HEALTH EQUITY and MOMS WITH MONITORS!!
by N. Gau
As many of you may recall, at the onset of the COVIS pandemic in March of 2020, the 2 Cochairs of the Healthcare Issue Group (N. Gau and Dr. Brent Schillinger) teamed up with our then President (Ken Thomas) to begin weekly COVID updates for our members, via Zoom. Dr. Schillinger would begin with a medical update, providing a plethora of information using local and state DOH data and statistics. Then we would feature a guest speaker on a variety of topics, including infection control, mental health, emergency response, etc. One of the topics (health disparities) particularly stood out for me and Brent as well. Over the years as Healthcare Chair, this was a topic that I took great interest in. A PowerPoint that we developed years ago, with the assistance of other team members, including Dr. Joe Goldberg and Dr. Ethelene Jones, included slides that revealed disparities in medical outcomes for minorities including cardiovascular disease, diabetes, infant mortality, etc. These disparities quickly became apparent with COVID as well. At the same time, I began to see many articles in the media about maternal mortality, namely that women of color had a 3-4% higher rate of death during pregnancy or delivery, or postpartum, as compared to white women. When I became Chair of the state (LWVFL) Maternal Equity Subcommittee (under Report Rights) we began studying this topic at large. This research amidst the pandemic lockdown made me realize that these high-risk women would fare even poorer. After many months of calls, we were able to secure two strong, local partners-T. Leroy Jefferson Medical Society and Healthy Mothers/Healthy Babies. After several months of Zoom meetings with Laurel Dalton, Dr. Colette Brown-Graham, Michelle Gonzales, Emilie McKendall and others, we kicked off our Moms With Monitors program on April 12, 2021. Due to COVID, the event was virtual but was a huge success, with recorded presentations by TLJ OB/Gyns, and presentations on nutrition, exercise, etc. and Healthy Mothers/Healthy Babies announced the donation of 60 blood pressure monitors. (We researched many devices and the TLJ physicians made the final choice.) These same physicians then began to interview and select the first 39 patients. Each was given a monitor with lengthy, detailed instructions and reporting materials. By August of 2022, 38 of the Moms had delivered. (There was 1 fetal demise.) TLJ hired a consultant to analyze the data, which resulted in a preliminary report (“The Dawn of a New Age”) written by TLJ’s Dr. Patricia Sherron, as follows:
“-Maternal death rate in the U.S. is 17.4 per 100,000 pregnancies. In Norway, Netherlands, & New Zealand it is less than 3!
-The Black maternal mortality rate in the U.S. is 41.7 deaths/100,000.
-CDC statistics from 2014-2017 on the cause of maternal deaths:
- 6.6/100,000 from hypertensive disorder
- 8.2/100,000 from cerebral vascular accidents
- 11.5/100,000 from Cardiomyopathy
-Patients in our study: 39 hypertensive gravid women. 24/39 were Black and 14/39 were Hispanic/White.
-59% recorded a BP log. 52% of those revealed persistent hypertension.
-4 patients demonstrated good BP control. Others were normalized with medication or diet. These patients did NOT get pre-eclampsia or deliver prematurely.
-Dr. Sherron’s conclusion: “Health disparity is caused by many factors and one of them is lack of home equipment to help monitor silent killers like HBP. Our study showed that home measurement of BP by hypertensive mothers, accompanied by healthy eating and perinatal specialist management helped ID mothers who were at risk for pre-eclampsia, stroke, fetal demise, and prematurity.”
TLJ is currently in the process of identifying the next group of patients. Due to an issue with compliance in the first group, we tweaked the process, with the hope of even better outcomes for these new mothers. Even though we are no longer directly involved, we continue to work with these two amazing partners, with ongoing updates on MWM and with legislative advocacy, e.g., in 2021 we worked together to successfully support the expansion of Medicaid postpartum coverage from 8 weeks to a full year.
We are proud to share that our project is spreading. Our LWV Healthcare colleagues in Polk County just kicked off their MWM program, partnering with their local March of Dimes and their county DOH Health Equity liaison. Broward County may be next!!
