Sweeping new study analyzes maternal health outcomes with SDOH, finds Black mothers at much higher risk

Black mothers living in the least vulnerable areas of the U.S. are more likely to die or have worse birth outcomes compared to white mothers living in the most vulnerable areas, a sweeping new study has found.

The peer-reviewed study, published in The Lancet, was conducted by Surgo Health, a health tech startup. It is said to be the first study to link real-world data on maternal mortality with social determinants of health (SDOH) at the county level.

Women living in the South and in rural America as well as Black women were found to be exposed to higher vulnerability than other groups. The research also showed pockets of high vulnerability within states that are largely low vulnerability, with drivers of vulnerability varying by geography. 

Researchers analyzed 13 million live births from 2014 to 2018, leveraging Surgo Health’s proprietary Maternal Vulnerability Index, which ranks counties and states based on vulnerability to poor outcomes. The index is built on more than 20 sources of data, and its scores are based on 43 contributors.

Black women in the least susceptible areas were found to be 44% more likely to have a newborn with low birth weight than white mothers in the most vulnerable areas. This gap cannot fully be explained by factors captured in the Maternal Vulnerability Index. 

"The findings suggest the root causes of racial inequities are complex, and that in addition to factors captured in our index, other strong social and societal factors are at play,” Sema Sgaier, Ph.D., CEO and co-founder of Surgo Health and a co-author of the study, said in an announcement. “These might include unconscious bias on the part of providers, attitudes, and beliefs among patients, and hyperlocal disparities in access to care. We need to dig deeper to determine what forces are causing these shocking disparities in outcomes.”

Surgo Health aims to understand people’s behavior at an individual level.

“For us, that ‘why’ question is really important to answer to be able to think about how to then improve outcomes by addressing the needs of the patients,” Sgaier told Fierce Healthcare. 

The startup launched last fall and says it is built on eight years of R&D. The company offers a real-world data platform it says is the most comprehensive socio-behavioral profile of Americans. It is leveraged by payers, providers and private companies to help improve outcomes, reduce costs and address inequities. Its data tools, like the COVID-19 Community Vulnerability Index, have been used by the likes of the Centers for Disease Control and Prevention and state departments of health.

Besides national, population health-level data, the Maternal Vulnerability Index offers localized data so payers and providers can serve members and patients in a personalized way.

“They need this kind of granular data to take the best possible action,” Peter Smittenaar, vice president of data science and artificial intelligence at Surgo Health, told Fierce Healthcare.

Last month, new federal data showed that maternal mortality rates in the U.S. rose 40% from 2020 to 2021, at its highest levels in nearly 60 years. The mortality rate among Black women was 2.6 times as high as the rate for white women.

The latest Lancet study demonstrates how important it is to study SDOH when looking at outcomes. It also validates the potential of the Maternal Vulnerability Index.

“It’s really a call to action to take this data and apply it,” Smittenaar said.