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Maternity & Family Benefits

The way the healthcare system disaggregates data perpetuates birth disparities for women of color; here’s what health plans and employers can do

July 14, 2020

Dr. Joia Crear-Perry, Founder and President of The National Birth Equity Collaborative, joined Ovia Health in June for a critical conversation on the current state of birth equity, how changes in our healthcare system due to COVID-19 threaten to impact communities of color, and what health plans and employers can do to mitigate and prevent adverse outcomes. You can download the complete webinar here.

Data on health outcomes have long been collected, disaggregated, and analyzed by broad categories, like race. However, the Human Genome Project proved long ago that race alone is not an indicator of health. In order to identify more useful insights into health outcomes, healthcare leaders need to dig deeper into the data to better understand and analyze the ways more critical factors, like access to health services, public safety, social support, and quality job training—or social determinants of health (SDoH) — impact health outcomes.

Health justice advocate, Dr. Joia Crear-Perry, and her organization, The National Birth Equity Collaborative, have been working to change the disaggregation of health outcome data. For the last five years, they’ve been fighting to ensure that health data is disaggregated beyond race so the healthcare community can focus on impacting critical issues, like the staggering Black and infant mortality rate, through more causal  factors, (i.e. SDoH), and preventative care.

By analyzing SDoH data, we can develop a more complete understanding of the factors that influence health outcomes. For instance, we know that Black women and infant mortality rates are 3x higher than white infant mortality rates. This is only a piece of the picture. For example, given the opportunity to further segment the data, we can also see that air pollution is linked to pregnancy risks, which impacts Black women at a higher rate, as they are more likely to live in highly polluted areas.

Dr. Perry links our healthcare system’s inability to address health disparities to long unfounded beliefs of a biological basis for race. Conclusions drawn from data disaggregated only by race perpetuate this bias, resulting in attitudes and policies that place the onus of adverse health outcomes on individuals.

Collecting, disaggregating, and analyzing data beyond race to examine SDoH enables the healthcare system to identify the root causes of adverse health outcomes, craft preventative programs and policies, and improve quality of care for all, especially communities of color.

By confronting healthcare leaders with data points that prove that SDoH are the prominent factors in health outcomes, Dr. Perry is hoping to help the healthcare community unpack and unlearn their biases and move away from policies and programs grounded in assumptions from data disaggregated only by broad racial categories.

How to improve outcomes for Black mothers and babies at an organizational level

Dr. Perry acknowledges that addressing racial and social disparities in maternal and infant health will take time; so what can health plans and employers do today?

The first step employers and health plans can take to drive positive change is acknowledge and take action to reduce implicit bias within their organizations.

Regular racial equity trainings (including trainings baked into the onboarding process) encourage individuals and organizations to think practically about the ways they can help create and support diverse and inclusive workplaces. We know this isn’t easy, which is why when Ovia Health started this journey, we enlisted the help of Dr. Perry, to conduct a racial equity training.

Creating a diverse and inclusive workplace isn’t just the right thing to do. According to a recent McKinsey report (May 2020): "In the case of ethnic and cultural diversity, our business-case findings are equally compelling: in 2019, top-quartile companies outperformed those in the fourth one by 36 percent in profitability, slightly up from 33 percent in 2017 and 35 percent in 2014"

Next, get to know the disaggregated data.

Understanding data disaggregation opens up opportunities for the healthcare system to act on factors that influence health outcomes and identify more impactful ways to support their members. At Ovia Health, we use SDoH data (i.e. food insecurity, access to transportation, access to care, substance abuse, etc) to inform our clinical services, member experience, and overall digital solution.

For example, The Ovia Health Clinical Research Group works with researchers from the University of Wisconsin, Madison to better understand the relationship between pregnancy loss and individual and environmental factors, including SDoH. Using data collected by Ovia, the research illuminated disproportionate rates of pregnancy loss among members exposed to violent crime, living in under resourced areas, struggling with substance abuse, experiencing stress and anxiety, and experiencing unsafe relationships, to name a few.

Informed by this work and in an effort to create solutions that equitably improve outcomes, Ovia Health has developed programs that address many SDoH. Recently, we added an intimate partner violence program to our solution after learning that during the pandemic, many members reported unsafe home environments at a higher rate than previously reported. This program helps health plans and employers identify and mitigate the experience of — and adverse outcomes associated with — members’ unsafe home environments and relationships.

Lastly, examine your maternity and family benefit offerings and partners. When auditing your program, or looking for new partners, ask yourself:

Does this solution partner take into account diverse experiences?

Does this solution partner prioritize health equity within their own organization and design equitable solutions, delivering unique experiences to each member based on their own unique needs?

How does this solution partner address SDoH and preventative care? Are they effective?

Can the solution partner deliver proof of sustained engagement for these populations?

Making a long-term commitment to improve birth outcomes for communities of color is a significant undertaking. It is beneficial to share the work with an impactful and values-aligned solution partner.

At Ovia Health we are committed to birth equity. To date, we’ve designed and participated in many leading research endeavors that aim to uncover the driving factors behind devastating healthcare disparities. We have created a solution that recognizes the uniqueness of each member, meeting them where they are to improve their chances of having a happy, healthy pregnancy, birth, and postpartum recovery.

For more on addressing birth equity in healthcare, download our webinar with Dr. Joia Crear-Perry “Birth Equity, COVID-19 and the future of healthcare: the impact on women of color”.

To find out more about Ovia Health's women and family health solutions, click here