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To Tackle Health Inequities, Start at the Beginning
New Jersey is one of the most diverse states in the nation— we embrace that title and celebrate it proudly. It’s also why New Jersey’s hospitals, state lawmakers, the Murphy Administration and health care providers are so concerned about health disparities for new moms and babies.

by Cathleen Bennett, president and CEO, New Jersey Hospital Association

In New Jersey, pregnancy-related deaths occur in 37 of every 100,000 live births. The Centers for Disease Control and Prevention defines a maternal death as any that occurs within one year of the end of a pregnancy, no matter the outcome or duration of the pregnancy. For black mothers, the rate is reported to be four to five times higher.

Although New Jersey has the eighth lowest infant mortality rate in the United States (4.5 per 1,000 live births in 2017) and the seventh lowest black infant mortality rate (9.7 per 1,000) according to the CDC, we must remain vigilant and focused on further reducing infant mortality and eliminating the disparity that impacts black infants.

To tackle these health inequities—and so many others—we need to start at the beginning.

We know hospitals only see moms for a short period of time that affects a mother’s and baby’s health outcomes. We are working to partner with community organizations and elected officials to better help families from preconception to prenatal care to delivery and follow-up care straight through to the milestone first birthday.

NJHA’s Perinatal Quality Collaborative (NJPQC) has one goal: giving every mom and every baby the healthiest start possible. NJPQC is one of 13 CDC-funded Perinatal Quality Collaboratives in the nation. Every birthing hospital in the state is engaged with NJPQC to improve care for moms and babies and to involve patients, families and community-based organizations in our efforts to make New Jersey the safest place to give birth.

Hospitals that are engaged with NJPQC are focusing on three challenges that mostly occur during the small window during a pregnancy that a mom is at the hospital for delivery: reducing severe hemorrhage, reducing complications from high blood pressure—called hypertension or preeclampsia—and reducing the number of unnecessary cesarean sections for low-risk, first-time moms, referred to as NTSV pregnancies.

Throughout these clinical quality improvement projects, our members are incorporating best-practices to reduce racial and ethnic disparities. One of the most important ways is by making each mom the “captain of the team” in health decision-making.

At a roundtable earlier this year convened by First Lady Tammy Murphy—who is championing these issues—a new mom expressed her frustration at the feeling that her wishes and her voice were not being heard. That is unacceptable. A patient’s engagement in her own care is a proven way to improve clinical outcomes and reduce health care disparities, and it is at the forefront of NJPQC’s work.

Another way NJPQC members are putting health equity as a priority in its quality improvement work is incorporating racial and ethnic data into reporting. We can’t have the right discussions about how to improve care if we don’t know when and where we are facing barriers. We know through research by the Center for Health Analytics, Research and Transformation at NJHA that in New Jersey, high blood pressure disproportionately affects low-income and black populations. By including racial and ethnic data into our work reducing preeclampsia, we can talk about why it’s happening and targeting interventions.

Having a baby isn’t two days in the hospital, or nine months of gestation—the entire process is two years of focused, coordinated care. We can’t do it alone, and our political leaders can’t do it alone. We need New Jersey’s rich diversity to come together as one state, for one goal: getting moms and babies to the first birthday every time.

To read the digital edition of South Jersey Biz, click here.

Published (and copyrighted) in South Jersey Biz, Volume 9, Issue 5 (May 2019).

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