Irene Headen, PhD, MS, is a Professor of Black Health at the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University. Dr. Headen and her research team used hospitalization data from the Pennsylvania Health Care Cost Containment Council (PHC4) for a research study entitled, Neighborhood Opportunity & Racial/Ethnic Disparities in Maternal Morbidity to evaluate the risk of severe maternal morbidity and postpartum hospital readmission for patients admitted for a delivery. The team also studied the impact of socioeconomic and neighborhood characteristics on these outcomes.
For the analysis, PHC4’s hospitalization data was linked to 1) birth certificate data from the Pennsylvania Department of Health, and 2) neighborhood characteristics data (such as residents’ income and accessibility to resources, transit, and services) from the Drexel University Urban Health Collaborative. The analysis focused on patients admitted for a delivery during 2003-2018 from a five-county region of Southeastern Pennsylvania.
The analysis involved two sub studies. The first revealed that a neighborhood’s socioeconomic status level did not consistently correlate with access to goods and services. That is, the results showed there were low-income neighborhoods with high access to goods and services, and conversely, high-income neighborhoods with low access to goods and services. Dr. Headen shared, “This indicated to us that there are important nuances in multidimensional factors that birthing people are exposed to through their neighborhood environment.”
This finding was important for the second aspect of the research team’s analysis, which evaluated the impact of neighborhood environments on patient outcomes such as severe maternal morbidity and the risk of postpartum hospital readmission within a one-year period. Results from this analysis indicated neighborhoods classified as low-income, with high resource/transit access but with low vehicle access had a higher risk of severe maternal morbidity but only in later time periods (2012-2015). The same neighborhood type (low income, high resource/transit access, low vehicle access) also demonstrated a higher risk of postpartum hospital readmission (although this analysis did not evaluate the effects of time period due to sample size constraints).
As noted by Dr. Headen, “These findings suggest that neighborhood factors are important for improving maternal outcomes, but determining the specific type of intervention will be essential since it is not necessarily lack of resources or access to transit that is driving adverse outcomes.”
Dr. Headen concluded, “The PHC4 data was a good fit for our study, and we received substantial support from the PHC4 staff when we had questions.” Dr. Headen is in the process of submitting a manuscript of her study findings to a scientific journal for publication in the near future.
