YOU.
>> AN AVERAGE OF 75 WOMEN IN
ILLINOIS DIE EACH YEAR WHILE
PREGNANT OR WITHIN ONE YEAR OF
PREGNANCY.
THAT IS ACCORDING TO A REPORT ON
MA TERM MORE BITTY AND MORTALITY
>> MATERNAL MORE BITBIDITY AND
MORTALITY.
83% OF ALL PREGNANCY RELATED
DEATHS WERE POTENTIALLY
PREVENTIBLE AND THE REPORT
HIGHLIGHTED THE IMPACT OF
SYSTEMIC RACISM FINDING BLACK
WOMEN WERE THREE TIMES MORE
LIKELY TO DIE FROM A PREGNANCY
RELATED CONDITION THAN WHITE
WOMEN.
JOINING US ARE THE EXPERTS WHO
HELPED PUT THE REPORT TOGETHER.
SHANNON LIGHTNER OFFICE OF
WOMEN'S HEALTH AND FAMILY
SERVICES AND Dr. ROBIN JONES.
JONES IS AN OBSTETRICIAN AT RUSH
UNIVERSITY MEDICAL CENTER THANK
YOU FOR JOINING US.
SHANNON LET'S START WITH YOU,
PLEASE, I WANT TO CLARIFY THE
DISTINCTION BETWEEN PREGNANCY
ASSOCIATED DEATHS AND PREGNANCY
RELATED DEATHS BECAUSE YOU
ANALYZE BOTH WHAT IS THAT
DIFFERENCE PLEASE?
>> PREGNANCY ASSOCIATED MEANS
THE DEATH OF A WOMAN WHO IS
PREGNANT OR ONE YEAR POST PAR
TESTIMONY FROM ANY CASE.
PREGNANCY RELATED IS THE DEATH
OF A WOMAN WHOSE DEATH IS
DIRECTLY RELATED TO A PREGNANCY.
IN OTHER WORDS WE ASK WOULD SHE
DIED HAD SHE NOT BEEN PREGNANT.
>> AMONG THE KEY FINDINGS OF THE
REPORT 34% OF WOMEN WHO DIED
EITHER WHILE PREGNANT OR WITHIN
A YEAR OF PREGNANCY DIED FROM A
PREGNANCY RELATED CAUSE.
OF THOSE WOMEN 40% HAD MENTAL
HEALTH ISSUE.
BLACK WOMEN ARE THREE TIMES MORE
LIKELY TO DIE THAN WHITE WOMEN
OF A PREGNANCY RELATED ISSUE AND
WOMEN ON MEDICAID WERE THREE
TIMES MORE LIKELY TO DIE WITHIN
ONE YEAR OF PREGNANCY.
Dr. JONES HELP US TO
UNDERSTAND THOSE NUMBERS,
PLEASE?
AND WHAT CLEAR DISPARITIES DO
YOU SEE THERE?
>> THANK YOU.
LET ME START BY SAYING THAT
BLACK WOMEN ARE MORE LIKELY TO
DIE FROM A PREGNANCY RELATED
MEDICAL THAN WHITE WOMEN.
WHITE WOMEN ARE MORE LIKELY TO
CAUSE TO DIE FROM A MENTAL
HEALTH CAUSE THAN BLACK OR
HISPANIC WOMEN.
AND WHEN YOU LOOK AT THE CAUSES
OF DEATH THE TOP FOUR INCLUDE
MELODIES ORDERS MENTAL HEALTH
DISORDERS, PREEXISTING DISEASE,
AND HYPERTENSION.
BUT UNDERSTAND THAT WE KNOW THAT
THERE ARE OTHER FACTORS THAT
CONTRIBUTE TO THE DEATHS OF
THESE WOMEN.
PARTICULARLY BLACK WOMEN.
>> OK.
AND I THINK WE WILL COME BACK TO
SOME OF THOSE AS WELL.
SHANNON LIGHTNER THE REPORT
ESTIMATED THAT 83% OF PREGNANCY
RELATED DEATHS COULD HAVE BEEN
PREVENTED.
WHY ARE WE AS A SOCIETY FAILING
THOSE WOMEN?
WHY WEREN'T THEY PREVENTED?
>> ONE THING TO CLARIFY IS WHEN
WE DETERMINE A CASE TO BE
PREVENTIBLE, WE MEAN THAT THERE
WAS SOME CHANCE THAT THE DEATH
COULD HAVE BEEN AVOIDED IF
REASONABLE CHANGES COULD HAVE
BEEN MADE, THE PROVIDER OR
HOSPITAL SYSTEMS OR PATIENT
LEVELS AND IT'S IMPORTANT TO
RECOGNIZE AMONG THE DEATHS THE
CHANCE OF PREVENTING THAT DEATH
CAN RANGE FROM A GOOD CHANCE TO
A SLIGHT CHANCE AND THE FACTORS
THAT CONTRIBUTE TO EACH GREAT
GREATLY INFLUENCE THE CHANCE OF
PREVENTABILITY.
