In America, Black mothers are 3-4 times as likely to die as a result of pregnancy than white mothers. Likewise, Black babies are 1-2 times more likely to die in childbirth than White babies.[1] At Proactive MD, families are at the center of everything we do, and this devastating disparity surrounding Black maternal and fetal mortality rates is unacceptable to us. The system has failed these women and children. We are leveraging the power of primary care to fight back on their behalf.

Environmental Impact

Multiple studies have found that Black individuals have significantly higher levels of skepticism about the care they receive in the healthcare system than white individuals – and for good reason. Yet, an environment of trust and mutual respect is essential to quality care: “Greater interpersonal trust has been found to be a significant predictor of acceptance of recommended care, satisfaction with care, loyalty and satisfaction with the physician, self-reported health improvement, and willingness to give the physician control in the relationship.”[2]

Proactive MD’s model is built to address this issue head-on, beginning with a foundation of strong provider-patient relationships. Our providers spend an average of 30 minutes with patients at every visit. They take the time to listen and understand their unique challenges and needs. This personal approach to care promotes trust between women and their providers. This simultaneously restores hope in the total healthcare environment, as patients benefit from high-quality referrals, comprehensive care coordination, and advocacy. With a personal healthcare partner to guide and support them through the process, Black mothers are more likely to receive and respond to prenatal, postnatal, and pediatric care that can keep them and their children safe.

Behavioral Impact

Chronic diseases like cardiomyopathy and hypertensive disorders are contributors to high maternal death rates in the Black community.[3] These effects are exaggerated in communities where lifestyle disparities exist between Black women and their white counterparts, as lack of access to healthy food, health education, and medical care make it more difficult to prevent and manage chronic disease.[4]

We are passionate about addressing these social determinants of health. We believe in working to remove barriers to care so that every patient can live a healthy lifestyle and receive high-quality healthcare. Through our Patient Advocacy program, every Proactive MD patient has access to a licensed social worker. This Patient Advocate can provide healthcare literacy education, behavioral health support, wellness coaching, community and government resources, financial assistance information, and concierge care navigation. Patient Advocates fight on behalf of all patients, including Black mothers and their children, to ensure they receive equal, fair treatment in the healthcare system and have what they need in all facets of life to be healthy and well.

Genetic Impact

Higher rates of the chronic conditions that contribute to maternal and fetal mortality among Black Americans are more closely related to behavioral and environmental factors than they are to genetic ones: “The … hypothesis that the root cause [of racial/ethnic variation in disease occurrence] is embedded in the historical and social circumstances … is more consistent with the data.”[5]However, genetic factors are at play as well, as anyone who has a family history of conditions like diabetes or heart disease will be at increased risk for the same medical conditions themselves.

Our providers address genetic risk factors through a comprehensive yearly Proactive Health Review that assesses patient health and medical history. Providers counsel patients based on their individual risk factors and educate on how to minimize the risk of developing chronic conditions. By promoting awareness of potential genetic predispositions and persistently providing preventive care, we can proactively reduce the risk of pregnancy complications for Black women.

While the issues causing the disproportionately high Black maternal and fetal mortality rates are complex and multifactorial, we believe the path forward begins with a simple first step: relationship. Our promise is to see our patients as people first, stopping at nothing in pursuit of their greatest good. As we fight passionately for the Black mothers and children in our care, we aim to care for these precious lives and restore hope and trust to healthcare— one mother and child at a time.


Sources:

[1] https://www.nytimes.com/2018/05/11/podcasts/the-daily/mortality-black-mothers-babies.html

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924632/

[3] https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html

[4] https://www.propublica.org/article/nothing-protects-black-women-from-dying-in-pregnancy-and-childbirth

[5] https://www.ncbi.nlm.nih.gov/books/NBK25517/