WASHINGTON, DC (March 8, 2021)—Although many pregnant people have extensive contact with health care providers, too few transition to ongoing primary and specialty care after they give birth—and Black, Latina, and Native American women are particularly likely to face barriers to seamless, high-quality care. To address these problems, the Bridging the Chasm (BtC) Collaborative, led by faculty members of Boston University Schools of Public Health and Medicine and a multi-stakeholder leadership council, brought together women with lived experience, advocates, researchers, clinicians, health care innovators, and policy experts to create a National Agenda for Research and Action. The team identified strategic priorities based on equity, innovation, effectiveness, and feasibility. They report their results in a new article in Women’s Health Issues and accompany it with a commentary that gives an overview of the project and places it within the context of current public health crises.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University. The BtC process was led by Lois McCloskey and Judith Bernstein, of the Boston University School of Public Health, and funded by the Patient Centered Outcome Research Institute (PCORI) Eugene Washington PCORI Engagement Award and two agencies of the National Institutes of Health: the National Institute of Diabetes, Digestive, and Kidney Diseases and the Office of Research on Women’s Health. The BtC Collaborative is a diverse group of women with lived experience, researchers, advocates, clinicians, health care innovators, and policy experts.
“Bridging the Chasm between Pregnancy and Health over the Life Course: A National Agenda for Research and Action” reports on six key strategic areas that BtC working groups identified. Recommendations include requiring health care institutions, as part of their accreditation, to make progress toward eliminating institutional and interpersonal racism; providing infrastructure support to community-based organizations run by and for Black, Indigenous, and other women of color; extending holistic team-based care to the postpartum year and beyond, with integration of doulas and community health workers on teams; expanding Medicaid coverage across the full postpartum year and supporting the development of Medicaid pay-for-performance policies that support linkage to primary care; preserving maternal narratives and data across providers; and aligning research with women’s lived experiences.
The commentary “It’s Time to Eliminate Racism and Fragmentation in Women’s Health Care” highlights three overlapping public health crises: deeply rooted systemic racism; the COVID-19 pandemic, which is particularly devastating to Black, Hispanic, and Native American populations; and the fact that Black and Native women face a risk of death from pregnancy-related conditions three times that of White women. The current landscape, McCloskey and her co-authors note, “creates a significant opportunity to elevate the issues of racism and fragmentation in women’s health care and to press for substantive policy changes in both public and private spheres.” They describe the key planks of the BtC agenda and point out that several recent legislative proposals offer policy levers to help enact it.
“We’re delighted to publish this work because Bridging the Chasm Collaborative is tackling a serious problem for women’s health and doing so with engagement of a wide range of stakeholders,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “Their vision is simultaneously bold and concrete, and it provides a roadmap to advancing equity and saving women’s lives.”
“Bridging the Chasm between Pregnancy and Health over the Life Course: A National Agenda for Research and Action” and “It’s Time to Eliminate Racism and Fragmentation in Women’s Health Care” have been published online as articles in press and will appear in a future issue of Women’s Health Issues.
