Tag Archives: Michigan Maternal Deaths

Maternal Deaths and the Impact of Being Uninsured

by Drawing Detroit | Leave a comment

Maternal deaths remain a concern, especially with Michigan’s maternal mortality rate at 16.4 per 100,000 live births in 2018, according to the National Center for Health Statistics, and the United States rate at 17.4 per 100,000 live births. As described in the Surgo Venture Maternal Vulnerability Index (MVI), there are many factors that contribute to maternal mortality rates including, but not limited to, accessibility, affordability and utilization of healthcare.

Health insurance plays an important role in a woman’s pregnancy, allowing for both the mother and unborn child to receive necessary care to ensure each individual remains healthy through regular checkups and addressing any issues that may be identified during the pregnancy.

Wayne County has the highest percentage of women of childbearing age (19-44) who were uninsured at 7.8 percent, followed by Macomb County where 7.5 percent of women of childbearing age are uninsured. In Wayne County 203 of the 610 Census Tracts have 10 percent or more of women of childbearing age without health insurance and in Macomb County that number is 57 of the 217 Census Tracts. As the second map below shows, the Census Tracts with the highest percentage of women of childbearing age without health insurance are in Wayne County, with additional pockets in Macomb and Monroe counties, where more than 16  percent of women of childbearing age in a Census Tract are without health insurance.

Washtenaw County has the lowest percentage of women of childbearing age without health insurance at 4.6 percent.

As noted, this data set plays a role in determining where a county or state falls in the General Healthcare Sub-Index of the MVI, which is one of six sub-categories that explores the factors that impact maternal mortality rates and maternal health in general. In Southeastern Michigan, St. Clair County has the highest vulnerability index at 45 while Washtenaw County has an index of 0, meaning there is ease in access to and affordability of healthcare for reproductive age women. Michigan has a General Healthcare Sub-Index of 29.

The fact that Washtenaw County has the lowest percentage of women of childbearing age without health insurance explains, in part, why it also has the lowest General Healthcare Sub-Index of the MVI. However, St. Clair County has the highest General Healthcare Sub-Index of the MVI in Southeastern Michigan but has the fourth lowest percentage of women of childbearing age without health insurance in the region (5.1 percent).

So, while access to and utilization of healthcare is a vital aspect in keeping maternal deaths low, it certainly is not the only factor. Other factors include mental health, substance use, socioeconomic status, education levels and more. We will further dig into these factors to see what factors impact the areas of Southeastern Michigan the most.

Maternal Deaths Highest in Detroit

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A look into the pregnancy related death rates in Southeastern Michigan showed that the City of Detroit had higher rates from 2008-13 (combined) than any other governmental unit reported for the region. The Michigan Department of Health and Human Services says pregnancy related deaths are those when a woman dies while pregnant or within one year of pregnancy from any cause related to, or aggravated by, pregnancy or its management. According to MDHHS data, the pregnancy related death rate for Detroit was 44.4 per 100,000 babies from 2007-13 (44.4 total). Pregnancy associated deaths, by contrast are those that occur while a woman is pregnant or within a year of pregnancy irrespective of cause; these deaths can include suicide, drug overdoses or medical causes such as cancer. The rate for Detroit was 62.7 per 100,000 babies for pregnancy associated deaths (48 total) from 2007-13. When comparing pregnancy associated deaths and pregnancy related deaths, the data shows that there were overall higher rates for pregnancy associated deaths. This is likely because pregnancy associated deaths encompasses a broader range of causes of death.

As stated, the data provided by the Michigan Department of Health and Human Services shows that Detroit had the highest rate of pregnancy related death and pregnancy associated death rates in the region. For pregnancy related deaths, Wayne County had the lowest rate at 9.5 per 100,000 babies (9 total), for the counties where data were available. Wayne County’s rate excludes the deaths in the City of Detroit. In Southeastern Michigan pregnancy related rates for Livingston, Monroe, St. Clair and Washtenaw counties were not available because there were five or less deaths.

For pregnancy associated deaths Oakland County had the overall lowest rate at 28.6 (7 total). In Southeastern Michigan, pregnancy associated rates for Livingston, Monroe and Washtenaw counties were not available because there were five or less deaths.

According to an article from the Detroit News, high maternal death rates are related to chronic health conditions and high rates of poverty, both of which are common in Detroit.

The Michigan Department of Health and Human Services does not have data for 2014 and 2015 because it had not been reviewed by the State’s maternal death committees, as of early December, according to a representative from the department. In early 2017, Public Act 479 of 2016 was signed into law making maternal death reporting mandatory. Prior to this law reporting was voluntary.