures reflected the model used in the America's Health Rankings, as well as the World Health Organization's definition of health. Data was taken from publicly available sources, including HHS, CDC, the U.S. Census Bureau, and the March of Dimes.

According to the brief, severe maternal morbidity was two times higher among Black mothers (139 per 10,000) than white mothers (69.9 per 10,000). Maternal morbidity among Black mothers was also 1.5 times higher than Hispanic mothers (94.6 per 10,000).

Black and American Indian/Alaska Native people also had the highest maternal mortality rates among all racial and ethnic groups at 51.3 deaths and 60.6 deaths per 100,000 live births, respectively. Only Asian and multiracial people met the Healthy People 2030 target of a maternal mortality rate of 15.7 deaths per 100,000 live births or less. 

There were also significant disparities when it came to infant mortality rates. Infants born to Black mothers had mortality rates that were 2.9 times higher than those born to Asian mothers between 2018 and 2021. Infants born to Black mothers also had mortality rates that were 2.4 times higher than those born to white mothers and 2.2 times higher than those born to Hispanic mothers.

Only Asian, white, and Hispanic groups met the Healthy People 2030 target of five infant deaths per 1,000 live births or less. 

However, there were some positive infant mortality trends among certain racial groups. For example, infant mortality rates improved by 15% among infants born to white mothers, 12% among black infants, and 9% among Hispanic infants.

Ways to address maternal health disparities

The brief highlighted some potential solutions to help address maternal health disparities.

For example, the United Health Foundation and Church Avenue Merchant Block Association launched a three-year, $3 million grant partnership in 2020 to increase access to prenatal care for underserved and unhoused individuals in Brooklyn.

So far, the partnership has helped over 475 pregnant people with care management plans, and 430 individuals received education about family health topics. In addition, 24% were connected to doulas or midwives.

Separately, the UnitedHealthcare Catalyst program has partnered with the Samuel U. Rodgers Health Center and Northland Health Care Access to address maternal and infant health disparities. Between 2020 and 2023, the program reported a 52% increase in engagement with postpartum care and a 66% decrease in the prevalence of low birth weight.

"Leveraging public health data and insights is vital to identifying and prioritizing the most critical health challenges to maternal and infant health. The America's Health Rankings platform helps us in addressing chronic conditions, reducing health disparities and promoting preventive care, ensuring our efforts are targeted, evidence-based and impactful," said Lisa Saul, national medical director of maternal child health at UnitedHealthcare. "Only through united, determined action can we effectively tackle and ensure a healthier future for all."

Advisory Board's maternal health and health equity resources

For more insights on maternal health and health equity, check out these Advisory Board resources:

Read our take on how to address the root causes of maternal health inequity. Similarly, this research outlines five steps to take to improve women's health and well-being.

Health plans are also making efforts to improve maternal health and reduce disparities. This research outlines health plans' top three maternal health priorities, including expanding reimbursement for midwives and doulas, increasing postpartum coverage, and implementing new technological tools.

Organizations interested in launching their own midwifery programs can also leverage this white paper, which outlines key tactics and explains how to overcome common implementation challenges. We also offer a cheat sheet on postpartum depression care.

For a broader look at maternal health in America, this Radio Advisory episode discusses key drivers of poor maternal health outcomes and explains why there needs to be a massive shift in how the healthcare industry thinks about maternal health going forward. (UnitedHealth Group news release, 8/27; Lagasse, Healthcare Finance, 8/28; Maternal and Infant Health Disparities Data Brief, accessed 8/29)

*Advisory Board is a subsidiary of Optum, a division of UnitedHealth Group. All Advisory Board research, expert perspectives, and recommendations remain independent.