MEDICAL SCHOOLS' AND TEACHING HOSPITALS' EFFORTS TO ADDRESS THE MATERNAL HEALTH CRISIS JUNE 2021 Maternal death rates and inequities in the United States are high - and on the rise. According to the Centers for Disease Control and Prevention, Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than White women." The nation's medical schools, teaching hospitals, faculty physicians, medical researchers, and other health professionals are committed to advancing a multipronged approach to avoid all preventable maternal deaths, improve maternal health, and promote health equity, especially through partnership with communities and stakeholders. Below are some of the diverse strategies and efforts that the AAMC and its member institutions have undertaken to combat the maternal ec e @\ AMC Tomorrow's Doctors, Tomorrow's Cures® health crisis and strengthen the systems that improve the health of birthing persons and infants. AAMC HIGHLIGHTS The AAMC develops resources, convenes experts, and provides opportunities to strengthen efforts around maternal health and to advance and support the work of medical schools and teaching hospitals nationwide. AAMC Telehealth Advisory Committee (established in 2018): Understanding telehealth's impact on maternal health and its potential to improve access for rural and underserved populations is one important tool to address today's maternal health crisis. This AAMC committee is focused on understanding and raising awareness of strategies to mitigate inequities in access to care via telehealth, including effective telehealth-related policies and practices to promote health care equity. AAMC Collaborative for Health Equity: Act, Research, Generate Evidence (CHARGE) Maternal Health External Work Group (established in 2019): This multidisciplinary network of experts in and beyond academic medicine, convened by the AAMC, serves as a hub for dedicated discussion around maternal health, where participants can share ideas and resources, funding opportunities and events, achievements, and news related to their specific maternal health interests and efforts. e AAMC New and Emerging Areas in Medicine Series: This guide is for everyone who develops curricula within the field of medicine and for clinicians learning to practice or continuing their professional development. A set of cross-continuum competencies being developed in diversity, equity, and inclusion aims, in part, to confront the factors that drive racism and bias in health care, as well as prepare physicians who are culturally responsive and trained to address these issues, including maternal health. Association of American Medical Colleges e AAMC Framework for Addressing and Eliminating Racism at the AAMC, in Academic Medicine, and Beyond (October 2020): This framework outlines concrete steps the AAMC will take to address structural racism across all fronts: as individuals, as an association, as part of the academic medicine community, and as members of society. ® AAMC-hosted webinar series (April-June 2020): In recognition of National Minority Health Month and Black Maternal Health Week, the AAMC hosted webinars to highlight innovative research and effective interventions occurring at AAMC-member institutions and focused on issues related to: ¢ The history of maternal health disparities. ¢ Rural and tribal mothers and families. e Maternal health equity for refugee, asylee and undocumented mothers. e AAMC Consumer Survey of Health Care Access (April 2021): Twice a year, the AAMC conducts a survey to assess access to health care services in the United States. Since December 2020, the survey has included a section on access to maternal and parental oQo health care, and recent analysis shows that the biggest barrier to accessing maternal health care (reported by women, ages 18-54) is finding a provider. e AAMC Center for Health Justice (expected launch in fall 2021): The center - part of the AAMC's new strategic plan - will focus on the intersection of population health, community health, and health equity, with maternal equity being a formal part of the research plan and agenda. For example, maternal health impact assessments will be a resource to help evaluate the potential health effects of a plan, project, or policy before it is built or implemented and will provide practical recommendations to increase positive and minimize negative maternal health effects. e AAMC Maternal Health Incubator Project (expected launch in 2022): This initiative will identify and convene academic medical centers, community partners, and other stakeholders currently engaged in evidence-based clinical, research, policy, and educational efforts that are effective at narrowing racial and ethnic maternal health inequities. (C7)) AAMC-MEMBER INSTITUTION HIGHLIGHTS Medical schools and teaching hospitals are leveraging their missions of medical education, research, clinical care, and community collaborations to improve maternal health. e Baby Love is a community-based outreach program designed to engage pregnant people and teens in early and continuous prenatal care in upstate New York. University of Rochester Medical Center's Strong Memorial Hospital, Rochester, New York ¢ B'more for Healthy Babies is an innovative initiative to reduce infant mortality and improve maternal health in Baltimore City through programs emphasizing policy change, service improvements, community mobilization, and behavior change. University of Maryland School of Medicine, Baltimore, Maryland e Cradle Kalamazoo is a multi-agency community initiative aiming to identify and implement evidence- based and holistic interventions to reduce infant death and promote respect for families, women, and their children in Kalamazoo, Michigan. Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan Reference e Maternal and Child Health Research Institute mobilizes Stanford discoveries and expertise to promote healthier lives for expectant mothers and children. Stanford Medicine, Stanford, California e Maternal and Infant Environmental Health Riskscape Research Center studies chemical and nonchemical exposures at the individual and neighborhood level from the biological, physical, and social environments - collectively referred to as the "riskscape" - that affect maternal and infant health in Houston. Baylor College of Medicine, Houston, Texas e Maternal Outcomes for Translational Health Equity Research Lab works to address and eradicate inequities faced by Black people who give birth in Boston, using research, advocacy, and mentorship to confront and dismantle the system that enables and perpetuates racism. Tufts University School of Medicine, Boston, Massachusetts 1, Petersen EE, Davis NL, Goodman D, et al. Racial/ethnic disparities in pregnancy-related deaths - United States, 2007-2016. MMWR Morb Mortal Wkly Rep. 2019;68:762-765. 21-090 (06/21) Association of American Medical Colleges