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Worsening disparities — US maternal deaths more than doubled over two decades, study estimates Black people have the highest overall rates of deaths in the US.

Beth Mole – Jul 5, 2023 10:37 pm UTC Enlarge / A pregnant woman holds her belly on September 27, 2016.Getty | Matthew Horwood reader comments 101 with

The number of people in the US dying of pregnancy-related causes more than doubled over two decades, with Black, Native American, and Alaska Native people facing the highest risks, according to a new study in JAMA.

The US has the highest rate of maternal deaths compared to other high-income countries, despite spending far more on health careboth on a per-person and share of gross domestic product basis. And, while US maternal deaths have long been high, they’ve only gotten higher while other high-income countries have seen declines.

Still, digging into US maternal mortality data to understand the trend is difficult. States define maternal deaths differently, some have been slow to add a standard pregnancy-related question on death certificates, and some delay the release of their data.

In the new JAMA study, researchers tried to make up for those differences by modeling state-level trends in maternal mortality using national data, looking specifically at death rates by race and ethnicity for each year between 1999 and 2019. The research was led by Gregory Roth at the Institute for Health Metrics and Evaluation at the University of Washington.

The big picture findings of the study square with what we already know of maternal mortality in the US: it’s high and getting higher and particularly high for Black people in southern states. But, it also revealed widening disparities in specific states and ethnic groups that had not been previously highlighted.

Overall, the study noted that in 1999 there were an estimated 505 pregnancy-related deathsdefined as deaths related to pregnancy by medical coding that occur up to one year after the end of pregnancy. (Unintentional injuries, homicides, and suicides were excluded). By 2019, the number of pregnancy-related deaths more than doubled to 1,210. The maternal mortality rate (deaths per 100,000 live births) went from 12.7 in 2009 to 32.2 in 2019. Advertisement Trends

Among Black pregnant people, the nationwide mortality rate went from 31.4 to 67.7 in that time. For every year studied, the Black population had the highest state median for maternal mortality rate. Unsurprisingly, many of the states with the highest maternal mortality rates that got higher during the study period were in the Southbut not all. New Jersey and Arizona were among the top five states that saw the largest increases in Black maternal mortality rates over the study period, along with Louisiana, Georgia, and Texas.

The American Indian and Alaska Native populations saw the largest increases in the median state mortality rates. Florida, Kansas, Illinois, Rhode Island, and Wisconsin all saw mortality rates in these populations increase by more than 162 percent during the study period. Asian maternal mortality rates, meanwhile, were high in Wyoming, Montana, and Nevada, which have high proportions of Filipino populations.

Hispanic and White populations saw lower maternal mortality rates than the other groups but still saw increases, particularly in the South and Northeast. The authors note that mental health is a leading factor in maternal deaths in these two groups, and because suicide and overdose deaths were excluded from the study, it may have masked some maternal death estimates in these groups.

Overall, the study paints a bleak picture of maternal health in the US. “Maternal mortality persists as a source of worsening disparities in many US states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis,” the authors concluded.

Moreover study period ended in 2019 before the CDC reported a pandemic-related spike in pregnancy-related deaths. Maternal morbidity and mortality are also expected to increase after the Supreme Court’s decision to overturn the constitutional right to abortion. Bans and restrictions that are now going into effect in roughly half of US states will limit abortion access and pregnancy care.

Editor’s Note: This post has been updated to correct the dates of the study. reader comments 101 with Beth Mole Beth is Ars Technicas Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes. Advertisement Channel Ars Technica ← Previous story Next story → Related Stories Today on Ars

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Brewers celebrate division title, feel like underdogs

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Brewers celebrate division title, feel like underdogs

ST. LOUIS — As celebratory prosecco and beer poured down his face, Christian Yelich soaked in the satisfaction of the Milwaukee Brewers‘ third straight NL Central Division title.

“This is the why,” Yelich said Sunday after the Brewers clinched, courtesy of the Cubs1-0 loss in Cincinnati. “This is why everything’s harped on throughout the year. Why we pay attention to detail, why there’s tough love throughout the season, why you keep grinding and why you keep trying to get better is for these moments — the fact that you can celebrate with your teammates.”

Carrying the best record in baseball, the Brewers won their fourth division title in the past five seasons and yet feel like the underdogs as the playoffs loom.

“In baseball, any team could beat anybody, especially in short series. Obviously, we’re not going to be favored. Everyone’s going to kind of point to our question marks and how there’s other teams that have more experienced players and, on paper, super talented rosters,” Yelich said. “But I think that gives our team a freedom. Nobody thinks that you’re going to be able to do this. So go out there and just play.”

