Mini Policy Review

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George Washington University *

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1020

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Medicine

Date

Apr 3, 2024

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pdf

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9

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How Maternity Deserts Impact the Maternal Mortality Rate in DC: Sofia Londono del Rio University Writing, George Washington University UW 1020: Writing Science and Health: Women’s Health as Point of Inquiry Dr. Jameta Barlow November 2, 2023
Executive Summary The United States has the highest maternal mortality rate of any developed country (Tikkanen et al., 2020). The people most often affected by the maternal mortality rate are those who live in high poverty areas. A maternity care desert is an area in which there is a lack of resources that pregnant people need to lead a healthy pregnancy (“Where You Live Matters, n.d.). This paper will focus on the relationship between maternity care deserts and the mortality rate in DC. Food and access to healthcare are rights; and, nutrition and regular check ups are crucial to a healthy pregnancy. The maternal mortality rate in the US is too high, and lack of food and healthcare should not be contributing factors. Maternity deserts are most commonly found in lower income areas of cities. Although DC is above that for maternity care, there is an uneven distribution in the maternity care residents receive (“Where You Live Matters, n.d.). Policies must be made to reallocate resources towards basic needs in wards 7 and 8. A functioning and well equipped maternal facility is necessary to address prenatal and postnatal pregnancy complications. These facilities would mean that the people in wards 7 and 8 have easy access to maternal care facilities as well as the staff to provide adequate health care to pregnant people. Policies are needed to ensure that income and race are not contributing factors towards a person's health. Looking at wards 3 and 4 in comparison to wards 7 and 8 it is clear that money is not a concern towards improving maternity care deserts, but rather the issue is distributing money towards communities in need to address major concerns. Looking at food insecurity policies, hospitals around DC, and policies concerning gentrification in DC will help to further understand the relationship between maternity care deserts in DC and its maternal mortality rate.
Scope of the Problem DC is a city that experiences a wide variety of socioeconomic and racial background. However, even though the city is proficient in diversity it lacks the even distribution of resources throughout their neighborhoods, resulting in a lack of resources in some neighborhoods, usually those with a high concentration of people of color. In DC wards 7 and 8 have a combined population of a little under 150,000 people (“2023 Demographics”, 2023). Along with the large population sizes they each average about $75,000 as a household income as opposed to DC’s average household income of about $150,000 (“2023 Demographics”, 2023). Two of the biggest issues concerning maternity care deserts in DC are, access to food and access to hospitals, or other healthcare facilities. Food Deserts: Food deserts, that are defined by the United States Department of Agriculture (USDA) “as a low income census tract that also has low access to food outlets” (Butler et al., 2022 p.171), can have a great impact on maternal nutrition. Even though wards 7 and 8 have such a large population of people, they only have 3 full-size grocery stores between the two wards (King et al., 2022). Food deserts are not simply to blame on the low-income status of a neighborhood's residents, but rather on the racist policies that tend to ignore neighborhoods with high populations of people of color (Sieloff, 2011). In DC wards 7 and 8 house 75% of the city's food deserts (Wilson, 2018) So to say that race doesn’t play a role in a person's access to food would be an oversimplification of the factors that play into a food desert. Distribution of Hospitals in DC: In 2022 there was only one working hospital, United Medical Center, in wards 7 and 8. The hospital was not only experiencing shortages in staff, it was in danger of closing (King et al.,
2022). The hospital has no obstetrics ward, due to its closing after many questionable decisions regarding the care of pregnant people and newborns in the facility (Wilson, 2018). Left without a functioning maternal care facility the residents of wards 7 and 8 often have to look at Howard University Hospital for labor and delivery services. Black women in DC are forced to travel approximately 1.9 times as far for maternity care as their white counterparts (“Where You Live Matters, n.d.). Howard University Hospital is not a viable solution seeing as its overflow of patients often leads to pregnant people in active labor being put in the hands of untrained professionals (Wilson, 2018). Although there are plans being put in place to build St. Elizabeths Hospital, the final hospital is not planned to be finalized till 2025, leaving pregnant people in wards 7 and 8 more susceptible to high-risk pregnancies for 2 more years (“Cedar Hill…”, n.d.). Policy Alternatives Gentrification in DC: Since the early 2000s DC’s demographics have begun to change. As the black population decreases the white population increases. These changes are most likely due to the higher pricing of real estate and overall cost of living within the city (Shinault, 2019). Rents continue to increase but the mean income for people of color tends to not increase with it (Shinault, 2019). As more Black people are pushed out of neighborhoods the populations of wards 7 and 8 continue to increase (“2023 Demographics”, 2023). What Isn’t Working: Plans to improve the city often mean, whether directly or indirectly, bringing in more white residents and pushing away people of color. As of right now there are very few plans in place to decrease gentrification in DC and its effects on residents of color (King et al., 2022).
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