Clark County Public Well being highlighted disparities in prenatal care entry throughout the county, significantly for these with Medicaid, throughout a Wednesday presentation on the Board of Well being assembly.
The Clark County Council, which additionally serves because the county Board of Well being, heard from three Public Well being workers, who additionally spoke in regards to the excessive price of postpartum care and the way to enhance entry to maternal well being companies throughout the state.
“We continue to hear from pregnant individuals and those that provide services to the community that accessing prenatal care with Apple Health coverage is difficult and sometimes impossible,” Public Well being Household Initiatives Coordinator Hayley Pickus mentioned. “This can be extremely harmful to both the fetus and pregnant person and will require a concerted effort to solve the problem in the short and long term.”
Prenatal care, provided throughout a being pregnant, could also be delivered by a major care supplier, midwife or OB-GYN. Routine prenatal care is a useful alternative to determine and deal with being pregnant problems, an infection or ailments — and provide well being counseling, Pickus mentioned.
However even people with complete being pregnant protection by way of Apple Well being, Washington’s Medicaid program, are struggling to entry care, Pickus mentioned.
“Investments early in life reap benefits into adulthood,” Pickus mentioned. “Early and regular prenatal care promotes healthy pregnancies, while inadequate prenatal care increases risk for pregnancy complications.”
Public Well being Epidemiologist Adiba Ali mentioned every year about 5,500 youngsters are born in Clark County, in response to the latest knowledge obtainable from Public Well being.
In 2023, 38 p.c of all births in Clark County have been coated by Apple Well being, whereas 57 p.c of births have been coated by non-public insurance coverage, Ali mentioned. The very best fee of Apple Well being births have been amongst Pacific Islander, Hispanic, Native American and Black populations.
That very same yr, total about 27 p.c of people that gave beginning in Clark County acquired insufficient prenatal care. This fee practically doubled for the county’s Pacific Islander neighborhood, with 56 p.c receiving insufficient prenatal care between 2018 and 2022, in response to Public Well being.
“This is really alarming and informative, and I think highlights your important role in analyzing and collecting the data and transforming all of that into actionable items,” Council Chair Sue Marshall mentioned to the staff from Public Well being on the assembly.
Emma Burghardt, a nurse with Public Well being’s Nurse-Household Partnership program, offered anecdotal perception into the countywide challenge.
A few months in the past, Burghardt acquired a referral from a younger, first-time mother whose second language was English. Burghardt recounted how she and her consumer struggled to discover a supplier who accepted Medicaid and provided prenatal care. The 2 contacted a number of clinics, making an attempt to substantiate whether or not Medicaid was accepted, however didn’t discover a appropriate possibility in Vancouver. The closest possibility for was a clinic in Longview.
“I tried to learn more about her pregnancy. She was growing anxious with how hard it had been to find a doctor,” Burghardt mentioned. “When we were finally able to connect with the staff, they asked her a series of questions, some of which she didn’t know how to answer. As I put myself in her shoes, I couldn’t help but feel her sadness and discouragement.”
The important thing takeaway is that there are levers — on the federal and state ranges — to enhance the best way Medicaid is managed, funded and delivered, Pickus mentioned.
The company hopes to get rid of obstacles to care by way of neighborhood initiatives, such because the Nurse-Household Partnership and Elevating Clark County.
Yasmina Aknin, program coordinator for Public Well being, beforehand mentioned the company is working to enhance referral pathways and improve current prenatal and postpartum help assets, which incorporates conversations round psychological well being and continuity of care.
“Our culturally specific community-based organizations share examples of biased clinical care, a provider population that does not reflect the county’s diversity, transportation barriers and social cultural norms that are not reflected in the American health care system,” Pickus mentioned. “We cannot discount these drivers.”
