Severe Maternal Health Outcomes Differ Across New Jersey Municipalities

Felix Muchomba, PhD; Julien Teitler, PhD; Lakota Kruse, MD; Nancy Reichman, PhD

Severe Maternal Morbidity (SMM) includes a range of life-threatening complications resulting in significant short- and long-term impacts on birth and health outcomes. When examining SMM rates across New Jersey’s diverse municipalities, significant disparities exist.

SMM rates are generally reported at state and national levels, however local prevalence estimates are not as widely available, presenting significant challenges in improving maternal mortality in the absence of robust data. A Rutgers University-led study, with research support from the Robert Wood Johnson Foundation's Evidence for Action program, found substantial variation in SMM rates across New Jersey.

The study sought to answer the key question: is municipal spending associated with SMM prevalence? Using birth and maternal hospital discharge records from 2008-2018, the research team found that municipal expenditures on fire and ambulance, transportation, health, housing, and libraries were negatively associated with severe maternal morbidity; police expenditures were associated with higher SMM odds. These findings suggest that municipal-level budget allocations may pose adverse consequences on SMM rates and potentially maternal mortality. Budget surveillance at the municipal level, a level rarely considered in studies of health outcomes, would be important for success in enhancing the targeting of resources that play a significant role in maternal morbidity and mortality rates.

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