NEW YORK – New statistics suggest that poverty and an obesity epidemic are contributing to stubborn mortality rates for pregnant women in New York City.
The city’s health department reported Friday that half of the 161 women who died because of a problem with their pregnancy between 2001 and 2005 were obese and a disproportionate number lacked health insurance.
Black women were hit hardest, with a mortality rate seven times that of white women.
The study was performed as part of an effort by health officials to understand why pregnancy mortality rates in New York City are among the worst in the U.S.
The report released Friday doesn’t solve the mystery, but it confirms worries health practitioners have had in recent years about a steady rise in the number of pregnant women who are morbidly obese and chronically unhealthy because of it.
The deaths recorded by the city occurred due to a variety of causes, but the leading culprits were blood clots, uncontrolled bleeding, infections and illnesses related to high-blood-pressure – all conditions more likely to occur in fat women.
“What we are seeing is a significant increase in the number of women with these problems who are getting pregnant,” said Dr. Jo Boufford, president of the New York Academy of Medicine, which hosted a conference on maternal mortality in conjunction with the release of the report.
The obesity problem, she said, has been more severe in the city’s black neighborhoods, where cheap junk food is plentiful, but greengrocers and nice places to exercise can be scarce.
While deaths are rare, New York City’s rate of 23.1 per every 100,000 live births is twice the national average.
That rate has changed little in New York or the nation since 1990 after dropping dramatically in previous decades due to improvements in medical care. In 1920, the national rate was a frightening 799 maternal deaths for every 100,000 live births.
Scientists have long been concerned with the great disparity in death rates between blacks and whites, which is mirrored in national data collected by the U.S. Centers for Disease Control and Prevention.
Four out of five deaths recorded in New York involved women who had undergone a Caesarean section, a surgical procedure now performed in about a third of all U.S. deliveries.
C-sections place women at additional risk of serious complications, and for many years health officials successfully persuaded hospitals to do fewer of them, but that trend reversed itself in the mid-1990s and they are now more common that ever.
Health officials also examined how people were paying for their care, and found that people with no health insurance had quadruple the mortality rate of women who had private insurance or were unrolled in Medicaid, the government health care program for the very poor.
Boufford said she was hopeful that health insurance reforms recently passed by Congress will help erase that disparity.