New Community Plan Offers Recommendations to Improve Maternal Health in Harris County

The rate of life-threatening maternal health complications in Harris County is not only higher than the Texas and U.S. rate; it’s increasing, but a group of local leaders is committed to tackling the issue, according to a new report released today by Houston Endowment.

“Improving Maternal Health in Harris County: A Community Plan” was developed by a steering committee of leaders from a wide range of backgrounds – including healthcare, behavioral health, social services, business, government and philanthropy – convened by Houston Endowment. The culmination of a year-long planning and research effort, the plan identifies the most important forces behind Harris County’s high rate of maternal morbidity – defined as unexpected complications of pregnancy, labor and delivery – and offers recommendations for action to improve maternal health.

The Plan’s recommendation to improve data collection and analysis on women’s health is timely given that a recent, updated analysis on maternal deaths statewide underscored the need for improved data quality and methods for verifying maternal deaths. In particular, the Plan calls for the creation of a countywide databank on the incidence of maternal mortality and severe morbidity, as well as the quality and safety of hospital care.

Original, local data collection informed the Plan’s findings and recommendations. By analyzing hospital discharge data, a research team from the UTHealth School of Public Health in Houston found that the rate of severe maternal morbidity in Harris County increased 53 percent between 2008 and 2015, greater than the overall increase across Texas of 15 percent. Further, in 2015, the rate of severe maternal morbidity in Harris County was 20 percent higher than the state rate.

“We believe strongly that our findings about maternal morbidity show that we have work to do in our community, particularly to address disparities in maternal health outcomes among African American women,” said Ann Stern, president and CEO of Houston Endowment. “We hope and expect that the recommendations from our work over the past year will help address this complex issue. The commitment from stakeholders across sectors to work together has been inspiring.”

Notably, the Plan recommends shifting the focus of community efforts from reacting to postpartum issues to putting greater emphasis on prevention and prenatal care, based on its finding that women’s health in Harris County has been subjugated to the health of babies so profoundly that the health of women of childbearing age is often not prioritized. This is compounded by challenges women face in accessing health coverage and care. Further, the planning effort found that the high rate of disparities in care and outcomes for African American women is driven in part by implicit bias around women, income and race that is endemic throughout the healthcare system.

In addition to research, the Plan’s recommendations were informed by women, community health workers, midwives, and labor and delivery nurses who shared their experiences in focus groups. The best practices and recommendations were also rigorously evaluated by people who actually work with women: more than 80 local healthcare and social service experts and community leaders.

Looking ahead, Houston Endowment has committed to supporting the following: (1) work to explore how a databank for Harris County can be developed; (2) the development of a pilot project aimed at creating a system of care that will improve women’s health outcomes in targeted communities, in partnership with the Episcopal Health Foundation and the Cullen Trust for Health Care; and (3) facilitation among efforts to implement the recommendations of the Community Plan. The Endowment is also executing a shared philanthropic approach to contraceptive access in Harris County with peer funders.

In the news
Houston Chronicle: “Harris County moms suffer preventable pregnancy complications at unacceptable rates [Editorial],” April 12, 2018.
Texas Monthly: “Mothers in Peril,” by Ricardo Nuila, May 2018.