Health Equity and Breastfeeding: Supporting our communities most vulnerable

Priority Health is taking steps to create a better environment for Michigan communities to thrive. We seek to discover and correct inequities that are avoidable, unfair, and unjust. Each community faces its own unique set of challenges and barriers to achieving good health and wellness, with some communities experiencing more than others.

This is unfortunately – and disproportionally – true for women of color, particularly during one of their most medically vulnerable moments: pregnancy and childbirth.

Pregnancy-related maternal mortality ratio for Black women in Michigan is 2.4 times higher than that of white women. Further, Black infants are dying at 2.6 times the rate of white infants in Michigan.

This is unacceptable, in part because it is preventable.

Every baby in this country deserves the opportunity to thrive in a healthy, supportive environment.?Breastfeeding is one way to start your child on that journey.

The CDC explains that breastfeeding is an investment in health, providing significant benefits for both infants and mothers, including reduced risk of asthma, obesity, Type 1 diabetes and Sudden Infant Death Syndrome and a reduced risk of Type 2 diabetes, high blood pressure and ovarian and breast cancer for the breastfeeding mother.

Our mission at Priority Health is to improve the health and lives of our more than one million members across Michigan. When people have access to the best care, they can feel their best and live their best. Yet Black women are less likely to be supported when it comes to breastfeeding and Black infants are 15% less likely to have ever been breastfeed than White infants.

While COVID-19 further exacerbated preexisting health disparities across all marginalized communities, Black women were three to four times more likely to die from pregnancy-related complications than white women even prior to the pandemic, with similar outcomes noted for breastfeeding success as well.

The persistence of this health crisis is one of the many reasons Michigan recognizes the last week of August (National Breastfeeding Month) as Black Breastfeeding Week – an opportunity to educate women of color and our Michigan communities about the opportunities and resources available to support Black women before, during and after pregnancy.

Priority Health is committed to supporting mothers who want to breastfeed by providing access to comprehensive, affordable options to ensure any mother who wishes to breastfeed can do so.

However, breastfeeding is not devoid of challenges. While social norms may view breastfeeding as ‘natural,’ this by no means assumes inherent ease, making access to resources, support groups and trained professionals (especially professionals of color) all the more necessary.

Earlier this year, the?Michigan Department of?Health and Human Services?(MDHHS) released an updated version of the?Michigan Breastfeeding Plan, the first time?since 2017.? Its strategies?contribute to Michigan’s larger goals of ensuring that all families can attain health potential and align with the strategies of the Mother Infant Health & Equity Improvement Plan of zero preventable deaths, zero health disparities. The plan outlines that breastfeeding has a significant impact on maternal and infant health, especially in communities of color.

Here are a few ways in which we can – together – support women of color and their families.?

Resource Availability is a Necessity

Providing women of color with education and resources to assist them with their breastfeeding journey is imperative. For example, it is not widely known that many breast pumps are covered through health insurance providers. Information is power and critically important to eliminating barriers and increasing access to health care resources for marginalized communities.

We can begin creating better access to care for mothers and their unborn children at prenatal visits, then continuing through the hospital stay and extending support into the home. The Maternal Infant Health Program (MIHP) provides support before, during and after pregnancy to help mothers have a healthy pregnancy and healthy baby. The MIHP is free for Priority Health Medicaid members and provides regular in-home visits by a nurse, nutritionist or community health worker.

Priority Health often partners with local organizations as well to provide additional support for women of color as they begin and/or continue their breastfeeding journey including YOLO Breastfeeding (Flint) and Milk Like Mine! (Battle Creek). Resources include doula services, lactation consultants and birthing classes.

Representation is Key

Many studies have referenced the benefits of representation within the medical field – and beyond – as distinctly important for better quality of care for people of color. In a 2017 national poll, nearly one third of Black Americans reported that they had personally experienced racial discrimination during a visit with a health care provider, and 22% said they had avoided seeking care because they were wary of discrimination.

Incorporating implicit bias training is a positive first step towards making marked change to be sure, but the need for more diversity and inclusivity across health care practices cannot be overstated. We need to ensure that women of color feel comfortable to ask questions and confident that their well-being is a priority.

Community is Crucial

Advocating for your health is always crucial – but not always easy. One way to ensure you have the support you need is to expand your community. Studies show that including family and friends during health care visits created a positive impact on overall patient care and health outcomes, as they served as additional patient advocates.

In addition to expanding your network of patient advocates, expectant mothers can also find community with group prenatal care. Centering Healthcare Institute’s (CHI) CenteringPregnancy? care model, an evidence-based model of group healthcare, combines a health assessment with interactive learning and community building to help support positive health behaviors, drive better health outcomes, and address the complex social determinants of health. Studies show CenteringPregnancy lowers the risk of preterm birth, closes the disparity gap in preterm birth between Black and white women, increases breastfeeding rates, and improves both visit adherence and patient satisfaction. Priority Health was the first insurer in Michigan to incentivize providers who adopt the Centering Pregnancy care model.

Investment in community building only creates a stronger, better environment for all. Priority Health takes this very seriously, recognizing that we need to support women of color beyond breastfeeding as well.

Our Maternal and infant health work includes diaper drives, supporting thousands of families with more than a million diapers donated through non-profit partnerships. You can learn more about Priority Health's support of Michigan communities at https://www.priorityhealth.com/about-us/priority-health-for-good.

They say it takes a village to raise a child – let’s ensure we begin building our village right from the start by supporting women of color and, by extension, the most vulnerable of our communities: our children.??