The Postpartum Assessment of Women Survey (PAWS): Informing Medicaid Policies to Improve Health in the "Fourth Trimester"

妇女产后评估调查 (PAWS)：为医疗补助政策提供信息以改善“第四个三个月”的健康

• 批准号: 10608748
• 负责人: Heidi Lynn Allen
• 金额: $ 73.83万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10608748
• 关键词: Address; Affect; Birth; Birth Certificates; Black race; COVID-19; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Characteristics; City Government; Collaborations; Collection; Conceptions; Data; Data Collection; Dimensions; Discrimination; Disparity; Economic Factors; Economics; Ethnic Origin; Fatigue; Funding; Geography; Goals; Grant; Health; Health Policy; Healthcare; Height; Hispanic; Housing; Indigenous; Individual; Infant Care; Infection; Insurance; Insurance Coverage; Intervention; Investments; Left; Link; Maternal Health; Maternal Mortality; Maternal health equity; Measures; Medicaid; Mental Depression; Mental Health; Methods; Modeling; Monitor; Morbidity - disease rate; New York City; Outcome; Pain; Participant; Personal Satisfaction; Physical environment; Policies; Policy Maker; Policy Making; Population; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Privatization; Public Health; Quality of life; Race; Recovery; Regulation; Research; Research Personnel; Resources; Risk Assessment; Risk Factors; Role; Rural; Sexuality; Sleep; Social Environment; Social Policies; Source; State Government; Statutes and Laws; Subgroup; Surveys; System; United States; Woman; Work; beneficiary; black women; clinical risk; cohort; economic determinant; economic disparity; ethnic minority; evidence base; experience; feeding; follow-up; fourth trimester; health care disparity; health data; health determinants; health disparity; health equity; health outcome disparity; improved; long-standing disparities; longitudinal dataset; maternal morbidity; multidisciplinary; neglect; novel; pandemic disease; physical conditioning; population based; post-pandemic; postpartum care; postpartum health; postpartum morbidity; pregnancy related death; prenatal; programs; public health emergency; racial minority; rural dwellers; rural residence; severe maternal morbidity; social; social determinants; social disparities; social factors; sociodemographics; substance use

PROJECT SUMMARY The year after birth, also known as the “fourth trimester”, is a growing focus of efforts to address high rates of maternal morbidity and mortality in the United States (U.S.), which disproportionally affect racial-ethnic minorities, rural women and women insured by Medicaid at delivery. More than half of pregnancy-related deaths occur in the year after delivery and a significant share of women experience postpartum morbidity due to physical and mental health conditions. As the payer for nearly half of U.S. births and a larger share of births among Black and Indigenous women, Medicaid is a key lever to improve population-level postpartum health disparities. As the COVID-19 pandemic subsides, policymakers are considering a range of Medicaid policy changes—alone and in conjunction with other social policy sectors—aimed to improve postpartum health, such as extending pregnancy Medicaid one year postpartum or addressing social risk factors. Yet, the determinants of postpartum wellbeing and health disparities are poorly understood. This is largely because the fourth trimester has been a neglected focus of maternal health policy and research. To drive evidence-based policymaking and fill the significant gap in high quality, representative data on postpartum health, our multidisciplinary team developed a large-scale follow-up survey administered one year after birth in collaboration with six states and New York City: the Postpartum Assessment of Women Survey (PAWS). The 2020 PAWS captured the postpartum experience of women who gave birth in 2020, during the height of the public health emergency (PHE). This proposed project leverages and builds on this first-of-its kind data collection effort to respond to the urgent needs of policymakers to improve postpartum health in the new public health, policy and social context that will emerge as the pandemic subsides, as the policies and protections of the PHE end, and as new policies begin (e.g. postpartum Medicaid extensions in 2022). Specifically, we will launch a new PAWS survey round following a 2023 birth cohort (data collected in 2024) to measure (1) maternal health outcome disparities in the postpartum year (by insurance, race-ethnicity, and urban/rural residence), (2) health care-related disparities and their contribution to disparities in postpartum health outcomes, and (3) social and economic disparities and their contribution to disparities in postpartum health outcomes. Drawing on expertise from our diverse, interdisciplinary team of junior and senior investigators, and in deep collaboration with state and city government partners, we will produce a highly valuable scientific resource and generate timely, rigorous findings to inform evidence-based policies with the potential to advance maternal health equity in the U.S.

项目总结