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Severe Maternal Morbidity, Mortality Both Up in Rural Areas

Clinical factors together with social determinants of health pose challenge for rural communities

TUESDAY, Dec. 17, 2019 (HealthDay News) — Rural communities face greater severe maternal morbidity and mortality than urban communities, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

Katy Backes Kozhimannil, Ph.D., from the University of Minnesota School of Public Health in Minneapolis, and colleagues used data from the National Inpatient Sample (2007 to 2015) to compare severe maternal morbidity and mortality during childbirth hospitalizations among rural and urban residents.

The researchers found that severe maternal morbidity and mortality increased among both rural and urban residents in the study period, from 109 per 10,000 childbirth hospitalizations in 2007 to 152 per 10,000 in 2015. When controlling for sociodemographic factors and clinical conditions, rural residents had a 9 percent greater probability of severe maternal morbidity and mortality versus urban residents.

“Attention to the challenges faced by rural patients and health care facilities is crucial to the success of efforts to reduce maternal morbidity and mortality in rural areas,” the authors write. “These challenges include both clinical factors (workforce shortages, low patient volume, and the opioid epidemic) and social determinants of health (transportation, housing, poverty, food security, racism, violence, and trauma).”

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