Office of Women's Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Office of Minority Health and Health Equity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Womens Health (Larchmt). 2022 Sep;31(9):1222-1231. doi: 10.1089/jwh.2022.0336.
There has been increasing national attention to the issue of racial disparities in pregnancy-related deaths. Federal legislation can support approaches at multiple levels of intervention to improve maternal health. As part of the CDC Policy Academy, a team of CDC staff completed a policy analysis to determine the approaches addressed in federal legislation to reduce racial disparities in pregnancy-related deaths. We analyzed federal maternal mortality legislation introduced January 2017 through December 2021. Common approaches addressed by the legislation were categorized into themes and reviewed for their alignment with approaches identified in clinical and public health literature to reduce pregnancy-related deaths, with an emphasis on social determinants of health (SDOH) approaches and reducing racial disparities. Thirty-seven unduplicated bills addressed pregnancy-related deaths, including 27 House or Senate bills that were introduced but not passed, 6 resolutions highlighting the maternal health crisis, 2 bills that passed the House only, and 2 bills enacted into law (Preventing Maternal Deaths Act of 2018 and Protecting Moms Who Served Act). The most common themes mentioned in federal legislation were improving maternal health care, addressing health inequities and SDOH, enhancing data, and promoting women's health. Legislation focused on health inequities and SDOH emphasized implicit bias training and improving SDOH, including racism and other social factors. The reviewed federal legislation reflected common clinical and public health approaches to prevent pregnancy-related deaths, including a significant focus on reducing bias and improving SDOH to address racial disparities.
全国越来越关注妊娠相关死亡中的种族差异问题。联邦立法可以支持在多个干预层面采取措施,以改善孕产妇健康。作为疾病预防控制中心政策学院的一部分,一组疾病预防控制中心的工作人员完成了一项政策分析,以确定联邦立法中为减少妊娠相关死亡中的种族差异而采取的措施。我们分析了 2017 年 1 月至 2021 年 12 月期间提出的联邦孕产妇死亡率立法。立法中涉及的常见措施被归类为主题,并根据临床和公共卫生文献中为减少妊娠相关死亡而确定的措施进行了审查,重点是社会决定因素(SDOH)措施和减少种族差异。有 37 项不重复的法案涉及妊娠相关死亡问题,其中包括 27 项众议院或参议院法案,这些法案已经提出但未获得通过,6 项决议强调了孕产妇健康危机,2 项仅在众议院获得通过的法案,以及 2 项颁布为法律的法案(2018 年预防孕产妇死亡法案和保护服役母亲法案)。联邦立法中提到的最常见主题是改善孕产妇保健、解决健康不平等和 SDOH、加强数据和促进妇女健康。针对健康不平等和 SDOH 的立法强调了隐性偏见培训和改善 SDOH,包括种族主义和其他社会因素。审查的联邦立法反映了预防妊娠相关死亡的常见临床和公共卫生方法,包括高度关注减少偏见和改善 SDOH 以解决种族差异。