Armstrong-Mensah Elizabeth, Dada Damilola, Bowers Amber, Muhammad Aruba, Nnoli Chisom
Georgia State University, School of Public Health, Atlanta, Georgia 30303, USA.
Int J MCH AIDS. 2021;10(2):278-286. doi: 10.21106/ijma.524. Epub 2021 Dec 13.
Over the past decade, the United States has been taking steps to reduce its rising maternal mortality rate. However, these steps have yet to produce positive results in the state of Georgia, which tops the list of all 50 states with the highest maternal mortality rate of 46.2 maternal deaths per 100,000 live births for all women, and a maternal mortality rate of 66.6 deaths per 100,000 live births for African American women. In Georgia, several social determinants of health such as the physical environment, economic stability, health care access, and the quality of maternal care contribute to the high maternal mortality rate. Addressing these determinants will help to reduce the state's maternal mortality rate. This commentary discusses the relationship between social determinants of health and maternal mortality rates in Georgia. It also proposes strategies for reversing the trend. We conducted an ecological study of the relationship between social determinants of health and maternal mortality in Georgia. We searched PubMed and Google Scholar and reviewed 80 English articles published between 2005 and 2021. We identified five key social determinants associated with high maternal mortality rates in Georgia - geographic location of obstetric services, access to health care providers, socioeconomic status, racism, and discrimination. We found that expanding Medicaid coverage, reducing maternal health care disparities among the races, providing access to maternal care for women in rural areas, and training a culturally competent health workforce, will help to reduce Georgia's high maternal mortality rate.
在过去十年中,美国一直在采取措施降低其不断上升的孕产妇死亡率。然而,在佐治亚州,这些措施尚未产生积极效果。佐治亚州在全美50个州中孕产妇死亡率最高,所有女性的孕产妇死亡率为每10万例活产中有46.2例孕产妇死亡,非裔美国女性的孕产妇死亡率为每10万例活产中有66.6例死亡。在佐治亚州,一些健康的社会决定因素,如物理环境、经济稳定性、医疗保健可及性和孕产妇护理质量,导致了高孕产妇死亡率。解决这些决定因素将有助于降低该州的孕产妇死亡率。本评论讨论了佐治亚州健康的社会决定因素与孕产妇死亡率之间的关系。它还提出了扭转这一趋势的策略。我们对佐治亚州健康的社会决定因素与孕产妇死亡率之间的关系进行了一项生态研究。我们在PubMed和谷歌学术上进行了搜索,并查阅了2005年至2021年发表的80篇英文文章。我们确定了与佐治亚州高孕产妇死亡率相关的五个关键社会决定因素——产科服务的地理位置、获得医疗保健提供者的机会、社会经济地位、种族主义和歧视。我们发现,扩大医疗补助覆盖范围、减少不同种族之间的孕产妇医疗保健差距、为农村地区的妇女提供孕产妇护理服务,以及培训一支具备文化能力的卫生工作队伍,将有助于降低佐治亚州高孕产妇死亡率。