Milwaukee lost Willy Adames to free agency and traded away closer Devin Williams in the offseason, and it was unclear what contributions veterans Brandon Woodruff (shoulder surgery) and Yelich (back) would be able to provide.

Both were able to be key players, although Woodruff’s status for the postseason is in question after he went on the injured list Sunday with what the team described as a moderate lat strain.

“Are we the most talented? No. Are we going to go up against teams far more talented with four times the payroll? Sure, but it doesn’t bother this team,” manager Pat Murphy said.

Since 2018, the Brewers have lost in the wild-card round four times, in the division series once and in the NL Championship Series once. The franchise’s only pennant came in 1982.

“I heard somebody say we’ve got the regular season figured out, now we’ve got to figure out the playoffs. That’s one of the most absurd comments I’ve ever heard,” Murphy said, emphasizing his squad’s body of work.

After losing 5-1 to St. Louis, the Brewers had to wait less than a half hour before the Cubs’ game ended. The team put on navy blue “division champs” shirts, sprayed bottles of chilled prosecco and dumped cans of beer on each other’s heads.

A blue flag with late announcer Bob Uecker’s signature hung in the soaked visitors locker room.

Owner Mark Attanasio suggested there was some “Brewer magic or Uecker magic” in this team.

“It’s really just the culture. We show up every spring training with the goal of winning the division,” said Sal Frelick, in his third year with Milwaukee. “So, it’s been great. I’m fortunate to be able to do it every year.”

The Brewers gathered on the Busch Stadium infield for a team photo and were about to disperse when Murphy came up the stairs from the dugout, almost left out of the moment.

“When we started the year, nobody thought we’d be here at this point. Obviously, we’ve had our share of injuries. Nobody could have imagined we’d be in this spot right now,” Woodruff said.

The Brewers were at their best during a 29-4 stretch in July and August, turning a four-game deficit into a commanding nine-game advantage in the division.

“We’ve done a heck of a job as a group to get to this point,” Woodruff said. “And you know what? There’s still a lot of baseball left for the Brewers.”

Last year, they won the Central by 10 games before dropping the wild-card series to the Mets — losing the decisive Game 3 after Williams squandered a two-run lead in the ninth inning. Pete Alonso‘s three-run home run was the key.

To Murphy, who took over as Milwaukee’s skipper before this past season, that’s the fickle nature of the playoffs.

“It takes a lot of things to go your way, and sometimes having great talent helps that,” Murphy said. “I don’t worry about this team, and I don’t worry about what anybody says about this team. I get to live it every day and see how special they are.”

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First AL ticket punched as Jays earn playoff spot

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First AL ticket punched as Jays earn playoff spot

KANSAS CITY, Mo. — The Toronto Blue Jays became the first American League team to secure a spot in the postseason on Sunday with an 8-5 victory against the Kansas City Royals.

The AL-best and AL East-leading Blue Jays locked up a playoff spot with a week remaining in the regular season after a less-than-stellar start of 16-20 in early May and trailing by as many as eight games in the division in late May.

“I remember back when we were in Tampa in May, we weren’t playing very well and we got swept there,” Blue Jays manager John Schneider said. “I think these guys did a great job of rallying around each other, but the turning point was really when we came out of Tampa and went into the Texas series.”

This is Toronto’s third playoff berth in four years and fourth in six seasons. They missed the postseason in 2021 and 2024. Playoff success has been elusive for the Blue Jays, who haven’t won a postseason game since 2016. And, unlike the past three trips, they hope this year they won’t have to play in the AL wild-card round as they try to win their first division title since 2015 as they close out the regular season with a six-game homestand against Boston and Tampa Bay.

“You could feel it with this group in spring training,” Schneider said. “I know that sounds really cliché, but when you get a group of men that are committed to the same goal, you can do things like this.”

The Blue Jays’ 90-66 record is tops in the AL and they lead their division by 2½ games over the New York Yankees. If Toronto wins the AL East and has one of the two best records in the league, it will advance to the AL Divisional Series, which starts Oct. 4.

The last time Toronto made it that far was nine years ago.

“I’m just so happy for them,” Schneider said. “It’s hard at this level for everyone to put their egos aside and to play for one another. It’s so cool to see these guys completely happy for one another when they get the job done no matter who it is. This is the most fulfilling team I’ve ever been a part of with different characters, different skill sets, guys coming together for one common goal which is what’s important now. This is something you always celebrate.”

The Blue Jays are trying to win their first World Series since 1993.

“Today we go back to the postseason, but the journey is not over yet,” Vladimir Guerrero Jr. said. “We still want to win the division over the next six games. Since spring training, everyone has been together and when you see a team like that you start believing.”

Toronto snapped a four-game losing streak with Sunday’s win, and after the game popped champagne in the visitors clubhouse in Kansas City.

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Fading Mets slump into wild-card tie with Reds

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Fading Mets slump into wild-card tie with Reds

NEW YORK — For nearly six months, almost the duration of an entire Major League Baseball regular season, the New York Mets occupied a spot in the National League playoff picture. That changed Sunday after a brutal loss that concluded an ugly weekend and prolonged a baffling three-plus-month swoon with a week remaining on their schedule.

The Mets’ 3-2 loss to the last-place Washington Nationals at Citi Field — a sloppy, toothless showing cemented with two jaw-dropping catches by Nationals center fielder Jacob Young — combined with the Cincinnati Reds’ 1-0 win over the Chicago Cubs dropped them from postseason position for the first time since April 5 when their season was eight games old.

“It’s the way it’s gone,” Mets left fielder Brandon Nimmo said. “I can believe it because I’ve watched it. We’ve been watching it happen right in front of us.”

While both teams have an 80-76 record with six games remaining, the Reds hold the tiebreaker after winning the season series between the clubs. The Mets, who have lost 11 of their last 15 games, finish the regular season with a road trip against the Chicago Cubs and Miami Marlins starting Tuesday. Cincinnati hosts the Pittsburgh Pirates for three games before concluding their schedule on the road against the Milwaukee Brewers.

The Arizona Diamondbacks are also looming, just one game behind the Reds and Mets in the standings for the third NL wild card spot. Arizona owns the tiebreaker over both clubs.

“We just gotta win,” Mets first baseman Pete Alonso said. “It’s simple. Winning solves everything at this point. We just gotta do it. That’s it. We got to solve our issues between the lines. That’s the simple fact.”

The Mets, at 45-24, boasted the best record in the majors through June 12. They looked like a club that would sail into October after clawing their way into the playoffs and defying expectations with a trip to the NLCS in 2024 through 69 games.

But this year’s team has produced inverse results from the 2024 version that stumbled early before a magical summer pushed them deep into October. These Mets, with the second-most expensive roster in the majors, have gone 35-52 since June 13. That is tied for the fourth-worst record over that stretch with the Chicago White Sox. Only the Nationals, Minnesota Twins and Colorado Rockies have been worse over the 87-game span.

They enter their final two series with a 50.1% chance of reaching the postseason, according to FanGraphs. They were given a 96.2% chance on June 12.

“I can’t put my finger quite on it other than we just haven’t been able to put it together as a team for an extended period of time,” Nimmo said.

The Mets, coming off an encouraging series victory over the playoff-bound San Diego Padres, took the series opener Friday behind an offensive outburst. But they fell on Saturday in 11 innings on an inside-the-park home before before early mistakes, coupled with Young’s defense, buried them on Sunday.

In the first inning, Juan Soto, who went 1 for 2 with two walks, was picked off at first base. In the second, Francisco Lindor committed a throwing error that allowed the game’s first run to score.

“If we want to be where we want to be, those things can’t happen,” Lindor said. “Full accountability on that. I have to be better.”

And in the third inning, Cedric Mullins failed to take second base on a line drive that he hit down the left-field line, a decision that potentially cost the Mets a run.

Mullins said he thought the ball was caught by Lile as he crashed into the wall. Meanwhile, first base coach Antoan Richardson thought it was ruled foul. But the ball was ruled fair and bounced out of Lile’s glove.

Luis Torrens, who was on second base, was unsure if Lile made the catch so retreated to tag up and scored on the play as Lile writhed in pain. Mullins, despite teammates yelling and signaling to him to run to second base, remained at first base. He was doubled off moments later when Lindor cracked a line drive to first base. Soto then lined what would’ve been an RBI double.

“You just gotta go,” Mendoza said.

On the mound, the Mets deployed Sean Manaea and Clay Holmes as a piggyback for the second time in the last week after both veterans struggled to effectively pitch deep into games in the second half. The duo combined to give up just three runs — all in the second inning off Manaea — over six innings, with the biggest damage coming from the light-hitting Nasim Nunez swatting a two-run home run.

In the end, the Mets’ $38 million tandem was outpitched by the Nationals’ $1.4 million piggyback of Jake Irvin and Mitchell Parker, who entered Sunday with the highest ERAs in the majors among qualified pitchers this season.

They were buoyed by two highlight-reel catches from Young in center field. The first, a circus grab in which he kicked the ball to himself, robbed Brett Baty of extra bases in the fifth inning. The second took away a potential game-tying home run for Francisco Alvarez in the ninth.

“Those were crazy plays,” Mullins said. “In the stretch we’re in, every win matters. To see plays like that made, definitely deflates [you] a little bit. [We’ve taken] some tough losses on the chin. We have a week left. We’re doing to do some damage so that’s what we’re focused on.”

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