The New York Fed’s Community Development team seeks to connect the dots between health and wealth. The topic of maternal health is important to the New York Fed because a healthy economy requires healthy people, a fact that has been undeniable throughout the pandemic. To do so, we are bringing together healthcare professionals, community-based organizations, and capital providers to understand challenges in addressing maternal and child health and drive related investments.
This white paper sizes the issue of maternal health in the U.S. and New York City, presents barriers and gaps, and elevates high potential policy and investment solutions focused on mothers throughout the pregnancy, the postpartum period, and beyond.
Pregnant and postpartum people in the United States face staggering mortality odds.
For every 100,000 live births, 20 pregnancy-related deaths occur, amounting to roughly 700 deaths per year nationwide.2 Moreover, maternal mortality and serious morbidity disproportionately impact people of color and their babies in the U.S., with more Black and Native American women of reproductive age living in conditions not conducive to good maternal health.
For example, Black women are two to four times more likely to die during or after childbirth than white women. In New York City, Black women are 12 times more likely to die. In 2017, Black women gave birth to 23 percent of New York City babies yet accounted for 55 percent of maternal deaths. In 2019, the maternal mortality rate worsened further, and these odds amounted to 44 deaths for every 100,000 live births among Black mothers in the U.S. versus 17.9 among white mothers and 12.6 for Hispanic mothers.
For Black infants, the mortality rate was twice that of infants born to both white and Hispanic mothers. In addition to the stark mortality figures, for every maternal death there are approximately 100 women suffering from serious, life-threatening complications—collectively referred to as severe maternal morbidity (SMM). These severe complications, such as intensive care unit admission and hemorrhage requiring life-saving uterus removal, occur 50 to 100 times more often than maternal death and affect 50,000 to 75,000 U.S. women each year.
The Center for Disease Control (CDC), which collects mortality data across the U.S., reports that at least 60 percent of pregnancy-related deaths are preventable. Many health experts argue that these outcomes are a consequence of systemic racism and a lack of access to quality medical care. In that context, advocates, researchers, and elected officials have grown their calls for targeted investment, funding, and civic and political will to address the injustices faced by Black and brown communities, prevent adverse maternal outcomes, and reduce the associated racial and ethnic disparities.
In a system-wide Federal Reserve event on the relationship among health, wealth, and
racism, Federal Reserve Bank of New York President John C. Williams stated:
“Having poor health is a challenge on many levels. We’re keenly aware that health can be a huge driver of economic inequality. People who lack good health or healthcare often struggle to participate fully in the economy. On top of that, social determinants of health—economic stability, housing, and education— can be barriers to employment and affect the kinds of jobs people get. Of course, we at the Federal Reserve are neither healthcare workers nor healthcare policymakers. But a major part of our core mission is to foster a strong economy and promote maximum employment. And to put it simply, we need healthy people to have a healthy economy and workforce.”
(Courtesy New York Federal Reserve)
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