Racial Disparities in Maternal Health

Link: https://www.usccr.gov/files/2021/09-15-Racial-Disparities-in-Maternal-Health.pdf

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Excerpt:

Over the past two decades, the U.S. maternal mortality rate has not improved while maternal
mortality rates have decreased for other regions of the world. Furthermore, the rate at which
women in the U.S. experience short-term or long-term negative health consequences due to
unexpected outcomes of pregnancy or childbirth has also steadily increased over the past few
decades, with nearly 50,000 women in the U.S. experiencing these health consequences in 2014.
Significant racial and ethnic disparities persist in both the rate of women in the U.S. who die due
to complications of pregnancy or delivery and the rate that women experience negative health
consequences due to unexpected pregnancy or childbirth outcomes.

…..

Compared to any other racial or ethnic group,7 Black8 women experience the highest rates of
nearly all of Centers for Disease Control and Prevention’s (CDC) severe maternal morbidity9
indicators.10 Black women in the U.S. are 3 to 4 times more likely to die from pregnancy-related
complications than White11 women in the U.S., and Native American12 women are more than 2
times more likely to die from pregnancy-related complications than White women in the U.S.13
Pregnancy-related mortality is also slightly elevated for Asian women (a 1.1 disparity ratio),14
and for Hispanic women in some geographic areas.15 Moreover, the risk of pregnancy-related
death is so elevated for Black women in certain regions of the U.S. that it is comparable to the

rate of pregnancy-related deaths16 in some developing countries.17 This racial disparity has not
improved in decades,18 and is also seen in other middle to high-income countries with
multiethnic populations.19 According to the World Health Organization (WHO), the U.S.
maternal mortality ratio ranked 56th in the world in 2017.20 According to the National Center for
Health Statistics (NCHS), in 2018, the maternal mortality rate in the U.S. was 17.4 maternal
deaths per 100,000 live births, with 658 women dying of maternal causes.21 In 2019, the
maternal mortality rate in the U.S. was 20.1 maternal deaths per 100,000 live births, with 754
women dying of maternal causes.

Author(s): U.S. Commission on Civil Rights

Publication Date: September 2021

Publication Site: U.S. Commission on Civil Rights

Dissenting Statement and Rebuttal of Commissioner Gail L. Heriot in U.S. Commission on Civil Right Report: Racial Disparities on Maternal Health

Link: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3924645

Full Citation:

Heriot, Gail L., Dissenting Statement and Rebuttal of Commissioner Gail L. Heriot in U.S. Commission on Civil Right Report: Racial Disparities on Maternal Health (September 15, 2021). San Diego Legal Studies Paper 21-028, Available at SSRN: https://ssrn.com/abstract=3924645 or http://dx.doi.org/10.2139/ssrn.3924645

Abstract:

On September 15, 2021, the U.S. Commission on Civil Rights published a report entitled Racial Disparities in Maternal Health (the “Report”). This Dissenting Statement and Rebuttal (the “Statement”) is a part of that report.

Among other things, the Statement points out several errors in Report. For example, the Report incorrectly states that maternal mortality has increased 50% over the last generation. What has actually happened is that changes in death certificates have caused more deaths to be classified as maternal in nature. The Report also emphasizes the theory that racism plays a prominent role in causing racial disparities in maternal mortality. The Statement points out in response that maternal mortality rates for Hispanic and Asian American mothers are lower than the rate for white mothers. This tends to detract from the theory that racism is what’s causing the disparities.

Author(s): Gail L. Heriot

Publication Date: 13 Oct 2021

Publication Site: SSRN

A Louisiana senator defends his statements on the state’s Black maternal health

Link: https://www.nbcnews.com/news/nbcblk/cassidy-defends-statements-louisianas-black-maternal-health-statistics-rcna30166

Excerpt:

Black pregnant women continue to face disproportionately high pregnancy-related deaths, with data from the Centers for Disease Control and Prevention indicating a 26 percent increase in the maternal mortality rate for Black women since the start of the pandemic. 

Though researchers do not have an explanation for the disparities, the research suggests it’s a culmination of institutional racism and other health factors, such as the increased risk of obesity and hypertension in Black women. Howell also added that stress and a lack of access to quality prenatal care further exacerbates this issue. 

“It really does boil down to how public health officials relate to Black women who are giving birth,” Howell said. “Statistics about Black maternal mortality are high across the board, no matter what your educational level is, no matter what your insurance level is.” 

In 2018, tennis star Serena Williams opened up in an interview with Vogue magazine about encountering severe health complications after giving birth because doctors neglected to listen about her existing medical conditions.

“When you have someone like Serena Williams having problems giving birth, and not being treated properly by nurses and doctors when she complains about not feeling well, then you look at the doctor of someone who is poor in Louisiana, and has the same kind of problem — they are probably treated even worse,” Howell said.

