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Member Research & Reports

Member Research & Reports

Columbia: Racial and Ethnic Disparities in Insurance Access Impact Maternal-Infant Health

Black, Hispanic and indigenous women are more likely to have gaps in insurance around the time of pregnancy than white women, a new study by Columbia University Mailman School of Public Health and the University of Michigan suggests.

Nearly half of all black, Hispanic, and Indigenous women had discontinuous insurance coverage between preconception and after delivering their babies compared to about a fourth of white women, according to the research in Obstetrics and Gynecology.

Spanish-speaking Hispanic women had the lowest rates of steady insurance, with nearly one in 10 not being insured at all between preconception and the postpartum period.

The study comes as women from racial and ethnic minority backgrounds face greater risks of maternal morbidity and mortality associated with childbirth. Black and indigenous women are two to four times more likely to die from pregnancy-related causes compared with white peers.

Data from 107,921 women in 40 states between 2015 to 2017 were analyzed at three at time points, the month before conception, at the time of delivery and 60 days after birth.

Among the biggest factors for disrupted care is Medicaid discontinuity. Pregnancy-related Medicaid coverage is only offered for up to 60 days after a baby’s birth, but there are bipartisan federal and state efforts to extend the coverage to a year.

“Medicaid stability before and after pregnancy is critical for ensuring continuity of coverage and access to care for women of color,” says lead author Dr. Jamie Daw, assistant professor of health policy and management at Columbia University Mailman School of Public Health.

“Extending pregnancy Medicaid to one year after birth is likely to reduce racial disparities in insurance disruptions and ultimately, disparities in postpartum health.”

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