December 3, 2019

Chicago Department of Public Health Releases First Maternal Morbidity and Mortality Report Showing Stark Health Disparities

Data provides City and its community and health partners new insight into areas of disparate impact; informs next steps toward addressing barriers to care for those most in need

Elena Ivanova    elena.ivanova@cityofchicago.org

CHICAGO – The Chicago Department of Public Health (CDPH) today released a new report, Maternal Morbidity & Mortality In Chicago, which is its first such assessment providing data on severe maternal morbidity (severe pregnancy complications) and pregnancy-associated mortality (death), along with specific rates by demographic subgroups. The report found that in Chicago, consistent with national and state trends, non-Hispanic Black women and women living in communities with higher economic hardship bear the largest burden of maternal morbidity and pregnancy-associated mortality

To address the disparities revealed in the report, the City is working with community partners to ensure that all expectant mothers, regardless of their race or where they live, have access to the care they need to have healthy pregnancies. One such effort is Family Connects Chicago, announced last month by Mayor Lori E. Lightfoot, a program designed to ensure mothers and newborns receive the support they need to grow and thrive.

“Maternal health outcomes are a critical marker of the health of our city. The racial and socioeconomic disparities highlighted in this report are a call to action for us,” said Mayor Lori E. Lightfoot. “In partnership with local healthcare providers, community organizations, and policy makers, we are working to increase access to care and address the historical social and economic barriers that have contributed to creating these disparities.”

In developing the Maternal Morbidity & Mortality in Chicago report, CDPH utilized data provided by the Illinois Department of Public Health (IDPH), as well as support from the IDPH Maternal Child Health federal grant. Some important findings in the report:

  • In 2016-2017, the severe maternal morbidity rate for non-Hispanic Black women in Chicago was over 2.5 times higher than for non-Hispanic White women, and about twice as high as Latinas or non-Hispanic Asian/Pacific Islander women.
  • From 2011 to 2016, the pregnancy-associated mortality rate in Chicago was almost six times higher for non-Hispanic Black women compared to non-Hispanic White women; and two times higher for Latina women than non-Hispanic White women.

In addition to racial-ethnic disparities, those living in communities with greater economic hardship (i.e., difficult economic conditions based on factors such as housing, income, unemployment, and education level) are disproportionately affected by severe maternal morbidity and pregnancy-associated mortality. The report also concludes that access to prenatal care is important for maternal health outcomes, which in turn is important for the health of infants.

  • In 2011-2016, among the women who experienced a pregnancy-associated death, 84% received some prenatal care, which is significantly lower than the percentage of all Chicago births (96%).
  • In 2011-2016, the percentage of births that were preterm (37%) and low birth weight (33%) was significantly higher among women who experienced pregnancy-associated mortality than among all births in Chicago, 11% and 10% respectively.

“In public health, we are committed to making data-informed decisions, and this report will help us ensure that we allocate valuable resources and expertise to where they are needed most,” said CDPH Acting Commissioner Allison Arwady, MD, MPH.

Arwady said that by analyzing and sharing these data, CDPH seeks to provide new insights and useful information to partners in the larger public health system who are working with the City to develop the programs, policies and systems needed to improve maternal health for all Chicago women.

“The findings of this report underscore CDPH’s mission to promote and improve health by engaging residents, communities and stakeholders in establishing services and policies that prioritize residents with the greatest need, and our shared vision for health equity,” Arwady said.

The City and its many partners are already taking steps to improve maternal and infant health outcomes. Last month, Mayor Lightfoot and CDPH launched Family Connects Chicago, a service designed to support the health and wellbeing of mothers, newborns and their families by providing postpartum home visits with registered nurses at no cost. The service, which is being piloted at four Chicago birthing hospitals, will also connect new mothers to community resources as needed. IDPH has provided almost $5 million to CDPH to help support the program.

“We are proud to partner with Chicago on bold steps, such as Family Connects, to reduce disparities and improve the health and wellbeing of mothers and infants,” said Ngozi Ezike, MD, Director of the Illinois Department of Public Health. “We are committed to efforts that ensure every mom and baby in Illinois receive the care and support they need through partnerships with local health departments and stakeholders in the healthcare system. Our hope is to obtain additional funding to duplicate the Family Connects Chicago program across the state.”

Family Connects Chicago is just one of many initiatives from the public health system and its community partners dedicated to improving maternal and infant health outcomes. Others include, but are not limited to:

  • Chicago Collaborative for Maternal Health – a quality improvement collaborative to improve care in outpatient clinics; a community engagement campaign to increase awareness and empower women and families; and a policy agenda based on findings of the initiative.
  • West Side United Maternal Child Health Workgroup – a workgroup that aims to improve maternal health outcomes by developing interventions across care settings on Chicago’s West Side.
  • Best Babies Zone – a resident driven, place-based initiative focused on reducing racial disparities in infant mortality in East Garfield Park.
  • UIC Healthy Start – a program to address infant and maternal health disparities in Auburn Gresham, South Shore and Englewood through case management support for health, education, employment and removal of barriers.
  • ACCESS Westside Healthy Start - an intensive case management program integrated into a medical home to reduce infant mortality and low birth weight focused on at-risk women in Austin, East and West Garfield Park, Humboldt Park and North Lawndale.
  • I PROMOTE-IL - a multi-faceted initiative addressing maternal health, morbidity and mortality through improved methods for collecting data, training for health care providers and design and implementation of a first-of-its-kind, two-generation postpartum clinic at UIC.

“From providing prenatal nutrition and education support, to expanding home visiting services for moms and babies, CDPH is working with our partners to improve maternal health, particularly among our most vulnerable populations,” said Dr. Arwady. “And we are committed to continuing to work with IDPH and others to ensure that these interventions and investments have a positive impact.”

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