Mortality Rates Among Women and Children Are Rising, UHG Report Finds

Mortality rates among women and children grew between 2018 and 2021, emphasizing the importance of prioritizing preventive care and public health interventions, a report from the United Health Foundation shared.

The America’s Health Rankings 2023 Women and Children Report analyzed data on 122 healthcare measures from 34 data sources. The findings reflect outcomes among women between 18 and 44 and children across the United States.

Maternal mortality is defined as deaths related to or aggravated by pregnancy occurring within 42 days of the end of a pregnancy per 100,000 live births. The maternal mortality rate increased by 29 percent between 2014 to 2018 and 2017 to 2021, rising from 17.3 to 22.4. In some states like Mississippi and Nevada, the rate more than doubled.

Maternal mortality rates varied among racial and ethnic groups and states. The rate was 4.4 times higher in Alabama (41.9 deaths per 100,000 live births) than in California (9.5 deaths).

The maternal mortality rate among American Indian/Alaska Native women was 4.5 times higher than multiracial, 4.3 times higher than Asian, 3.4 times higher than Hispanic, and 3.1 times higher than White women. The rate was 2.6 times higher among Black women compared to their White counterparts.

Maternal mortality was more common among women who are high school graduates compared to college graduates. However, research suggests that racial and ethnic disparities surpass other factors, as college-educated Black women saw higher maternal mortality rates than White and Hispanic women without a high school education.

Since 2016, severe maternal morbidity has increased by 22 percent, defined as significant life-threatening maternal complications during delivery per 10,000 delivery hospitalizations. Between 2019 and 2020, the severe maternal morbidity rate increased by 9 percent from 81.0 to 88.3.

Deaths among women unrelated to pregnancy also increased. The number of deaths due to drug injury per 100,000 females ages 20 to 44 grew 27 percent between 2016 to 2018 and 2019 to 2021. The drug death rate rose by 90 percent in North Dakota, 89 percent in Mississippi, and 82 percent in Washington, DC.

As with maternal mortality rates, racial disparities persisted among drug death rates. Between 2019 and 2021, the rate was 18.1 times higher among American Indian/Alaska Native women (56.0) compared to Asian women (3.1).

The growth in drug deaths contributed to a 17 percent increase in injury deaths between 2016 to 2018 and 2019 to 2021. The injury death rate consists of deaths due to injury per 100,000 females aged 20 to 44.

The injury death rate also increased among children ages 1 to 19 over this time, rising 11 percent from 15.7 to 17.4. The leading method of injury deaths was firearms.

The share of women reporting having very good or excellent health grew by 10 percent between 2019 and 2021. However, high health status was more common among college graduates, those with an annual income of $75,000 or more, and White women.

Mental health challenges worsened from 2019 to 2021, with the share of women reporting frequent mental distress rising from 18.1 percent to 21.0 percent and the share reporting depression increasing from 25.3 percent to 27.4 percent.

Payers can help improve mental and maternal healthcare in numerous ways. Some payers have expanded their provider networks to increase access to mental and behavioral health specialists. Payers have also leveraged technology, including telehealth services and mobile health applications, to connect people with maternal care.