Interdisciplinary team to study why African-American women
have more pregnancy problems
Black women are three times more likely than white women to die during pregnancy, and twice as many Black babies as white babies die in infancy. Yet researchers know little about why pregnancy and infant health differ by race, despite massive efforts to address the persistent problem.
Now, researchers at U-M will examine the issue from an interdisciplinary perspective to help solve this problem. More than a dozen widely varied U-M schools and centers will be involved in the effort, from public health and medicine, to business and engineering.
"The whole issue of health care disparities is mostly unsolved. While there has been tremendous effort and a lot of money spent to address the problem, in my opinion almost nothing has been accomplished with all that investment. Individual niche programs are a Band-Aid that doesn't solve the problem," says Dr. Scott Ransom, director of the U-M Program for Healthcare Improvement and Leadership Development and scientific director of the University's Griffith Leadership Center.
"I believe the answer will require an interdisciplinary solution. That's what's unique about our effort. Business, information and engineering haven't looked at this issue at all, while social work, nursing, medicine and public health haven't looked at it together," says Ransom, associate professor of obstetrics and gynecology at the Medical School and of health management and policy at the School of Public Health (SPH).
Ransom is principal investigator on the new three-year initiative, which received a $1.7 million grant from the National Institutes of Health as part of its Roadmap for Medical Researcha series of far-reaching initiatives designed to transform the nation's medical research capabilities and speed the movement of research discoveries from the laboratory bench to the bedside.
While compliance with traditional prenatal care among Black women has improved in recent years, it still lags behind white women: 75 percent of Black women seek prenatal care vs. 89 percent of white women. The discrepancy continues after a baby is born: 58 percent of white infants get all recommended well-child care, compared to 35 percent of Black infants.
Further, previous studies have shown traditional medically oriented prenatal care has minimal impact on improving pregnancy outcomes. The project will look at whether more comprehensive and coordinated prenatal care strategies may improve pregnancy outcomes.
Researchers will tackle the issue of racial disparities from three perspectives: leaders at hospitals, government agencies and prenatal clinics; health care providers; and patients.
An interdisciplinary group of researchers, led by Lynn Wooten, assistant professor in the Stephen M. Ross School of Business, will look at how leadership affects access to and improvements in prenatal care, as well as the leader's role in managing the racial gap in birth outcomes.
Providers, including obstetricians, nurses, midwives and social workers, come into contact with pregnant patients regularly. A project led by Ransom will evaluate and make recommendations on how providers can improve care and interact with all races and ethnicities. The team will evaluate possible augmented prenatal care strategies that coordinate traditional prenatal care with education, social services, technology and other approaches.
Briggett Ford, assistant professor in the School of Social Work (SSW), will lead a group that will evaluate the patient's role in health care disparities and look at how better coordinated and augmented prenatal care programs address possible social and environmental factors.
"When we think of 'multidisciplinary' in medicine, we usually mean two medical departments collaborating. With the resources and the longstanding collaborative spirit at the University of Michigan, we can truly make this effort interdisciplinary," Ransom says.
The U-M areas involved in the project are the Institute for Research on Women and Gender, the Program for Healthcare Improvement and Leadership Development, the Medical School, SPH, the Griffith Leadership Center, the Institute for Social Research, the Center for Research on Ethnicity, Culture and Health, the Institute for Social Research, the School of Nursing, the Center for Health Disparities, the Center for Health Promotion, the SSW, the Ross School of Business, the School of Information, the College of Engineering, the Research Center on Poverty, Risk and Mental Health, and the departments of Obstetrics and Gynecology, Health Management and Policy, and Psychology.