Women who give birth face numerous risks leading up to, during, and after delivery.
Pregnancy complications can bring about physical and mental effects, including post-partum depression, infections, preterm labor, and other significant risks. Without proper medical care, these risks can increase — especially for women of color and those living in rural communities.
That’s why the Rural Health Information Hub released its Rural Maternal Health Toolkit to promote creation of and support for maternal health programs for pregnant women and new mothers in rural communities.
“Rural women experience poorer maternal health outcomes compared to their urban counterparts, including higher pregnancy-related mortality,” Lexie Schmidt, an outreach specialist the Rural Health Information Hub, writes in an email. “Additionally, there are racial, ethnic, and socioeconomic disparities in maternal health outcomes, particularly for women living in tribal communities.”
The Issue of Maternal Health and Mortality
Pregnant women and mothers in rural areas face significant struggles.
Barriers to a healthy pregnancy for rural women, according to the Department of Health and Human Services’ Maternal and Obstetric Care Challenges in Rural America report, include:
- Lack of access to health and human services
- Transportation challenges
- Lack of educational and employment opportunities
“Rural women experience poorer maternal health outcomes compared to their non-rural counterparts, including higher pregnancy-related mortality (death while pregnant or within one year of the end of a pregnancy),” the advocates at Rural Health Information Hub write in their toolkit. Women in rural and urban communities also experience racial, ethnic, and socioeconomic disparities in maternal health outcomes.”
Black and Latina women and those with low incomes fare worse, even among rural white women.
“To address the unique barriers that rural women face, there is a need for high-quality maternal health programs in their communities,” Schmidt writes.
How the Toolkit Can Address Maternal Health and Mortality
The toolkit, created in partnership with the University of Minnesota Rural Health Research Center and the NORC Walsh Center for Rural Health Analysis, contains seven different modules that can help expecting mothers.
- Module 1: Introduction
- Overview of maternal health in the U.S. and unique challenges faced by rural communities.
- Module 2: Program Models
- Models for addressing maternal health in rural communities.
- Module 3: Program Clearinghouse
- Examples of promising maternal health programs that have been implemented in rural communities.
- Module 4: Implementation
- Module 5: Evaluation
- Tools that can help with the evaluation of a maternal health program.
- Module 6: Funding and Sustainability
- Information on funding and resources to help with planning for the sustainability of a rural maternal health program.
- Module 7: Dissemination
- Ideas and resources for disseminating findings from a rural maternal health program.
“This toolkit provides model programs, resources, and information to support the implementation of maternal health programs in rural communities,” Schmidt wrote.
It’s important to focus on the rural health of mothers.
Moreover, it’s critical to take action in the health disparities impacting rural Americans — especially one of that demographic’s most at-risk groups, Latinos.
Disparities Impacting Rural Latinos
The sad fact is that disparities in rural poverty exist across geographies.
Disparities in poverty rates also exist across geography: child poverty rates are highest in rural counties, at 23.2%, compared to large urban metro areas (21.2%), smaller metro areas (20.5%), and suburban counties (14.5%).
Race/ethnicity and geography intersect as well.
The poverty rate among black and Latino children in suburban counties is higher than it is for white children in rural counties.
Access to a primary care physician may also prove difficult for those living in rural areas.
In the United States, rural areas represent approximately 19% of the total population, but are served by only 9% of practicing physicians.
In a population-based study of physicians aged 50 or older in British Columbia, Canada, Hedden et al. found that compared to physicians who practiced in metropolitan areas, those who practiced in rural areas had higher age-specific odds of retirement.
In addition to the lack of physicians in rural areas, 89 rural health centers across the United States have closed since 2010.
Moreover, in rural areas only 24% of people live within 10 miles of a trauma center, and 29% do not have a trauma center within 30 miles. In addition, high-poverty communities were at a higher risk of facing a 30 minute or greater increased drive time due to trauma center closures in both urban and rural areas, and rural communities, which already have higher baseline drive times, had the highest risk of experiencing a significant increase in drive time compared to urban communities.
What You Can Do
While focusing on improving maternal health is a key component in the fight to end rural health disparities, attacking the underlying inequities is critical.
“There are strong links between the social determinants of health — including structural discrimination and social inequities — and obstetric outcomes,” the advocates at Rural Health Information Hub write in their toolkit. “Factors that influence maternal health status before and during pregnancy include racial disparities, insurance status, educational attainment, a2nd median income level.”
You can find out more about the health inequities in your area.
Select your county name and get a customized Health Equity Report Card by Salud America! at UT Health San Antonio.
You will see how your area stacks up in housing, transit, poverty, health care, healthy food, and other health equity issues. These compare to the rest of your state and nation.
You can email your Health Equity Report Card, share it on social media, and use it to make a case for community change to boost health equity.
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