Improving the Collection of Maternal Health Data

MedCity FemFwd Podcast:
Episode 20 with Maggie McCullough

Marissa: Welcome back to MedCity FemFwd. I’m Marissa Plescia, reporter for MedCity News. The federal government keeps track of maternal health data, but it’s not always the most granular and has a significant lag. Here to talk about the ways that we can improve the collection of maternal health data, we have Maggie McCullough of PolicyMap.

Hi Maggie. Thanks so much for joining MedCity FemFwd.

MAGGIE: Thanks for having me. It’s great to be here.

Marissa: Yeah, absolutely. And you know, today we’re going to be talking about the current state of maternal health data and how it can be improved. But before we get into all of that, can you just tell us a little bit more about yourself and PolicyMap?

MAGGIE: Sure. So my name is Maggie McCullough, and I’m the CEO and founder of PolicyMap. PolicyMap is a data and mapping application that we’ve built to make it easier for people to understand what life is like in neighborhoods across the country. And we do that by collecting as much data as we can, including the maternal health data that we’ll talk about today, making it available in a single location so that people can get insights into communities by looking at that data in combination with each other to then create strategic decisions, interventions, investments in communities that are designed to really address the issues that the data is showing are prevalent in the community.

So our very strong belief is that good data will drive good decision-making. And so we want to be a tool that enables people to be able to do that. And I had this idea after working for most of my career in government, trying to make data easier for people to understand. And then within a nonprofit where I was working called the Reinvestment Fund, it’s a community development financial institution, basically a nonprofit bank, where we were trying to understand what impact our investments were having in communities. We were trying to think about what other communities we should be making investments in, and we’ve realized how crucial it is to have easy access to this kind of data. And that’s kind of what spurred the development of PolicyMap.

Marissa: Really interesting. Thank you so much for sharing. And so when it comes to maternal health data, specifically like government maternal health data, what do you think is wrong with the way that it’s currently collected?

MAGGIE: So the good news is that there’s a lot of data that the federal government puts out about maternal healthcare, right? So everything from maternal mortality rates to birth outcomes to when women are able to take, you know, get to a prenatal visit, at what point in the pregnancy, disparities that exist in this, whether it’s by gender, race, ethnicity, geography. There’s some data available on the mental health of pregnant women as well as postpartum, substance abuse during pregnancy. I mean, it’s really a lot of information that the federal agencies put out. The problem is, is that the data it’s just one piece of information coming from one agency, so it’s very siloed. And it is hard to connect the dots when you’re only looking at one piece of information at a time.

Marissa: Got it. So, what insights do you feel like we’re really missing with the way that it’s currently collected?

MAGGIE: I think that if we assume that the reason the data’s being collected and distributed in the first place is to actually help improve maternal health outcomes, it’s really hard to get insights from one piece of information without having all those pieces of information looked at in a holistic way. I think that the first issue that we talked about, that the data is siloed in these different agencies, is a problem. I think secondly, there’s a big problem with the lag in the release of the data. And it’s not just maternal health data that has this lag, it’s all data coming from the federal government.

It’s many times a one to three-year lag. It became really obvious how important or how problematic that lag was during COVID because if we were looking in 2021 to see what health conditions looked like in neighborhoods, you realize you were looking at data from 2018 or 2019 and you realize this is really historical data that doesn’t bear a lot of relevance on current life.

So that’s a problem. The third is that many data sets are not released down to a neighborhood-level. You can get county-level data or state-level data, which is great. You can see trends like how a state is changing over time. But if you really want to find out what’s going on in a neighborhood and the kind of interventions a particular neighborhood needs, you need that data down to a more granular level.

And then fourth, I think is again, if the reason that we’re collecting this data, the federal government is collecting and releasing the data, is to understand where women are facing maternal health challenges and why, why is what’s going to drive the kind of intervention that’s needed to help. There’s not as much data available on the stressors that women are facing that may lead to poor maternal health outcomes.

So whether they’re financially insecure, they’re food insecure, or they don’t have enough money, they’re living in unstable housing – this kind of data, some of it’s out there, some of the social determinants of health data is out there, but it’s not as prevalent as it should be.

Marissa: Yeah. Yeah. Really well said. Thank you for explaining that. So, are there any specific populations in the US that are really affected by the way that the data is currently collected?

MAGGIE: I don’t know that there’s any specific populations that are affected. I think certainly in areas in the country where you have a higher prevalence of poor maternal health outcomes, those areas may get overlooked a little bit. If you are not able to make a strong case for all the other factors in the neighborhood, that suggests this is a place where we really need to pay attention.

