A groundbreaking study published today in JAMA Health Forum has revealed significant disparities in out-of-pocket expenses for maternity care among different racial and ethnic groups. The research, conducted by scholars from the University of Maryland School of Public Health (UMD SPH) and Harvard T.H. Chan School of Public Health, examined over 87,000 cases of pregnancy, delivery, and postpartum care from 2018 to 2022. It found that Black, Hispanic, and Asian individuals with private insurance tend to incur higher personal costs compared to their white counterparts. This disparity is most pronounced during prenatal care, where Black individuals paid significantly more, highlighting another layer of inequality in maternal healthcare.
Study Details Reveal Stark Differences in Maternity Care Expenses
In a comprehensive analysis spanning five years, researchers scrutinized anonymized data from Blue Cross Blue Shield of Massachusetts (BCBSMA). They discovered that Black, Hispanic, and Asian individuals faced disproportionately higher out-of-pocket costs for maternity care services. Specifically, during prenatal care, Black individuals paid an average of 74% more, while Hispanic individuals paid 51% more, and Asian individuals paid 4% more than whites. These differences were less pronounced but still notable during delivery and postpartum periods.
The financial burden was particularly significant for Black and Hispanic families, as these costs represented a larger share of their household income. Dr. Rebecca Gourevitch, lead author of the study and assistant professor at UMD SPH, emphasized that these findings underscore the urgent need to address inequities in healthcare access and affordability. She noted that coinsurance rates—where patients pay a percentage of medical costs after meeting their deductibles—are a major driver of these disparities, especially for high-cost services like hospital deliveries.
Dr. Mark Friedberg, senior vice president of performance measurement and improvement at BCBSMA, highlighted the importance of this study in understanding the root causes of longstanding inequities in maternal health outcomes. The insights gained could inform policy changes aimed at making healthcare more equitable for all pregnant individuals.
Anna Sinaiko, senior author and associate professor at Harvard’s TH Chan School of Public Health, pointed out that eliminating out-of-pocket costs for maternity care, as proposed in some states, could have a substantial impact on reducing these disparities. Such policies would particularly benefit Black and Hispanic communities, who currently bear the highest costs.
The study's authors conclude that there is a clear opportunity for health insurance companies, employers, and policymakers to collaborate in designing more equitable health insurance plans that lower out-of-pocket expenses for pregnant and postpartum individuals.
This research underscores the critical role of systemic changes in addressing healthcare inequalities. By shedding light on these financial disparities, it calls for proactive measures to ensure that all individuals receive equitable and affordable maternal care, regardless of their racial or ethnic background.
In a significant development in pediatric healthcare, recent research highlights the critical need to reassess diagnostic practices for asthma in children. A groundbreaking study published in JAMA Network Open on February 28, 2025, reveals that traditional race-specific equations used in diagnosing lung function may inadvertently disadvantage Black children. These outdated methods can lead to under-diagnosis and delayed treatment, affecting long-term health outcomes.
The current diagnostic process for asthma involves multiple steps, starting with symptom reporting by caregivers or medical professionals. Children then undergo pulmonary function tests, which measure lung capacity using spirometers. These devices calculate expected lung function based on age, sex, body size, and race. However, this approach stems from flawed historical studies that inaccurately assumed racial differences in lung function. Consequently, these assumptions have led to adjustments in lung function calculations, potentially skewing results and perpetuating health disparities.
The introduction of new race-neutral equations by the Global Lung Initiative (GLI) Network in 2022 aims to rectify this issue. The updated equations eliminate race as a variable, providing a more equitable assessment of lung function. The study, led by Wan Chi Chang, MS, demonstrated that the race-neutral equation identified significantly more Black children with reduced lung function compared to the traditional race-specific method. This shift could ensure earlier and more accurate diagnoses, leading to timely interventions and better health outcomes for affected children.
Embracing the race-neutral equation is not just a step forward in medical practice; it is a commitment to justice and equality in healthcare. By adopting these updated guidelines universally, healthcare providers can address longstanding disparities and improve asthma diagnosis and treatment for all children. This change underscores the importance of continuous evaluation and adaptation in medical practices to ensure equitable care for every patient.
شهدت الجولة الرابعة والعشرون من الدوري الفرنسي لكرة القدم حادثة مثيرة خلال مواجهة بين أولمبيك ليون وستاد بريست. تسببت قرارات الحكم في طرد مدرب الفريق الأول، مما أدى إلى احتقان كبير على أرض الملعب. رغم هذا الحادث، نجح ليون في تحقيق الفوز بالمباراة.
رد فعل عنيف من مدرب ليون إزاء قرار الحكم
في الدقائق الأخيرة من المباراة، تصاعد التوتر عندما قام حكم اللقاء بمراجعة موقف عبر تقنية الفيديو. رفض المدرب الهدوء والصبر، مما أدى إلى استفزازه وتشنج الأجواء داخل الملعب. اتخذ الحكم قرارًا حاسمًا بإخراج البطاقة الحمراء للمدرب.
خلال الوقت بدل الضائع، بدأ القلق يسيطر على الجميع بسبب قرار الحكم بتقييم الواقعة عبر نظام مساعدة الحكام. لم يستطع فونسيكا كتم غضبه واعترض بشدة على هذا الإجراء، مما دفع الحكم إلى اتخاذ إجراء صارم بطرده من الملعب. اقترب المدرب من الحكم وهو يصرخ بأعلى صوته، لكن لاعبيه تدخلوا بسرعة لمنع أي تصعيد إضافي.
استمرار اللعب وانتهاء المباراة بفوز ليون
بعد هذه الحادثة الدرامية، واصل الفريقان المنافسة حتى النهاية. تميزت الدقائق المتبقية بالتوتر الشديد، حيث حاول الفريقان استعادة التركيز رغم الانفعالات التي سادت الموقف.
بشكل غير متوقع، لم يتم احتساب ركلة جزاء لفريق ستاد بريست بعد مراجعة الفيديو، مما أثار تساؤلات حول صحة القرار. ومع ذلك، تمكن أولمبيك ليون من إنهاء المباراة بنجاح وتحقيق الفوز بهدفين مقابل هدف واحد، مؤكدًا موقعه في سباق المنافسة بالدوري الفرنسي.