This week is Black Maternal Health Week, highlighting the disparities in health outcomes for pregnant people.

Black mothers are two to three times more likely to die from pregnancy-related complications than their white counterparts.

Dr. Jemma Nonog, thriving families director of health equity, Kaiser Permanente of Washington, who also practices midwifery, said there are similar mortality rates in Washington, and the pandemic has exacerbated the issues of structural racism within the health system. Nonog said racism manifests in the body.

“The extra stress causes preterm births and amplifies some of the things that we see even before the pandemic,” Nonog explained.

In 2021, the White House began recognizing Black Maternal Health Week and has released a proclamation this year as well.

Nonog pointed out there are important warning signs for pregnant people to look out for. They should reach out to a health professional if they have headaches that will not go away, fainting spells or unusual swelling.

Nonog noted they also should be aware of thoughts of harming themselves or their baby because it could be signs of a mood disorder. Perhaps equally important, the doctor added, people know they deserve to be heard.

“As a BIPOC provider who also is a parent, it can be difficult to really speak up, given my own history of internalized racism,” Nonog acknowledged. “I had to work three to four times harder than my white counterparts just to be heard or valued.”

Nonog added Kaiser Permanente is supporting pregnant people in other ways too, such as monthly cohorts meeting with health professionals. The doctor emphasized the health organization is also trying to step back to understand its role in addressing structural racism.

“We are listening to the community, inviting them in to give us feedback of what they need,” Nonog stressed. “And we’re trying to look at the data. We’re trying to assess any implicit bias that we might have.”

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Advocates for older Americans are urging Congress to take action on lowering drug prices, specifically, allowing Medicare to negotiate with drug companies.

The Build Back Better Act would have done so, as well as cap out-of-pocket costs for seniors and impose tax penalties on drug companies for excessive pricing. The legislation has been stalled in the U.S. Senate after the House passed it last year.

In New Hampshire, the average annual cost of prescription drug treatment increased by more than a quarter from 2015 to 2019, but annual income for residents only increased 9%.

Jennifer Delaney, associate state director of advocacy, AARP New Hampshire said the price inflation is hurting Granite Staters.

“A lot of folks cannot afford their drugs,” Delaney observed. “They’re choosing between heating their homes, putting food on the table or taking their life-saving prescription medicines. And I’m talking about folks who have cancer, Parkinson’s, diabetes.”

Delaney pointed out when people ration their medicine or skip doses, it can have negative health outcomes, and even lead to hospitalization. She added according to the Congressional Budget Office, drug-pricing measures passed by the House would save the federal government hundreds of billions of dollars over the next two decades.

Megan O’Reilly, vice president of federal health and family government affairs for AARP, said the Senate Finance Committee recently held a hearing on the urgent need to lower drug prices. Opponents argued it would harm innovation, but O’Reilly noted support for Medicare negotiation is high across the political spectrum.

“Taxpayers are bearing the burden of these increased prices, but they’ve also been paying to help in the research and development of them,” O’Reilly contended. “And yet there’s no check on the drug industry, as they continue to raise these rates, really, out of the pocketbooks of families across New Hampshire and across the country.”

More than 85% of respondents to an AARP survey said Congress needs to take action to lower drug prices. More than 75% of Democrats and more than 50% of Republicans said they would look more favorably on a political candidate who supports reducing drug costs.

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No news is good news for Ohioans who enrolled in Medicaid coverage during the COVID-19 public health emergency.

State Medicaid agencies are prohibited from dis-enrolling beneficiaries until the end of the month in which the emergency expires. Saturday is set to be the termination date, but because the feds have not yet notified states, advocates expect that deadline to be pushed to mid-July.

Elizabeth Thuranira, an organizer for UHCAN Ohio, said it’s crucial that enrollees respond to any renewal forms sent by Medicaid so they don’t lose coverage.

“The emphasis currently is on updating your contact info, whether that’s their mailing address, their phone number or even email,” she said. “Just getting people to update those is imperative at this time, so that they do not end up losing coverage.”

When the public health emergency ends, more than 14 million Medicaid enrollees could lose coverage nationally. In the meantime, Thuranira said, they should continue making use of the preventive health services available as part of their coverage. In Ohio, Medicaid enrollment increased nearly 20% between March 2020 and last January.

If Medicaid beneficiaries are found to be ineligible in the redetermination process, Thuranira said the
Marketplace is a good option that often has discounted premiums for individuals and families. She explained that health insurance navigators are available throughout Ohio to assist with enrollment.

“They are the navigators who have been tabling at local events, at churches, at social services centers and even on campuses and just getting the word out that Ohioans do have options when it comes to coverage,” she said.

The Centers for Medicare and Medicaid Services has a special enrollment period, open until the end of the year to help people earning up to 150% of the federal poverty level receive free health insurance coverage. For a family of four, that’s $39,750.

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An analysis of mobile health clinics launched in the Detroit metro area during the pandemic finds it’s a model that can deliver health screenings and health care and could be replicated in other communities.

The Wayne Health Mobile Units are specially equipped vans with medical equipment and professionals. They began as testing sites for front-line workers in the early days of COVID-19, out of a partnership between Wayne State University and Ford Motor Co. Over time, they transitioned to what Dr. Phillip Levy, a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne state and chief innovation officer for Wayne State University Physician Group, called a “vision of patient-centric, portable population health.”

“If they have comorbidities and need doctors’ appointments or health care,” said Levy, who runs the program, “can we provide linkages around that? If they have food insecurity, can we help them get food access, so that we can really be delivering on the holistic approaches that are needed in order to keep this person healthy and avoid complications?”

Levy noted they have a Patient Portal for folks to register online, but appointments are not necessary, and they don’t require insurance or identification – which can be barriers to care. He added that bringing care into communities also reduces the barriers of transportation time and cost.

Beyond testing and treatment for COVID, Levy said the Mobile Health Units do blood screenings for high cholesterol, diabetes and kidney disease and provide prevention infrastructure – as well as blood pressure screenings for hypertension. He said they also are building out HIV screening and treatment, and have started working with the state’s needle-exchange program.

“Can we use these vehicles to reach vulnerable communities of IV drug users,” he said, “not to distribute needles alone, but to test for HIV and hepatitis C and B, and provide medical linkages to care?”

Levy pointed out that 40% to 50% of the people who visit the Mobile Health Units come from areas where the social vulnerability index is extremely high. For other communities looking to replicate the program, he said building trust over time is important, and can be done with the help of faith groups and community-based organizations.

“Communities know that when the Wayne Health vans come, they’re not coming for one time, they’re going to be there, maybe for several days in a row,” he said. “But we’re going to be back over and over again, providing these resources to community members.”

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