TOPEKA — The rate at which Kansas women of color die from pregnancy increased sharply over 20 years, furthering racial disparities, according to a new national study.
The Institute for Health Metrics and Evaluation and Mass General Brigham conducted a state-by-state analysis of maternal deaths rates for 1999-2019, and released the study Monday.
While maternal mortality rates rose consistently across the U.S. for all ethnic groups, Kansas experienced some of the nation’s largest spikes in terms of American Indian and Alaska Native populations, and had consistently high risk levels for Black mothers.
Sharla Smith, director and founder of the Kansas Birth Equity Network, said the disparity in these death rates wasn’t a surprise.
“When it comes to Indigenous, Hispanic and Black women, what we’ve seen in recent literature and in recent reports is that they are significantly mistreated in our health care systems,” Smith said.
The study showed Black mothers in the state had higher death rates than the surrounding states in many of the years studied. In 2019, Black women were more than twice as likely to die from pregnancy-related causes in Kansas as in Missouri, Nebraska and Colorado.
Between 2016 to 2018, the premature birth rate for Black women in Kansas was 13.6%, 51% higher than the rate among all other women. During these years, Black women accounted for 14% of pregnancy-associated deaths but only 7.1% of births in Kansas.
Kansas was one of the five worst states in terms of American Indian and Alaska Native pregnancy death increases, with a rise of more than 162% during the study’s time period. Other states with similar increases were Florida, Illinois, Rhode Island and Wisconsin.
Common causes of maternal deaths included bleeding after birth and infection.
Christina Pacheco, assistant professor at the University of Kansas Medical Center and project director for Communities Organizing to Promote Equity, an organization trying to reduce health inequities, said a long history of systemic trauma and equity had to be considered with the results.
“I’m not so sure I’d say it’s surprising, but it’s definitely validating,” Pacheco said. “This gives credence to what we’re seeing in the field. And for one of the first times the American Indian population is being highlighted for the disparities that they are facing. They have an ongoing historical trauma due to colonization, genocide, forced migration and cultural erasure. They’re also one of the populations that are extremely underinsured.”
Kansas ranked in the five worst states for the Asian, Native Hawaiian or Other Pacific Islander category, experiencing a maternal mortality increase of more than 83% for this ethnic group during the time of the study.
Laura Fleszar, an author of the paper and researcher at the Institute for Health Metrics and Evaluation, said social determinants, such as systemic racism, often contributed to these statewide results.
“If you look at all of the racial and ethnic groups combined, you can see that Kansas is kind of middle of the pack. … It tells a different story when you look at it by racial and ethnic group,” Fleszar said.
Black women in the Kansas Legislature have advocated for legislation to investigate the disparity in health outcomes for Black mothers.
Kansas remains one of 10 states that hasn’t adopted Medicaid expansion — a move that would provide health care insurance to about 150,000 more low-income Kansans.
Smith pointed to Medicaid expansion as one area that would help improve outcomes but said the state needed to also look at less commonly thought of measures, such as lowering grocery taxes, lowering housing prices and investing in more community engagement.
“As researchers, we’re going to have to definitely do more work centered around why we’re seeing these numbers and what we can do in our communities to change them,” Smith said.