According to the CDC, Black women in the U.S. are three to four times more likely than non-Hispanic white women to die from pregnancy-related causes. Black women are also twice as likely to experience severe maternal mortality or life-threatening pregnancy-related complications. Joanne Armstrong, M.D., M.P.H., Chief Medical Officer for Women’s Health and Genomics at CVS Health, recently spoke with Sara Heath for a Healthcare Strategies podcast about CVS Health and Aetna efforts to address these experiences.
“People are aware of this crisis of maternal morbidity and mortality, especially for Black women, but what does it really mean? Black women across the income and education spectrum, from all walks of life, and in good health have worse outcomes in maternal and child health compared to their White counterparts. Why is that?” she said.
Armstrong noted that multiple factors contribute to these poorer outcomes, including variation in quality health care, implicit bias among providers, underlying chronic conditions, and structural racism.
“There’s something different that's happening about the experience of Black women when they enter our maternal care system. If you ask what are these differences, what are the important drivers of bad health outcomes, and what things are preventable, you can start to get down to the causes,” she noted.
Aetna’s Maternity Program is focusing on addressing preventable maternal risks on a number of fronts, including via its preeclampsia prevention initiative.
Preeclampsia, a form of high blood pressure that rises quickly to severe levels and occurs only in pregnancy, is more common in Black women and is a leading cause of maternal death.
Women who experience preeclampsia can suffer complications, several of which may be life-threatening to the mother and/or baby. The good news is that the risk of preeclampsia and all the harm associated with it can be reduced with a simple intervention: low-dose aspirin taken during pregnancy.
The preeclampsia prevention initiative leverages predictive analytics to identify Aetna members who are at risk for preeclampsia. These members then receive a personalized prenatal care kit with educational instructions and a bottle of low-dose aspirin, a low-cost, yet effective way to lower the risk of developing preeclampsia.
“Studies show that low-dose aspirin can reduce the risk of preeclampsia by about a third,” Armstrong said. “The education we include in the kit empowers women to speak with their OB/GYN about their own risks for preeclampsia as well as if this therapy is right for them.”
The initiative has been highly successful, with about 40 percent of the members who received the kit reporting that it prompted them to talk to their doctor about the risk factor checklist and low-dose aspirin therapy. Importantly, for self-identified Black women, the rate was about 52 percent.