Black women are three times more likely than white women to die during pregnancy, and twice as many black babies as white babies die in infancy. Yet researchers know little about why pregnancy and infant health differ by race, despite massive efforts to address this persistent problem.
Now, researchers at the University of Michigan will examine the issue from an interdisciplinary perspective to help solve this problem. More than a dozen widely varied U-M schools and centers will be involved in the effort, from public health and medicine, to business and engineering.
“The whole issue of health care disparities is mostly unsolved. While there has been tremendous effort and a lot of money spent to address the problem, in my opinion almost nothing has been accomplished with all that investment. Individual niche programs are a Band-Aid that doesn’t solve the problem,” says Scott Ransom, D.O., MBA, MPH, director of the U-M Program for Healthcare Improvement and Leadership Development and scientific director of the U-M’s Griffith Leadership Center.
“I believe the answer will require an interdisciplinary solution. That’s what’s unique about our effort. Business, information and engineering haven’t looked at this issue at all, while social work, nursing, medicine and public health haven’t looked at it together,” says Ransom, an associate professor of Obstetrics and Gynecology at the U-M Medical School and of Health Management and Policy at the School of Public Health.
Ransom is principal investigator on this new three-year initiative, which received a $1.7 million grant from the National Institutes of Health as part of its Roadmap for Medical Research, a series of far-reaching initiatives designed to transform the nation's medical research capabilities and speed the movement of research discoveries from the laboratory bench to the bedside.
While compliance with traditional prenatal care among black women has improved in recent years, it still lags behind white women: 75 percent of black women seek prenatal care vs. 89 percent of white women. The discrepancy continues after the baby is born too: 58 percent of white infants get all recommended well-child care, compared to 35 percent of black infants.
Further, previous studies have shown traditional medically oriented prenatal care has minimal impact on improving pregnancy outcomes. The new project will look at whether more comprehensive and coordinated prenatal care strategies may improve pregnancy outcomes.
U-M researchers will tackle the issue of racial disparities from three perspectives: leaders, health care providers and patients.
Researchers have not typically looked at how the perspectives or principles of leaders at hospitals, government agencies and prenatal clinics can influence health care disparities. Government and private organizations have provided money to fund prenatal programs, but these have made little difference in the overall problem. In this new study, an interdisciplinary group of U-M researchers, led by Lynn Wooten, Ph.D., an assistant professor in the U-M Stephen M. Ross School of Business, will look at how leadership affects access to and improvements in prenatal care, as well as the leader’s role in managing the racial gap in birth outcomes.