ASCEND-WI
Medical College of Wisconsin
The Addressing Key Social-Structural Risk Factors for Racial Disparities in Maternal Morbidity in Southeastern Wisconsin (ASCEND WI) Center of Excellence at the Medical College of Wisconsin utilizes innovative approaches, equitable collaborations, and skilled academic and community-based partners to create sustainable change and eradicate maternal health disparities in Southeastern Wisconsin and beyond.
Medical College of Wisconsin
Contact
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Co-Principal Investigator: Dr. Anna Palatnik
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Co-Principal Investigator: Dr. Julia B Dickson-Gomez
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Co-Principal Investigator: Dr. Jessica M. Olson
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Co-Principal Investigator: Dr. Joni Strom Williams
At a Glance
2
Research Projects
11+
Community Partners
Research Topics- Housing
- Medical mistrust
Status
Research activities started
Overarching Aims
Partner with community organizations to mitigate the impact of social-structural risk factors on maternal health
Develop and evaluate interventions to address social-structural risk factors for racial disparities in maternal health.
Research Project Details
Reducing Housing Instability and Neighborhood Deprivation Effect on Maternal Health (HOME)
The HOME project aims to investigate the effects of different housing statuses and stability on maternal physical and mental health to motivate policy change to increase housing stability among pregnant people and reduce maternal disparities. The study population will include 589 low-income birthing people experiencing housing instability in Wisconsin.
Building Trust and Uniting Teams through Doula Partnership (BUNDLE)
The BUNDLE project aims to reduce medical mistrust for Black birthing people by developing and testing a model of care that integrates community-based doulas in prenatal care. The study population will include 412 Black pregnant people from the city of Milwaukee, Wisconsin.
Key Maternal Health Indicators: Wisconsin
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60,049
live births in 2022 1
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27.4%
of births were cesarean deliveries 1
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10.3%
of births were preterm 1
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34.1%
of deliveries were covered by Medicaid 1
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764
women with life-threatening complications per every 100,000 births 2
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7.2
women die from pregnancy complications per every 100,000 births 3
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2.4x
more Black women die from pregnancy complications than White women 3
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Top-3 causes
of pregnancy-related deaths: mental health conditions, hemorrhage, and cardiomyopathy 3
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3.1%
of women are without a birthing hospital within 30 minutes 4
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82.2%
of birthing women start prenatal care in the 1st trimester 1
Partner Organizations
- The African American Breastfeeding Network (AABN) an organization that works to improve maternal and child health and champion breastfeeding equity by advocating for system and policy-level change, partners to provide community-based, family-centered, culturally tailored health education and support services
- The Social Development Commission (SDC) a Community Action Agency that provides services to low-income families and acts as a Housing Counseling agency
Additional partnerships include: Acts Housing, Housing Authority of the City of Milwaukee, UW-Milwaukee, UW-Madison, Marshfield Clinic Research Institute, Alverno College, United Community Center, Sixteenth Street Community Health Centers, and Froedtert Hospital.
“As healthcare providers, we know that health is more than what happens in the clinic or hospital. Where one lives, learns, and works has a much greater impact on length and quality of life, but not everyone lives in a place that affords them the opportunity to reach their full potential. The primary goal of MCW’s Maternal Health Research Center of Excellence is to address key social-structural risk factors for racial disparities in maternal morbidity in Southeastern Wisconsin identified by our research community and community partners. These risk factors include housing instability, medical mistrust, and fragmented access to prenatal and postpartum care."
Our Work
References
- Data are from 2022 live births occurring within the US to US residents. Cesarean deliveries are the percentage of live births where the final route and method of delivery was cesarean. Preterm births are the percentage of live births where the gestational age at birth was less than 37 weeks. Medicaid coverage is the percentage of live births where the source of payment for the delivery hospitalization was Medicaid. Prenatal care in the 1st trimester is the percentage of live births where the first prenatal appointment occurred between the 1st and 3rd month of pregnancy.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. - Life threatening complications are deliveries with a diagnosis or procedure code indicating severe maternal morbidity. Information reported for 2021.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases 2010 to 2021. - Number of deaths and difference in rate of deaths between Black and White women is based on pregnancy-related deaths in 2011-2015. Top 3 causes are based on pregnancy-related deaths in 2016-2017. Pregnancy-related deaths include deaths during or within a year of pregnancy from causes related to or aggravated by the pregnancy or its management.
Source: 2016-17 Wisconsin Maternal Mortality Report, April 2022. - March of Dimes Maternity Care Deserts Report 2023.