Building a Maternal Vulnerability Index for the United States

The Challenge

The United States has the highest rate of maternal mortality in the developed world, and it is the only country where the rate of mothers dying is rising. Yet, practitioners and policymakers in the U.S. lack the detailed data and resources needed to make informed decisions, design services to help, and allocate resources to tackle the problem.

Our Approach

We are building a national maternal vulnerability index that will provide a valuable dataset around maternal mortality in the U.S. Shedding light on vulnerable populations who are being disproportionately affected, this index will provide a rich set of tools to federal, state, and local decisionmakers — allowing them to efficiently direct resources toward mitigating and improving the United States’ dire maternal mortality rates.

The United States has the highest rate of maternal mortality in the developed world, and it is the only country where the rate of mothers dying is rising. Despite the urgency of the crisis, it is difficult to identify patterns at a national level with a high level of precision to make informed, data-driven decisions and design interventions and support.

To address this data gap, and working with support from the Bill and Melinda Gates Foundation, we are researching and integrating more than 100 indicators into one national index to highlight communities within the United States at high risk of adverse maternal health outcomes. This index, available at a national level but with the granularity to provide information at a municipal level, will provide a valuable dataset and set of tools to policymakers, while also shedding light on and highlighting vulnerable populations who are being disproportionately affected. Ultimately, our index will allow policymakers and stakeholders to efficiently direct resources toward mitigating and improving the United States’ dire maternal mortality rates.

To undertake this work, we will draw upon the expertise and framework that has been developed in the course of building our COVID-19 Community Vulnerability Index (CCVI) — a census-tract level index that aggregates indicators specific to COVID-19 vulnerability to give a neighborhood-level estimate of underlying community vulnerabilities.

Our forthcoming maternal vulnerability index will enable a wide range of federal, state, and local decision makers to glean insights on disparities at a regional level in pregnancy and maternal health outcomes by race, income, and other factors. It will show both which areas are vulnerable and highlight why they are vulnerable. For example, our index will not only identify which areas have higher proportions of certain racial groups known to have worse maternal health outcomes, but it will measure other factors that influence those outcomes — such as strength of the health system, access to care and transportation, and underlying rates of epidemiological factors. This will provide a much richer picture of factors that are influencing racial disparities in pregnancy and maternal health outcomes at a regional level.

We look forward to launching this index, alongside a comprehensive, publicly available suite of research and data tools, in October 2021.