Thread by @HoarseWisperer

To me, maternal and infant mortality rates are two of the most powerful overall metrics in healthcare.

Maternal and infant death rates aren't really medical measures as much as they are proxies for poverty; access to healthcare; and racial inequities in a country.

1/

https://twitter.com/ewarren/status/1121164657455136768

There are a healthy number of people who believe the U.S. has the best healthcare in the world. That's not close to true.

While we have as much overall medical expertise as any developed country, we lag far behind in affordability and access. More people die as a result.

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That comes into sharper focus when looking at maternal mortality because childbirth is a discrete early-to-midlife event less affected by things like disease.

It's a proxy for poverty, healthcare affordability, access to care, and the impact of long-term systemic inequities.
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As any or all of those factors get worse, maternal mortality get worse.

The thing is, in a developed country, maternal mortality isn't supposed to get worse. Healthcare generally gets better over time. Treatments improve. Survival goes up.

Something has gone very wrong though.

Infant mortality in the U.S. hasn't worsened in the way maternal mortality has but we lag far behind comparable countries and are not closing the gap.

Infants die at a higher rate in the United States than in virtually any country in the developed world.

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The infant mortality rate in the United States is more than double that of countries like Sweden and Japan and is 60% higher than comparable countries on average.

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Going back to why these metrics are so illuminating, they shine a very bright light on wealth distribution and inequity... and they point toward the scale of systemic disadvantages and which populations are most affected by them.

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When healthcare is unaffordable, people die. When it isn't locally accessible, people die. When those issues persist for decades, communities grow accustomed to accessing care less and less urgently - and people die.

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Elizabeth Warren is drawing attention to the most glaring intersection of every one of these issues: maternal mortality among Black women.

Infant and maternal mortality are proxies for social progress. We're failing badly.

Kudos to Warren for calling that out. She's right.

9/9

While this is in the news because of Warren's comments yesterday, Kamala Harris has been working on improving racial equity in maternal care since long before her announced run.

She announced legislation in 2018 specifically focused on the issue.

harris.senate.gov/news/press-rel…

Senator Gillibrand has also sponsored legislation (in Jan) to address rising maternal mortality rates.

Her legislation noted the particularly acute maternal mortality rate among Black women but the legislation itself addressed overall maternal care.
gillibrand.senate.gov/news/press/rel…