Maternal mortality's vexing rise

The ideas and innovators shaping health care

Jul 07, 2023 View in browser   By Evan Peng and Erin Schumaker DATA DIVE Black people had the highest mortality rates in the U.S. over the past two decades, according to a new study. Wong Maye-E | AP The maternal mortality rate in the U.S. more than doubled over a 20-year period ending in 2019, according to a study published this week in the medical journal JAMA. From 1999 to 2019, the national maternal mortality rate, measured in deaths per 100,000 live births, went from 12.7 to 32.2, the study showed. Researchers used data from the CDC’s National Vital Statistics System to create a modeling process that produced estimates of maternal deaths in each state and racial/ethnic group. Evan Peng Why it matters: Compared to other high-income countries, the U.S. has a higher maternal mortality rate even while spending more on health care than those countries. CDC numbers from recent years showed the pandemic exacerbated the problem as people stayed home and delayed seeking care. But detailed, long-term data for every state and racial/ethnic group were lacking; this study fills in those gaps. The government and public health groups need that information to know where to target interventions. The study confirmed that, though maternal health deteriorated for all racial and ethnic groups, some groups were more affected than others. Black individuals had the highest rates of maternal mortality, while Native American individuals saw the highest growth rate in maternal mortality over the 20-year period studied. In addition to the South, a known epicenter of the crisis, particularly for Black individuals, the researchers found high maternal mortality rates clustered in the Midwest and northern Mountain states, driven by high rates among Native American individuals in that region. What’s next? It remains to be seen how maternal mortality rates will change after the overturning of Roe v. Wade last year and the reintroduction of abortion bans in many states. Already, there have been reports of health care professionals reluctant to provide conventional procedures to protect the pregnant person’s health, fearing running afoul of abortion bans.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WELCOME TO FUTURE PULSE Huletts Landing, N.Y. | Andrew Nazdin This is where we explore the ideas and innovators shaping health care. A fleet of drones is patrolling New York-area beaches after five people were bitten by sharks off the coast of Long Island this week, the Associated Press reports. While there's been a rise in shark bite reports in New York over the past two years, the overall risk of being bitten remains low. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Katherine Ellen Foley talks with Daniel Payne, who recently spoke with Jesse Ehrenfeld, the newly inaugurated president of the American Medical Association — one of the most influential groups in Washington — about his plans to focus on the political pressures doctors face as well as on their pay. Listen to today’s Pulse Check podcast THE NEXT CURES Human organs available for transplant are in short supply. Mark Lennihan | AP When scientists successfully transplanted a genetically modified pig heart into a human last year, the achievement marked a giant step forward in organ-transplant technology. Still, the patient died just 60 days after the procedure. A new paper published in The Lancet analyzes what went wrong. Those lessons — of what to do and what not to do — could inform future transplants, physician-scientists at the University of Maryland School of Medicine said, and improve patients’ odds of longer-term survival. Lessons from the transplant team:  — The patient’s health might have been a key factor. The 57-year-old, who was ineligible for a human heart transplant, had end-stage heart disease and had been hospitalized before the procedure. The next recipient chosen won’t be as sick, according to study author Muhammad Mohiuddin. — The medical team didn’t know the pig heart was infected with a latent pig virus, which might have compromised the organ. Future pig organs will undergo new types of testing to ensure they’re clear of the virus. — The patient received an immunosuppressant drug to prevent infection, which could have damaged his heart-muscle cells and triggered an anti-pig immune response. What’s next: "We are working on additional studies involving nonhuman primates to demonstrate consistency and safety of our protocol in preparation for a submission to the FDA to enable us to begin clinical trials involving patients," Mohiuddin told Erin. Why it matters: Human organs are in short supply. About 100,000 Americans are on the national waitlist for an organ transplant, and at least 17 people in the U.S. die each day waiting for one. "Xenotransplantation [transplants from one species to another] could potentially save thousands of lives," Mohiuddin said.   SUBSCRIBE TO POWER SWITCH: The energy landscape is profoundly transforming. Power Switch is a daily newsletter that unlocks the most important stories driving the energy sector and the political forces shaping critical decisions about your energy future, from production to storage, distribution to consumption. Don’t miss out on Power Switch, your guide to the politics of energy transformation in America and around the world. SUBSCRIBE TODAY.     PROBLEM SOLVERS A discovery by researchers at University of Glasgow raises hopes people could dodge avian flu in the case of a pandemic. | Nathan Stirk/Getty Images Public health experts list bird flu among the diseases that could, under the wrong circumstances, cause the next pandemic. So a discovery by University of Glasgow researchers that a human gene, BTN3A3, provides protection against the disease offers hope for heading off a calamitous outbreak, POLITICO’s Carlo Martuscelli reports. They identified BTN3A3 after testing the effects of hundreds of different types of genes on avian virus replication. The researchers found the virus replicated more easily in human cells when BTN3A3 was silenced. Calculating risk: The discovery will help disease-monitoring agencies better assess the human — and pandemic — risk of a bird flu outbreak, said study leader Massimo Palmarini, the director of the University of Glasgow’s Centre for Virus Research. Even so: The researchers, who published their results in the journal Nature, said that while we don’t yet understand all the mechanisms that block the spread of bird flu in humans, this gene is one piece of the puzzle. And certain outbreaks of avian influenza have mutations that allow the virus to sidestep the protection granted by BTN3A3. This was the case in a recent outbreak in a mink farm in Spain, where a BTN3A3-evading mutation was detected.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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