Author(s): Tat Bellamy-Walker

Publication Date: 23 May 2022

Publication Site: NBC News

Japan Has Economic Choices, Two of Them are Poison

Link: https://mishtalk.com/economics/japan-has-economic-choices-two-of-them-are-poison

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Excerpt:

1. Japan can defend its interest rate line by printing more money but at expense of the yen 

2. Japan can defend the yen by hiking rates or by selling its reserves until reserves run out

Japan has a nasty choice 

I received this email reply to the above Tweet from Michael Pettis.

Looks right. I’d add that by weakening the yen, Japan seems always to support their exporters at the expense of their consumers, which may be why domestic demand is always so weak and growth so sluggish.

The smart thing for Japan would be to hike rates and let the Yen strengthen. 

Instead, if they stay on the same path, the yen might blow up.

All of Japan’s efforts to achieve growth by inflation and exports have backfired. One might think that after 40 years they would try something else.

The single worst choice for Japan would be to blow its currency reserves in an attempt to defend both the Yen and its interest rate peg.

Author(s): Mike Shedlock

Publication Date: 22 Jun 2022

Publication Site: Mish Talk

Millions retired early during the pandemic. Many are now returning to work, new data shows.

Link: https://www.washingtonpost.com/business/2022/05/05/retirement-jobs-work-inflation-medicare/

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Roughly 2.4 million additional Americans retired in the first 18 months of the pandemic than expected, making up the majority of the 4.2 million people who left the labor force between March 2020 and July 2021, according to Miguel Faria-e-Castro, a senior economist at the Federal Reserve Bank of St. Louis.

The percentage of retirees returning to work has picked up momentum in recent months, hitting a pandemic high of 3.2 percent in March, according to Indeed. In interviews with nearly a dozen workers who recently “un-retired,” many said they felt comfortable returning to work now that they’ve gotten the coronavirus vaccine and booster shots. Almost all said they’d taken on jobs that were more accommodating of their needs, whether that meant being able to work remotely, travel less or set their own hours.

“This is primarily a story of a tight labor market,” said Bunker of Indeed, who added that there was a similar rebound in people returning from retirement after the Great Recession. “For so much of last year, the big question in the labor market was: Where are all the workers? This year we’re seeing that they’re coming back.”

Author(s): Abha Bhattarai

Publication Date: 6 May 2022

Publication Site: WaPo

Charted: The Global Decline of Fertility Rates

Link: https://www.visualcapitalist.com/cp/charted-the-global-decline-of-fertility-rates/

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Excerpt:

Over the last 50 years, fertility rates have dropped drastically around the world. In 1952, the average global family had five children—now, they have less than three.

This graphic by Pablo Alvarez uses tracked fertility rates from Our World in Data to show how rates have evolved (and largely fallen) over the past decades.

What’s The Difference Between Fertility Rates and Birth Rates?

Though both measures relate to population growth, a country’s birth rate and fertility rate are noticeably different:

  • Birth Rate: The total number of births in a year per 1,000 individuals.
  • Fertility Rate: The total number of births in a year per 1,000 women of reproductive age in a population.

Author(s): Pablo Alvarez

Publication Date: 10 Jun 2022

Publication Site: Visual Capitalist

As Pandemic Continues, More Older Adults Are Working — What’s Tempting Them?

Link: https://www.magnifymoney.com/news/working-older-adults-study/

Excerpt:

Amid the coronavirus pandemic, a rising share of adults 65 and older are working. In late April and early May 2020, 19.5% of Americans 65 and older were working. That figure jumped more than 2 percentage points in late April and early May 2022 to 21.9%. At the same time, the share of U.S. adults who reported that they’re retired is up similarly — from 14.9% in April and May 2020 to 17.4% in April and May 2022.

More than a quarter of working Americans 65 and older are self-employed. 25.6% of employed older Americans are self-employed — more than triple the rate among working Americans 25 to 39. Meanwhile, the government isn’t the landing spot it once was for older workers: In April and May 2020, 15.2% of employed Americans 65 and older worked for the government. In April and May 2022, however, that percentage plummeted by a third to 10.1%.

New Jersey saw the largest jump in older adults in the workforce since the beginning of the pandemic. In April and May 2020, 18.1% of Americans 65 and older were employed in New Jersey. By April and May 2022, that was up 18.9 percentage points to 37.0%. The other states with double-digit increases were West Virginia (17.2 percentage points) and Pennsylvania (14.6).

North Dakota saw the biggest dip in the percentage of adults 65 and older in the workforce. The rate of older working adults went from 36.0% in April and May 2020 to 25.0% in April and May 2022 — a drop of 11.0 percentage points. Other big drops were seen in Wisconsin (8.3 percentage points) and North Carolina (6.3).

