Dear Health Care Transformation Community,
Our Black mothers in California are facing a health crisis
Black mothers face the highest rates of maternal mortality of any racial or ethnic group, four times more likely to die during childbirth than the general population. This statistic captures only a fraction of the disparities that many Black mothers face in health care today, a sobering reminder that industry leaders have significant work to do to reach the goal of health equity.
And while Serena Williams, Beyonce, Michelle Obama, and other notable figures have elevated the topic, we in the health care transformation community have our work cut out for us to close these gaps.
Our health care ecosystem needs to move past discussion to activation.
Last week, Governor Newsom signed Senate Bill 65, the California Momnibus Act, which aims to close existing racial gaps in maternal and infant mortality rates. This exciting legislation furthers California’s commitment to support maternal health, advance the state’s equity goals, and address systemic racism.
Other policy developments include Medi-Cal’s recent announcement that it will begin offering doula services as covered benefits, ensuring that Black and other women have access to services throughout the reproductive lifecycle. Research shows that women who receive support like doula services during labor report higher satisfaction rates and need fewer interventions that those that go without them.
On the heels of these exciting health equity developments, on October 5th, our Industry Initiatives team hosted a panel of diverse industry leaders to discuss how they were working to proactively identify and address the needs of Black mothers in and outside of the health care system. This panel of incredible speakers included:
- Melissa Hanna, CEO of Mahmee
- DD Johnice, Vice President of the Health Transformation Lab at Blue Shield of California
- Dr. James Kyle, Medical Director of Quality, Diversity, Equity and Inclusion at LA Care
- Kindra Montgomery-Block, Vice President of Diversity, Equity, and Social Impact for the Sacramento Kings
Diving into a discussion around outcomes and the ongoing work to address them, Kindra described how her team used data to drill down on public health knowledge and awareness among Black communities in Sacramento to reduce preventable deaths in her prior work with the Black Child Legacy Campaign. She underscored the work underway in neighborhoods that are most at-risk by leveraging trusted messengers.
Dr. Kyle reinforced what’s at stake in this work and the importance of involving Black women in it. “This is going to require disruptive change on the part of us all collectively reaching out to Black mothers and trying to save their lives and the lives of their children.” In agreement, Melissa and DD said that to combat the disheartening numbers, we need to meet women where they are, in safe spaces where they can share the challenges that they face in the places they feel heard. They both noted that there are still major gaps in our health care infrastructure that prevent effective collaboration for impactful interventions.
Melissa identified “time to care” as a critical area for improvement. “We need to figure out the timetable between somebody expressing a need and getting that person to care,” she said. She described the heartbreaking story of a new mother who was turned away from the Emergency Department – even though she was referred by a specialist – because the providers could not identify the status of a breast abscess on her mixed-race skin. Ultimately, this mother needed to be admitted for intensive care. It’s not enough for providers to make referrals and complete documentation, Melissa reminded us. At all levels, advocates need to step up and provide expedient care. “We have gotten to a point now where there is an absolute inevitability of change because going further in this direction is actually disastrous for our country in many ways: economically, health-wise, and socially,” she said.
Health plans were also mentioned as having a critical role in this work. DD discussed how a value-based payment model in development at Blue Shield of California can help to close care gaps for people of color and incentivize providers to do better for their Black patients. She said,
“With one of our provider groups, we are doubling the incentive to close care gaps for people of color, for Black people. And it sounds crazy that you need to incentivize someone to care for the people who need it the most, and the people who have the most egregious disparities, but we do.”
In agreement, Dr. Kyle noted that L.A. Care Health Plan has developed an equity award, a bonus for providers who demonstrate that they are using an equity lens in their practice. This is part of a multi-pronged approach that includes education, systems change, and ensuring that there are providers in under-resourced areas and that they are being adequately compensated.
Panelists agreed that bringing a social justice framework to this work is a key ingredient to making progress on Black maternal health. “We know that the one way we can start to turn around the results when it comes to black maternal and infant health is if we were to have more Black women inside of the system actually taking care, and represented at every level of care, for the mother and the family,” Kindra said. We truly need an upstream strategy that focuses on the comprehensive care of the whole community, not merely the woman or the family.
Melissa noted that workforce development programs must be tied to initiatives at the state and federal levels to connect all the dots. “You can have all of the ideas, but you need to get all the people in the room,” she said.
Our speakers called on attendees to join the movement to support Black women’s health. Dr. Kyle noted that industry competitors must collaborate on this issue. “It’s not just about business. It is life and death.” “Folks need to stretch,” Kindra noted in her response. Allies need to not only listen to Black women, but make sure Black women have a place at the leadership table when decisions are being made.
I felt both inspired and humbled by the contributions of the over 250 participants in the chat. Those who have experienced firsthand the issues at hand and those who felt passionately about this topic weighed in. I am grateful that they felt safe to share their personal stories and concerns in the space we created.
I’d love to thank our panelists not just for their participation, but also for their candor and thoughtfulness in addressing this topic. The depth and breadth of their experience and knowledge is invaluable, and I was honored to have the opportunity to join them in this conversation.
I look forward to further discussions—and transformational change— and hope that my fellow health care transformation leaders and advocates feel activated to get involved in the movement for better Black maternal health in their community.
Here are some organizations you can support:
- Her Health First - Improving access to care by offering tools and resources to give the best pregnancy experience.
- Diversity Uplifts - Provides frontline doula support at no cost and doula training.
- BLACK Wellness & Prosperity Center - Provides advocacy, research, education and infrastructure building.
- Black Mothers United - Provides doula care, lactation support, health & wellness, and mommy mingles.
- Birth Equity Advocacy Project - Advocates for racial equity in maternal health in California
I’d love to hear from you! Drop a comment and share your thoughts on how to advance this important work.
Check out the full event recording: