Search

Begin New Search Author Laurie Zephyrin

1. Health Care for Women: How the U.S. Compares Internationally

Author:
Munira Z. Gunja, Relebohile Masitha, and Laurie Zephyrin
Publication Date:
08-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Recently released federal data once again show the United States with by far the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic.1 Racial disparities are also extreme: Black women in the U.S. are nearly three times more likely to die from pregnancy-related complications than white women are. But maternal deaths and complications may be an indicator of the nation’s wider failures with respect to women’s health and health care. Compared to women in other high-income countries, American women have long had worse access to the health care they need. While the U.S. spends more on health care than other countries do, surveys regularly find that Americans avoid seeking care because of costs at the highest rates, even as the U.S. continues to lead in the prevalence of chronic disease.2 At the same time, limited access to primary care and inadequate coordination of health services are likely factors in the nation’s poor performance when it comes to the prevention, diagnosis, and management of diseases.3 In this brief, we compare selected measures of health care access and outcomes for women in high-income countries. We drew upon data from four sources: the Commonwealth Fund’s 2023 International Health Policy Survey of Australia, Canada, France, Germany, the Netherlands, New Zealand, Switzerland, the United Kingdom, and the United States, which allowed us to analyze responses by race and ethnicity;4 the Centers for Disease Control and Prevention National Vital Statistics System; the Organisation for Economic Co-operation and Development (OECD); and the Institute for Health Metrics and Evaluation Global Burden of Disease. The latter two data sets permitted us to show results on selected measures for five additional countries — Chile, Japan, Korea, Norway, and Sweden. (See “How We Conducted This Survey” for more details.)
Topic:
Women, Public Health, Healthcare System, and Life Expectancy
Political Geography:
United Kingdom, Canada, France, Germany, Australia, and United States of America

2. Insights into the U.S. Maternal Mortality Crisis: An International Comparison

Author:
Munira Z. Gunja, Evan D. Gumas, Relebohile Masitha, and Laurie Zephyrin
Publication Date:
06-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
The United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths — over 80 percent — are likely preventable.1 With policies and systems in place to support women during the perinatal period, several high-income countries report virtually no maternal deaths. As policymakers and health care delivery system leaders in the U.S. seek ways to end the nation’s maternal mortality crisis, these countries may offer viable solutions. This brief updates an earlier Commonwealth Fund study of differences in maternal mortality, maternal care workforce composition, and access to postpartum care and social protections between the U.S. and other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.2 In this edition, we have also included data on Chile, Japan, and Korea — all high-income countries with universal health care systems. For our analysis, we used the most recently available data from the U.S. Centers for Disease Control and Prevention (CDC) and from the Organisation for Economic Co-operation and Development (OECD), of which the U.S. is a member. Where country-specific data are more than five years old, we note whether more recent published data from other sources are available for that country. Readers should be aware that because the methods we used to derive updated numbers from other sources may be different from methods the OECD uses, data points may not be comparable to the U.S. rates. For complete details on our methods, see “How We Conducted This Study.”
Topic:
Development, Inequality, Public Health, and Maternal Mortality
Political Geography:
United Kingdom, Canada, Norway, France, Germany, Australia, Switzerland, North America, Sweden, Netherlands, New Zealand, and United States of America

3. Health and Health Care for Women of Reproductive Age: How the United States Compares with Other High-Income Countries

Author:
Munira Z. Gunja, Shanoor Seervai, Laurie Zephyrin, and Reginald D. Williams II
Publication Date:
04-2022
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
The maternal mortality crisis in the United States has been well documented: U.S. women have the highest rate of maternal deaths among high-income countries, while Black women are nearly three times more likely to die from pregnancy-related complications than white women are.1 But maternal deaths and complications may be a bellwether for the U.S.’s wider failures with respect to women’s health and health care. Using data from the Commonwealth Fund’s 2020 International Health Policy Survey and the Organisation for Economic Co-operation and Development (OECD), this brief compares selected measures of health care access and outcomes for women of reproductive age (18 to 49) in 11 high-income countries. After identifying gaps in U.S. health system performance for women in this age group, we explore some of the policies other nations have put in place to ensure more equitable access and better health outcomes. We also suggest policy options for the United States.
Topic:
Health Care Policy, Reproductive Rights, Reproductive Health, and Abortion
Political Geography:
United States

4. Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries

Author:
Laurie Zephyrin, Molly FitzGerald, Munira Z. Gunja, and Roosa Tikkanen
Publication Date:
11-2020
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
The U.S. has the highest maternal mortality rate among developed countries. Obstetrician-gynecologists (ob-gyns) are overrepresented in its maternity care workforce relative to midwives, and there is an overall shortage of maternity care providers (both ob-gyns and midwives) relative to births. In most other countries, midwives outnumber ob-gyns by severalfold, and primary care plays a central role in the health system. Although a large share of its maternal deaths occur postbirth, the U.S. is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period.
Topic:
Health, Health Care Policy, Women, and Reproductive Health
Political Geography:
United States and Global Focus