Dear AJPM  reader,

Disparities in maternal child health are often preventable and typically originate in poor access to care due to geographic, demographic, and socioeconomic factors. According to the CDC , U.S. pregnancy-related deaths increased from 7.2 deaths per 100,000 live births in 1987 to 16.9 deaths per 100,000 live births in 2016, which is the highest rate among all developed nations globally. Similarly, the U.S. has a greater infant mortality rate than other developed countries at 5.8 deaths per 1,000 live births, based on CDC data for 2017 .

Our February issue includes several articles examining maternal and infant mortality rates in the United States. One especially interesting study by Hawkins and colleagues investigates the impact of state reproductive laws and policies on maternal mortality rates, while another examines the significance of place and racial/ethnic disparities in understanding the infant mortality rate. Finally, a third paper explores the contribution of early vaccination to healthy infancy.  

Hawkins SS, Ghiani M, Harper S, Baum CF, Kaufman JS.
  • This study examined state-level factors affecting reproductive health and found a 20% reduction in Planned Parenthood clinics increased the maternal mortality rate by 8%, while restricting abortions based on gestational age increased the maternal mortality rate by 38%.

Womack LS, Rossen LM, Hirai AH.
  • This examination of disparities in urban-rural infant mortality found the most frequent causes of excess infant deaths were sudden unexpected infant deaths and congenital anomalies, with variation by race and ethnicity.

Vader DT, Lee BK, Evans AA.
  • Children who received a hepatitis B birth dose had 2.01 times the odds of being up-to-date on the combined seven-vaccine series at 18 months as children who did not receive the birth dose.

We hope you find these articles and the rest of our February issue to be timely, topical, and informative.  

Yours in prevention and health,

Matthew L. Boulton, MD, MPH

American Journal of Preventive Medicine