House Ways and Means Committee Chairman Richie Neal (D-Mass.) and Kevin Brady (R-Texas) released a Government Accountability Office (GAO) report on May 10, “Maternal Mortality and Morbidity: Additional Efforts Needed to Assess Program Data for Rural and Underserved Areas.”
Neal and Brady requested the report as part of the committee’s ongoing efforts to address maternal mortality and morbidity in the United States, and specifically asked the GAO to examine maternal mortality and severe maternal morbidity (SMM) in rural and underserved areas.
Upon releasing the report, Neal and Brady issued a press release stating that, “This report confirms our long held worry that rural mothers in America have disproportionately higher death rates than those living in metropolitan areas. The report further highlights the disproportionately higher mortality rates that mothers in underserved areas—areas with lower numbers of certain health care providers per capita—face.” They also urged the relevant agencies highlighted in the report to adopt the recommendations made in the report.
The report describes the current state of research on maternal mortality and SMM. It points to “key factors that can affect maternal mortality and SMM in rural and underserved areas,” and examines several existing federal programs that aim to reduce maternal mortality and SMM within the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). And it takes a global look at the actions the Department of Health and Human Services (HHS) has taken to improve maternal health and monitor progress on its programs.
The report included the following findings:
- Rural and underserved areas have higher pregnancy-related maternal morality ratios, while both rural and underserved and metropolitan areas have higher rates of SMM, according to HHS data.
- Several factors can impact maternal health outcomes in rural and underserved areas, including health systems, socioeconomic status, and the patients in the area.
- While CDC and HRSA both fund maternal mortality and programs, they do not “systemically analyze program data by rural or underserved areas.”
- Increased coordination is needed to monitor maternal health efforts at HHS.
The GAO concluded that there are administrative actions that could be taken to improve maternal mortality and SMM, including that the Director of the CDC and the Administrator of HRSA should ensure that maternal program data is systemically disaggregated and analyzed by rural and underserved areas, and “make adjustments to program efforts, as needed.”
Additionally, the report stated that the HHS Secretary should “direct the Healthy People Maternal, Infant, and Child Health Workgroup and the Maternal Health Working Group to establish a formal coordinated approach for monitoring maternal health efforts across HHS, including in rural and underserved areas.” The GAO noted that this type of approach could include regular meetings to discuss program efforts and outcomes, as well as exchange information.