At PolicyMap, for example, one of the things that we’re doing, that we do is we allow people to take that disparate data and layer it on top of each other pretty easily. So if you wanted to see, for example where across the country the CDC says there are high percentages of children with low birth weight and where a different agency would say that maternity care is in short supply, and where communities have high rates of food insecurity, you can layer that all together and say, you know, in a world of limited resources, that’s where I should be spending my money. And so, to your point, to your question, I think communities get overlooked when they’re only looking at one piece of data at a time, it’s this combination that tells a story of both what’s going on and what could be done to improve health outcomes.

Marissa: I’m sorry, was there more that you wanted to add there?

MAGGIE: No, just the other thing is in addition to what we do at PolicyMap, there are organizations out there. We are working with a group called Surgo Health, where they take the disparate data, they create an index from zero to a hundred to make it easy for people to understand, on a scale of zero to a hundred, how in trouble the women are in this community, right? And they do it not just for maternal healthcare overall but they look at some of those social determinants of health. Is it related to transportation? Is it related to the fact that they don’t have access to medical care? And so on. And so we have partnered with them and we’ve pulled in their index into PolicyMap as yet another indicator that can be used to help people figure that out.

Marissa: Got it. Yeah. Very interesting. Yeah. And going off of that, is there anything, you know, that you would like to see changed on a federal level to really improve the way they collect this data?

MAGGIE: I think that I would love to see the federal government collect data at a more granular level and not just release county-level data. Sometimes it’s at the zip code, but even that can be a little too large. I think that there must be ways for the federal government to partner with healthcare providers because healthcare providers collect a lot of data on the social determinants of health of the patients that they’re serving.

We’ve all been in the doctor’s office where we fill out the survey, and it says, you know, are you living paycheck to paycheck? Or do you feel safe at home? All of that information that does not get distributed. And I know that there are privacy reasons that it doesn’t get distributed, but I have to think that there is some way to de-identify that data, aggregate it to a larger geography, that maybe the federal government could help with some of that work so that it would be more information about the stressors that people are facing that impact their health. And it would be more timely if we could get it out, and within a year, even that would be better than having a three-year lag.

I think that the federal government, the lag is an issue. I wish there were a way for them to get the data out faster. And I do think they could probably work with some private sector folks that are already collecting data and just help find ways to get it out into the public domain.

Marissa: Do you see the federal government being interested in making those changes? Would it be a big financial undertaking there?

MAGGIE: You know, I haven’t seen them making those efforts, and I don’t know what the financial undertaking would be, so I don’t have a good answer to that question.

Marissa: Sure. Yeah. So, what are some things that PolicyMap is doing to kind of move this forward to improve the collection of maternal health data?

MAGGIE: For the most part we’re trying to make sure that we have every single piece of information that’s out there, both in the public domain, and then if there is any data that we can license that we would license it, like the Surgo Health data, to really give our users a full curated collection of what seems to be the most reliable data when it comes to maternal health, and then making sure that within our platform it’s easy for them to layer different pieces of information and connect the dots.

And so, it’s also one thing to understand where needs are, like where you have areas that meet certain criteria, suggesting that this is a place where interventions are necessary. We also try and make sure that we map the assets, so that if you are, for example, a hospital and you have a set of interventions in the community that you serve, you could see, for example, where all the nonprofits are in the area that you serve. You could see where all of the food banks are in the area that you serve. You could see where all of the anchor institutions are in a community. Because it’s one thing to try and do it alone, it’s another to try and do it in partnership with other entities who already have a foothold in the community, already have people that they work with on a regular basis to create an intervention that’s going to be sticky.

And then what we also do is we include designations like opportunity zones, which are geographic designations around the country where investors can get tax incentives for doing work. And these tend to be underserved, poorer areas, but hospitals, if they have an intervention or if a health provider wants to set up a new office, they can get more investors to the table if they do it within an opportunity zone as well.

So, it’s really like looking at all the data and taking it down to the lowest level possible and saying, if I’m going to do one thing, I should really do it here because the conditions say that this is needed. There are assets in this community that I can work with. And maybe I can get more investors interested in my project if I sit in a tax-friendly location.

Marissa: Interesting. Yeah. Thanks so much for sharing that. And going off of that, you know, what are some things that other healthcare stakeholders can really do to improve maternal health data, whether it be providers, payers, employers, etc.?

MAGGIE: Yeah, I think if they can find ways to better share the data that they have in a way that doesn’t harm someone’s personal privacy, in a way that de-identifies the data, I think it will marry what the federal government is putting out there really well.

I hope that will be something that we’ll find a way to do because the patient level data, there are troves of information in that that could be really useful.

Marissa: A great recommendation there. Well, Maggie, this was such a great conversation. Thank you so much for joining MedCity FemFwd. I really appreciate it.

MAGGIE: Thank you. I appreciate it too. Thanks for your time.