The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

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June 17, 2024

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Maternal Deaths in U.S. Far Higher Than in Other Countries

 

Pregnancy and childbirth are far more dangerous for American women — especially Black women — than for women in other high-income nations, according to a Commonwealth Fund study of maternal health outcomes across 14 countries. Despite a decline since the end of the pandemic, the U.S. maternal mortality rate remains the highest, with nearly two-thirds of pregnancy-related deaths occurring after birth. The United States has a severe shortage of maternity care providers, especially midwives, and it’s the only country in the study that doesn’t guarantee paid parental leave or home visits to mothers after childbirth.

 

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A Community-Led Approach to Transforming Maternity Care

 

When Birth Detroit opens this fall, it will be the first Black-led birth center in Michigan. The new center is the product of 40 efforts across the U.S. to establish birth centers in low-income communities. In Transforming Care, the Commonwealth Fund’s Sarah Klein and Laurie Zephyrin, M.D., explore how women in low-income communities most affected by maternal health disparities are rallying together to build safer systems of care. Learn about the impact these birth centers are having, and what actions are needed to ensure their continued success.

 

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FEATURED CHART

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Hospital Global Budgeting in the U.S. and Abroad

 

Global budgeting in health care has been successfully deployed by a number of nations, as well as the state of Maryland, to bring cost stability and predictability to hospitals and patients alike. A Commonwealth Fund report by health policy and payment expert Bob Atlas examines how Maryland and four nations each implemented global budgeting — and what the necessary conditions are for wider U.S. implementation. Atlas says global budgeting models must be designed carefully to ensure the clinical choices that providers make are aligned with the decisions of those who manage hospital resources.

 

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QUIZ

Quiz-01

Removing the “firewall” between employer health coverage and subsidized coverage sold through the Affordable Care Act’s marketplaces would reduce the number of uninsured Americans by...?

  1. 14,000
  2. 140,000
  3. 1.4 million
  4. 14 million

Scroll down to see if you got it right.

Supporting Community Health Centers Post-Dobbs

 

Community health centers provide maternity care for millions of U.S. women. But the Supreme Court’s 2022 Dobbs decision eliminating the constitutional right to abortion has created challenges for these essential health care providers. On To the Point, George Washington University’s Caitlin Murphy and colleagues report on interviews conducted with people who work at health centers. Many staff members say they are hard-pressed to find ob-gyns and nurses willing to work in states with abortion restrictions, even as their clinics face greater demand for contraception, prenatal care, and other reproductive health care.

 

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Sweden Has Dramatically Reduced Motor Vehicle Deaths

 

Over the past three decades, Sweden’s Vision Zero program has managed to cut motor vehicle–related deaths by 50 percent. In the new edition of International Insights, the Commonwealth Fund’s Evan Gumas looks at Sweden’s proactive strategies and what lessons they could hold for U.S. cities that have declared motor vehicle–related deaths a public health issue. Sweden’s experience demonstrates that “while traffic accidents are part of life in the modern world, they don’t have to cost so many people their lives or health.”

 

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Join the Caregiving Conversation: Tune In to Uncared For

 

Some 42 million Americans are caregivers for a sick or frail loved one, and that number is only rising. How we’re going to care for everyone is at the heart of season 2 of Uncared For, a podcast produced by Lemonada Media with Commonwealth Fund support. It turns a spotlight on unpaid caregiving through intimate conversations with family caregivers, who talk about the highs and lows they’re experiencing as they strive to ensure their loved ones age with dignity.

 

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What Rural Hospitals Can Do to Survive

 

Since January 2023, 27 rural hospitals in the U.S. have converted to emergency hospitals in order to remain in operation. Under the new designation, these facilities continue to provide emergency and outpatient services but offer no inpatient care. A report by the Commonwealth Fund and the Bassett Research Institute explored some of the other strategies rural hospitals are pursuing to stay afloat.

QUIZ: Answer

Quiz-02

The answer is C, 1.4 million.

Americans who are offered affordable health coverage through an employer aren’t currently eligible for subsidized coverage through the Affordable Care Act marketplaces. What would happen if this “firewall” were removed? A Commonwealth Fund brief by Urban Institute analyst Jessica Banthin and colleagues estimates that dropping the firewall between the employer and individual insurance markets would reduce the number of people without insurance by 1.4 million and save households $4.4 billion by allowing workers to switch to more affordable coverage. Employers would also save billions in premium costs.

Affordable, quality health care. For everyone.

The Commonwealth Fund, 1 East 75th Street, New York, NY 10021

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