From Paper to Practice - U.S. Maternal Health Legislation and Racial Disparities 2013-2023: An analysis of race-conciousness in U.S. maternal health policy and its impact on Black maternal health outcomes. Public

Adelekan, Adeola (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/k643b251f?locale=fr
Published

Abstract

This thesis delves into the nexus of U.S. maternal health legislation and its impact on

Black maternal health outcomes, with a focus on race-consciousness in policy formulation and

implementation. Drawing on historical contexts and contemporary legislative trends, the research

explores how policy initiatives have addressed racial disparities in maternal health outcomes

over the past decade. Through a comprehensive analysis of 33 pieces of federal legislation

introduced or passed between 2013 and 2023, the study identifies patterns, trends, and outcomes

concerning the intersection of policy and Black maternal health.

The findings reveal a significant increase in the introduction of maternal health-related

bills in Congress over the study period, with 76% of these bills addressing racism in various

forms. However, despite the prevalence of race-conscious legislation, the success rate of race-

conscious bills remains disproportionately low, with only 9% becoming national law.

Contrastingly, bills that did not address racism showed a 50% success rate, indicating a systemic

barrier to the enactment of race-conscious policies.

Through case studies of specific legislative proposals, such as the Kira Johnson Act and

the Black Maternal Health Momnibus Act, the research illustrates the nuanced dynamics of

policy development and implementation. While some bills, like the Preventing Maternal Deaths

Act, focus solely on maternal health without addressing racial disparities, they have shown

higher success rates in legislative processes. Conversely, bills like the Black Maternal Health

Momnibus Act, which comprehensively address institutional and interpersonal racism in

maternal healthcare, face significant hurdles despite their evidence-based approach.

The study highlights the urgent need for effective policy interventions that not only

acknowledge but actively work to dismantle structural racism in maternal healthcare. It proposes

strategies to combat legislative apathy, increase investment in anti-racist healthcare initiatives,

and promote community advocacy and engagement. Ultimately, the research underscores the

critical role of legislation in shaping maternal health outcomes and advocates for comprehensive,

race-conscious policies that prioritize the well-being of Black mothers and address historical

injustices embedded in the healthcare system.

Table of Contents

Introduction ............................................................................................................................................... 8

Background ............................................................................................................................................... 9

US Maternal Health Overview............................................................................................................13

Literature Review ..................................................................................................................................16

Rationale ..................................................................................................................................................27

Hypothesis ................................................................................................................................................28

Search Strategy .......................................................................................................................................28

Methods ....................................................................................................................................................29

Results .......................................................................................................................................................34

Data Analysis...........................................................................................................................................38

Additional Contextualization ..............................................................................................................44

Addressing Counter Claims ................................................................................................................49

Discussion .................................................................................................................................................50

Conclusion................................................................................................................................................57

Figures ......................................................................................................................................................61

References ................................................................................................................................................77

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