Understanding Reproductive Healthcare and Outcomes Among Women Veterans: A Review of Recent Research and Future Opportunities

Presentation focused on reproductive health issues among women Veterans in VA care. In particular, examines patterns of healthcare utilization for gender-specific conditions among women Veterans, as well as beliefs and preferences for reproductive health care services within the VA healthcare system. Then explores innovative new research aimed at better understanding reproductive health services and outcomes among women Veterans

Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance

In this report, we evaluate health equity across race and ethnicity, both within and between states, to illuminate how state health systems perform for Black, white, Latinx/Hispanic, AIAN, and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations. Our hope is that policymakers and health system leaders will use this tool to investigate the impact of past policies on health across racial and ethnic groups, and that they will begin to take steps to ensure an equitable, antiracist health care system for the future

State of Reproductive Health In Women Veterans – VA Reproductive Health Diagnoses and Organization of Care

Reproductive health (RH) is a critical part of health. For women, RH encompasses gynecological health throughout life, preconception care, maternity care, cancer care, and the interaction of RH with other mental and medical conditions. Reproductive Health is defined as a state of complete physical, mental, and social well-be­ing and not merely the absence of reproductive disease or infirmity. This definition highlights the importance of taking a health systems approach that integrates RH care issues and services with other aspects of care needed across the life course. The RH needs of women are shaped by their stages of life and life experiences. For women Veterans, their military experiences may influence their RH in important ways. Given the increasing numbers of women in the military and women Veterans, it is critical to understand key aspects of RH in this unique population of women. This first report of the State of Reproductive Health in Women Veterans provides an overview of the RH diagnoses of women Veterans utilizing the Department of Veterans Affairs (VA) health care services, VA delivery of RH care, and a vision for RH in VA

How Expanding the Role of Midwives in U.S. Health Care Could Help Address the Maternal Health Crisis

Midwives are licensed health care providers who offer a wide range of essential reproductive and sexual health care services, from birth and newborn care to Pap tests and contraceptive care. Research consistently demonstrates that when midwives play a central role in the provision of maternal care, patients are more satisfied, clinical outcomes for parents and infants improve, and costs decrease. Use of midwives is also associated with fewer cesarean sections, lower preterm birth rates, lower episiotomy rates, higher breastfeeding rates, and a greater sense of respect and autonomy for the patient.Given the many benefits of midwives, and the profound maternal care inequities affecting Black and Indigenous families in the U.S., it's important to understand how they could be better integrated into the U.S. health care system. This includes the intentional integration of midwifery across the complex health care ecosystem in order to ensure midwifery care is accessible, affordable, and equitable to all childbearing people

The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions

Issue: In response to the U.S. Supreme Court's overturning of Roe v. Wade, a number of states have passed, or are planning to pass, partial or complete bans on abortion. A key question is whether these restrictions will result in reduced overall access to maternal and infant care, as well as worse health outcomes, in these states.Goals: Compare the current status of maternal and infant health in states that have or are likely to have bans or restrictions on abortion access with states that will preserve abortion access and consider how new abortion restrictions could affect maternal and infant health in the future.Methods: We drew on public data sources such as the CDC WONDER birth and death files, Area Health Resources Files, and the March of Dimes maternity care deserts report. We stratified states based on Guttmacher Institute ratings of the restrictiveness of state abortion policies.Key Findings and Conclusions: Compared to states where abortion is accessible, states that have banned, are planning to ban, or have otherwise restricted abortion have fewer maternity care providers; more maternity care "deserts"; higher rates of maternal mortality and infant death, especially among women of color; higher overall death rates for women of reproductive age; and greater racial inequities across their health care systems

How Discrimination in Health Care Affects Older Americans, and What Health Systems and Providers Can Do

Racial and ethnic discrimination has a significant impact on the health of people of color, affecting mental health and contributing to high blood pressure, negative health behaviors, and early aging. For Black older adults, the cumulative effects of race-related stress experienced over the course of a life can increase the risk for mental and physical health problems.In health care settings, experiences of discrimination can include providers dismissing a patient's symptoms or health concerns, offering different treatment based on a patient's type of insurance, or not providing care in a patient's preferred language.We analyzed findings from the Commonwealth Fund 2021 International Health Policy Survey of Older Adults to examine experiences of racial discrimination in health care settings among Latinx/Hispanic and Black older adults. (See "How We Conducted This Study" for more details.) To provide some cross-national context, we first detail the extent to which older adults in 11 high-income countries believe their national health system treats people unfairly because of race or ethnicity. We then look more in-depth at the United States and report on older Americans' experiences of discrimination and the consequences of health providers' unfair or dismissive treatment. Finally, we consider steps that U.S. health system leaders, health care educators, policymakers, and others can take to address discrimination and dismantle systemic racism in health care

Health and Health Care for Women of Reproductive Age: How the United States Compares with Other High-Income Countries

The maternal mortality crisis in the United States has been well documented: U.S. women have the highest rate of maternal deaths among high-income countries, while Black women are nearly three times more likely to die from pregnancy-related complications than white women are. But maternal deaths and complications may be a bellwether for the U.S.'s wider failures with respect to women's health and health care.Using data from the Commonwealth Fund's 2020 International Health Policy Survey and the Organisation for Economic Co-operation and Development (OECD), this brief compares selected measures of health care access and outcomes for women of reproductive age (18 to 49) in 11 high-income countries. After identifying gaps in U.S. health system performance for women in this age group, we explore some of the policies other nations have put in place to ensure more equitable access and better health outcomes. We also suggest policy options for the United States