SOME OF THE CASES WE SEE
SOCIETAL FACTORS.
BARRIERS TO CARE, CHILDCARE,
TRANSPORTATION, LACK OF ACCESS
TO CARE AND SOMETIMES WE SEE
POOR QUALITY OF CARE.
IT REALLY DOES DEPEND ON EACH
SITUATION, EACH CASE AND THE
NUMBER OF FACTORS THAT COULD
HAVE BEEN PLAYING A ROLE.
>> A NUMBER OF FACTORS NOT ALL
ARE NECESSARILY WITHIN THE
HEALTHCARE SETTING?
>> CORRECT.
>> OK.
Dr. JONES, THIS IS THE SECOND
STATE REPORT ON MATERNAL
MORBIDITY AND MORTALITY THE
FIRST FOUND THAT BLACK WOMEN
WERE SIX TIMES MORE LIKELY TO
DIE OF A PREGNANCY RELATED
CONDITION THAN WHITE WOMEN.
THE GAP HAS SHRUNK BUT YOU ARE
SAYING IT IS NOT EXACTLY A SIGN
OF PROGRESS.
WHY NOT?
>> WELL, LIKE I SAID, WE HAVE
PARTNERED WITH THE CDC AND
LOOKING AT FACTORS OTHER THAN OR
IN ADDITION TO MEDICAL FACTORS.
SO WE'RE LOOKING AT SOCIAL
DETERMINANTS OF HEALTH AND WE
ARE LOOKING AT STRUCTURAL
RACISM.
AND ACTUALLY THE CDC HAVE LED
THE WAY IN THIS WORK AND ACROSS
THE STATE THEY HAVE PROVIDED
STATES WITH THE LOOK AT FACTORS
SUCH AS DISCRIMINATION AND
INTERPERSONAL RACISM.
>> AND Dr. JONES YOU TALKED
ABOUT THE DISPARITIES THAT THE
REPORT IDENTIFIED AND THAT ROLE
OF SYSTEMIC RACISM.
EXPLAIN THE WAYS THAT SYSTEMIC
RACISM IS IMPACTING THE HEALTH
OF BLACK AND BROWN WOMEN?
>> WE HAVE STARTED OVER THE LAST
YEAR IN LOOKING AT SOCIAL
DETERMINANTS OF HEALTH.
AND UNTIL WE HAVE A BETTER
UNDERSTANDING OF HOW SOCIAL
DETERMINANTS OF HEALTH, POVERTY,
QUALITY EDUCATION, HEALTHY FOOD,
INCOME, HOW THAT ACTUALLY
AFFECTS A WOMAN'S HEALTH AND HER
ACCESS TO NEEDED HEALTHCARE, IT
DOESN'T HEALTHCARE DOESN'T EXIST
IN A SILO.
WE WILL HAVE TO ADDRESS THOSE
FACTORS AND UNDERSTAND THOSE
FACTORS AND THEN MAKE
RECOMMENDATIONS THAT WILL
ADDRESS THE SOCIAL DETERMINANTS
OF HEALTH.
BECAUSE THEY ARE DEFINITELY
IMPACTING WHAT WE'RE SEEING IN
OUR HEALTHCARE SYSTEM.
>> SHANNON, HOW WOULD YOU
COMPARE ILLINOIS TO OTHER STATES
ON THESE ISSUES?
>> I THINK THAT ILLINOIS IS
DEFINITELY A LEADER IN TRYING TO
UNDERSTAND MATERNAL MORTALITY
AND UNDERSTAND THE DRIVERS WHAT
IS LEADING MATERNAL MORTALITY
AND PUTTING RECOMMENDATIONS OUT
THERE.
OUR REPORT IS HELD UP AS AN
EXAMPLE FOR OTHER STATES TO LOOK
TO.
WE WERE THE FIRST STATE TO NAME
RACISM AS A CAUSE OF MATERNAL
MORTALITY AND DIVE INTO RACISM
IT IS A CONCRETE EXAMPLE HOW
STRUCTURAL RACISM CONTRIBUTES TO
MATERNAL MORTALITY.
I THINK WE ARE LEADING THE WAY
IN TRYING TO IDENTIFY THE CAUSES
IN PUTTING OUR RECOMMENDATIONS
OUT THERE IN 2018 WE RECOMMENDED
THAT MEDICAID BE EXTENDED TO ONE
YEAR POSTPARTUM AND WE BECAME
THE FIRST STATE TO HAVE MEDICAID
EXTENDED FOR CONTINUOUS
ELIGIBILITY.
SO I THINK WE ARE LEADING THE
WAY.
WE HAVE A LONG WAY TO GO BECAUSE
THAT DISPARITY DOES NEED TO BE
ADDRESSED.
>> MORE WORK TO BE DONE AND
SOMETHING WE WILL CONTINUE
TALKING ABOUT.
Dr. ROBIN JONES AND SHANNON