Wednesday, January 15, 2025
1/15/2025
Alabama has consistently been ranked among the worst for infant and maternal health in the U.S. Infant and maternal mortality rates are consistently above the U.S. average. Disparities by race and ethnicity persist, and health care access issues exacerbate these disparities in rural areas of the state. Co-morbid and chronic conditions, limited insurance coverage, providers in certain regions, and economic barriers for women all create circumstances that compound health issues for the most vulnerable populations in AL. Women and children of color are affected more acutely by these and other critical issues. Although there are many pressing challenges for the perinatal population in Alabama, the burden of opioid addiction on both mothers and babies is staggering. In 2020, Alabama had the highest prescribing rate of opioid narcotics in the country. National data from 2021 show an increase of 131% of maternal opioid-related diagnoses at the point of delivery between 2010-2017. In 2019, approximately 7% of women used prescription opioid pain medication during pregnancy, and 1 in 5 reported misuses for a reason other than pain management. Nationally, substance overdoses have increased since the start of the COVID-19 pandemic. In Alabama, for the entirety of the population, those rates increased by more than 20% in 2020. There are multiple reasons that AL data on maternal substance use disorder (SUD) and, subsequently, NOWS are likely inaccurate. In 2016, substance use contributed to a large proportion of maternal deaths. However, detailed information or data on SUD during pregnancy or postpartum is limited and inconsistent. Because of the challenges with maternal SUDs, the ALPQC and its collaborators identified standardizing the treatment of NOWS as one of its priorities. In Year 1, the ALPQC will focus QI strategies and activities specifically on NOWS. Continuing into future years, the ALPQC will progressively expand the reach of the NOWS project to include strategies to address maternal opioid misuse at the hospital and community level while further building the infrastructure of the ALPQC to engage in other QI initiatives. We will also continue to increase collaboration and engagement with patients, families, and the community. Through funding from Component A of the State Perinatal Quality Collaboratives, the Alabama Perinatal Quality Collaborative (ALPQC), housed at the University of Alabama at Birmingham, School of Public Health, Department of Health Policy and Organization, can begin to address some of the challenges faced by the maternal and infant populations in Alabama. Through the QI-focused projects, the clinical care, and outcomes for and data on pregnant and postpartum people and their babies, and even families, can improve. In addition, the collaborative partnerships with the ALPQC, hospitals, Alabama Department of Public Health (ADPH), the Alabama Hospital Association (AlaHA), and other entities potentially can address gaps in infrastructure, data, and communication. The efforts of the ALPQC focus on Healthy People 2030 indicators related to opioid use during pregnancy, maternal mortality, and others as well as aligning with national public health strategies and priorities. Previous work of the ALPQC provides evidence of the project team’s ability to engage in QI projects with hospitals throughout the state.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).