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A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020

Background: Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due to programs and policies available to pregnant people. In Massachusetts, Black women were approximately twice as likely...

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Autores principales: Carvalho, Keri, Kheyfets, Anna, Maleki, Pegah, Miller, Brenna, Abouhala, Siwaar, Anwar, Eimaan, Amutah-Onukagha, Ndidiamaka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8566737/
https://www.ncbi.nlm.nih.gov/pubmed/34746071
http://dx.doi.org/10.3389/fpubh.2021.664659
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author Carvalho, Keri
Kheyfets, Anna
Maleki, Pegah
Miller, Brenna
Abouhala, Siwaar
Anwar, Eimaan
Amutah-Onukagha, Ndidiamaka
author_facet Carvalho, Keri
Kheyfets, Anna
Maleki, Pegah
Miller, Brenna
Abouhala, Siwaar
Anwar, Eimaan
Amutah-Onukagha, Ndidiamaka
author_sort Carvalho, Keri
collection PubMed
description Background: Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due to programs and policies available to pregnant people. In Massachusetts, Black women were approximately twice as likely as white women to experience pregnancy-associated mortality, with a large percentage of these deaths reported to be preventable (3). Methods: Using Massachusetts as a state-level comparison to national policies, we searched the US Congress and Massachusetts legislative databases for maternal health policies from 2010 to 2020. We screened 1,421 national and 360 Massachusetts bills, following set inclusion/exclusion criteria. Data analysis included (1) assessment of bill characteristics, (2) thematic analysis, and a (3) quality appraisal following an adapted model of the analytical framework for evaluating public health policy proposed by the National Collaborating Centre for Healthy Public Policy. Additionally, our data analysis identified the level of racism (internalized, interpersonal or institutional) that each policy addressed. Results: From 2010 to 2020, 31 national and 16 state-level policies were proposed that address maternal health and racial disparities. The majority of policies addressed racism at the institutional level alone (National: N = 19, 61.3%, Massachusetts: N = 14, 87.5%). Two national and two Massachusetts-level policies became law, while two national policies passed only the House of Representatives. Our critical appraisal revealed that the majority of unintended effects would be neutral or positive, however, some potential negative unintended effects were identified. The appraisal also identified 54.8% (n = 17) of national policies and 68.8% (n = 11) of Massachusetts with positive impact on health equity. Conclusions: There has been an increase in policies proposed addressing racial disparities and health equity in maternal health over the last 10 years. Although half of national policies proposed showed positive impact on health equity, shedding light on the work the U.S. is doing on a federal level to confront the Black maternal health crisis, only two policies made it to law, only one of which addressed racial disparities directly and had a positive impact on health equity.
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spelling pubmed-85667372021-11-05 A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020 Carvalho, Keri Kheyfets, Anna Maleki, Pegah Miller, Brenna Abouhala, Siwaar Anwar, Eimaan Amutah-Onukagha, Ndidiamaka Front Public Health Public Health Background: Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due to programs and policies available to pregnant people. In Massachusetts, Black women were approximately twice as likely as white women to experience pregnancy-associated mortality, with a large percentage of these deaths reported to be preventable (3). Methods: Using Massachusetts as a state-level comparison to national policies, we searched the US Congress and Massachusetts legislative databases for maternal health policies from 2010 to 2020. We screened 1,421 national and 360 Massachusetts bills, following set inclusion/exclusion criteria. Data analysis included (1) assessment of bill characteristics, (2) thematic analysis, and a (3) quality appraisal following an adapted model of the analytical framework for evaluating public health policy proposed by the National Collaborating Centre for Healthy Public Policy. Additionally, our data analysis identified the level of racism (internalized, interpersonal or institutional) that each policy addressed. Results: From 2010 to 2020, 31 national and 16 state-level policies were proposed that address maternal health and racial disparities. The majority of policies addressed racism at the institutional level alone (National: N = 19, 61.3%, Massachusetts: N = 14, 87.5%). Two national and two Massachusetts-level policies became law, while two national policies passed only the House of Representatives. Our critical appraisal revealed that the majority of unintended effects would be neutral or positive, however, some potential negative unintended effects were identified. The appraisal also identified 54.8% (n = 17) of national policies and 68.8% (n = 11) of Massachusetts with positive impact on health equity. Conclusions: There has been an increase in policies proposed addressing racial disparities and health equity in maternal health over the last 10 years. Although half of national policies proposed showed positive impact on health equity, shedding light on the work the U.S. is doing on a federal level to confront the Black maternal health crisis, only two policies made it to law, only one of which addressed racial disparities directly and had a positive impact on health equity. Frontiers Media S.A. 2021-10-21 /pmc/articles/PMC8566737/ /pubmed/34746071 http://dx.doi.org/10.3389/fpubh.2021.664659 Text en Copyright © 2021 Carvalho, Kheyfets, Maleki, Miller, Abouhala, Anwar and Amutah-Onukagha. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Carvalho, Keri
Kheyfets, Anna
Maleki, Pegah
Miller, Brenna
Abouhala, Siwaar
Anwar, Eimaan
Amutah-Onukagha, Ndidiamaka
A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title_full A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title_fullStr A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title_full_unstemmed A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title_short A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020
title_sort systematic policy review of black maternal health-related policies proposed federally and in massachusetts: 2010–2020
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8566737/
https://www.ncbi.nlm.nih.gov/pubmed/34746071
http://dx.doi.org/10.3389/fpubh.2021.664659
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