Katy B Kozhimannil1, Julia D Interrante2, Amanda Corbett2, Sarah Heppner3, Jennifer Burges3, Carrie Henning-Smith2. 1. University of Minnesota Rural Health Research Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota. Electronic address: kbk@umn.edu. 2. University of Minnesota Rural Health Research Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota. 3. Federal Office of Rural Health Policy, Health Resources and Services Administration, Rockville, Maryland.
Abstract
OBJECTIVES: Between 1990 and 2013, maternal mortality nearly doubled in the United States and rural residents experienced decreasing access to obstetric care. To improve maternal health, many states have established maternal mortality and morbidity review committees (MMRCs). We assessed the extent of rural representation in state policy efforts related to MMRCs. METHODS: We reviewed publicly available information on MMRCs (websites, statutes, bills, media) in all 50 states and the District of Columbia, separately identifying highly rural states (with >30% of the population being rural residents). We assessed whether each state 1) had established an MMRC, 2) had passed legislation requiring an MMRC, 3) had considered, but not passed, legislation requiring an MMRC, 4) mentioned rural populations in MMRC legislation, 5) required representation on the MMRC from any particular groups, and 6) required rural representation on the MMRC. RESULTS: As of December 2018, MMRCs were established in 45 states and the District of Columbia, an increase from 23 in 2010. Legislation was in place in 27 states, up from 6 in 2010. Only three states specifically mentioned rurality in legislation (including one highly rural state), and only two states required rural representation among their MMRC members (neither of which were highly rural states). CONCLUSIONS: Recent growth in MMRCs has had a limited focus on rural residents, despite their worse health outcomes and more limited access to health care, including obstetric services. Lack of rural representation may hamper geographically tailored efforts to reverse rising rates of maternal morbidity and mortality nationally.
OBJECTIVES: Between 1990 and 2013, maternal mortality nearly doubled in the United States and rural residents experienced decreasing access to obstetric care. To improve maternal health, many states have established maternal mortality and morbidity review committees (MMRCs). We assessed the extent of rural representation in state policy efforts related to MMRCs. METHODS: We reviewed publicly available information on MMRCs (websites, statutes, bills, media) in all 50 states and the District of Columbia, separately identifying highly rural states (with >30% of the population being rural residents). We assessed whether each state 1) had established an MMRC, 2) had passed legislation requiring an MMRC, 3) had considered, but not passed, legislation requiring an MMRC, 4) mentioned rural populations in MMRC legislation, 5) required representation on the MMRC from any particular groups, and 6) required rural representation on the MMRC. RESULTS: As of December 2018, MMRCs were established in 45 states and the District of Columbia, an increase from 23 in 2010. Legislation was in place in 27 states, up from 6 in 2010. Only three states specifically mentioned rurality in legislation (including one highly rural state), and only two states required rural representation among their MMRC members (neither of which were highly rural states). CONCLUSIONS: Recent growth in MMRCs has had a limited focus on rural residents, despite their worse health outcomes and more limited access to health care, including obstetric services. Lack of rural representation may hamper geographically tailored efforts to reverse rising rates of maternal morbidity and mortality nationally.
Authors: Katy B Kozhimannil; Julia D Interrante; Mariana S Tuttle; Carrie Henning-Smith; Lindsay Admon Journal: Am J Public Health Date: 2020-07-16 Impact factor: 11.561
Authors: Sara C Handley; Molly Passarella; Heidi M Herrick; Julia D Interrante; Scott A Lorch; Katy B Kozhimannil; Ciaran S Phibbs; Elizabeth E Foglia Journal: JAMA Netw Open Date: 2021-10-01
Authors: Regine A Douthard; Iman K Martin; Theresa Chapple-McGruder; Ana Langer; Soju Chang Journal: J Womens Health (Larchmt) Date: 2020-11-18 Impact factor: 2.681