Author(s): Alex Cook

Publication Date: 6 Jun 2022

Publication Site: Magnify Money

U.S. Births Increase for First Time Since 2014

Link: https://www.wsj.com/articles/u-s-births-increase-for-first-time-since-2014-11653364861

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Excerpt:

U.S. births increased last year for the first time in seven years, according to federal figures out on Tuesday that offer the latest indication the pandemic baby bust was smaller than expected.

American women had about 3.66 million babies in 2021, up 1% from the prior year, according to provisional data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. It was the first increase since 2014. The rebound spanned age groups, with birthrates rising for every cohort of women age 25 and older.

Births still remain at historically low levels after peaking in 2007 and then plummeting during the recession that began at the end of that year. The total fertility rate — a snapshot of the average number of babies a woman would have over her lifetime — was 1.66 last year, up from 1.64 the prior year, when it fell to the lowest level since the government began tracking it in the 1930s.

Author(s): Janet Adamy and Anthony DeBarros

Publication Date: 24 May 2022

Publication Site: WSJ

Births: Provisional Data for 2021

Link: https://www.cdc.gov/nchs/data/vsrr/vsrr020.pdf

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Excerpt:

Methods—Data are based on 99.94% of all 2021 birth records received and processed by the National Center for Health Statistics as of February 10, 2022. Comparisons are made with final 2020 data and earlier years.

Results—The provisional number of births for the United States in 2021 was 3,659,289, up 1% from 2020 and the first increase in the number of births since 2014. The general fertility rate was 56.6 births per 1,000 women aged 15–44, up 1% from 2020 and the first increase in the rate since 2014. The total fertility
rate was 1,663.5 births per 1,000 women in 2021, up 1% from 2020. Birth rates declined for women in age groups 15–24, rose for women in age groups 25–49, and was unchanged for adolescents aged 10–14 in 2021. The birth rate for teenagers aged 15–19 declined by 6% in 2021 to 14.4 births per 1,000 females;
rates declined for both younger (aged 15–17) and older (aged 18–19) teenagers. The cesarean delivery rate rose to 32.1% in 2021; the low-risk cesarean delivery rate also rose to 26.3%. The preterm birth rate rose 4% in 2021 to 10.48%, the highest rate reported since 2007.

Author(s): Brady E. Hamilton, Ph.D., Joyce A. Martin, M.P.H., and Michelle J.K. Osterman, M.H.S.,
Division of Vital Statistics, National Center for Health Statistics

Publication Date: May 2022

Publication Site: CDC

Life Insurance Has an Inclusivity Problem

Link: https://www.thinkadvisor.com/2022/06/10/life-insurance-has-an-inclusivity-problem/

Excerpt:

Modern underwriting approaches and distribution methods, often spearheaded by insurtech companies, unlock unique, data-driven insights that enable the industry to understand who they’re serving well — and where they fall short.

The industry can use these insights to adopt a more personalized, progressive approach to product design, underwriting, and distribution to reach specific populations with coverage options and pricing that suits their unique needs.

For the LGBTQ+ community, historical rules and underwriting approaches around mental health could make coverage unattainable or unaffordable.

For example, while our survey didn’t ask respondents about treatment for mental health, the cost of health care in general was a primary concern for nearly 70% of respondents.

A study published in the National Library of Medicine found that LGBTQ+ people used mental health services at 2.5 times higher rates than heterosexual or cisgender individuals.

Additionally, studies have found that they are two and a half times more likely to experience depression, anxiety, and substance abuse — items that are all considered in the underwriting process for life insurance.

Since many in the LGBTQ+ community struggle with mental health concerns, we must find better ways to understand the situation and evaluate the risk holistically.

Author(s): Jeremy Bill

Publication Date: 10 Jun 2022

Publication Site: Think Advisor

Debtor Nation

Link: https://reason.org/debtor-nation/

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Organizations incur long-term financial obligations in forms other than bonds and the U.S. federal government is no exception. Some common types of financial obligations include pension and retiree health care costs for veterans, civilian federal employees, and the general public (through Social Security and Medicare benefit commitments). Looking at the federal government’s balance sheet as of 2021, public holdings of U.S. Treasury securities make up less than one-quarter of total federal liabilities. Unfunded entitlements, like Medicare and Social Security, account for the most at 59% of obligations.

Overall federal obligations have now surpassed $300,000 per American. While substantial in their own right, the debt obligations of state and local governments across the country are dwarfed by the various categories of federal debt.

Author(s): Jordan Campbell, Marc Joffe

Publication Date: 16 May 2022

Publication Site: Reason