New Yorkers rallied this week, calling for action to help address the structural inequality Black and Brown people experience during pregnancy and birth.

Black women are at least three times more likely to die from pregnancy-related causes than their white counterparts, according to the Centers for Disease Control and Prevention. New York City Public Advocate Jumaane Williams wants Congress to pass the Black Maternal Health "Momnibus" Act of 2021, which would direct agencies to address and improve maternal-health issues.

"We've got to get it done this year, with - and for - Black and Brown women, in honor of those we have lost," Williams said. "Birth equity is a social justice issue."

In a report, Williams' office identifies the main inequities in maternal health as access and quality of care, underlying chronic illness, structural racism and implicit bias. Williams' legislative package to the New York City Council also includes a maternal health bill of rights, and addresses inequities after pregnancy related to reentry in the workplace.

Black residents of New York City are eight to 12 times more likely than white residents to die from pregnancy complications. Sharon Rose, founder of the Christopher Rose Community Empowerment Campaign, said a higher number of pregnant people her group works with in Brooklyn aren't giving birth naturally, which puts their health at risk.

"Normally they would spend time in the clinic," she said. "Now, we're seeing that they're being rushed through, and more C-sections have been opted for - not by the clients, not by the participants, but by the physician, to be able to hurry up the birth so that it doesn't flood the system."

The Public Advocate's report also called for New York to require health-insurance plans to provide free coverage of midwifery and doula services in pregnancies.

Bruce McIntyre III is founder of the Save a Rose Foundation, a group named after his partner, Amber Rose Isaac, who died from complications during childbirth. McIntyre told the crowd his group is pushing for solutions to offer the prenatal and postpartum care to help prevent maternal deaths.

"We need to change the course of birthing equity toward solutions that have better birthing outcomes," he said. "We need to open midwifery-led birthing centers. We're aiming to bring one in the Bronx, but we need a chain throughout New York State."

The CDC has noted that, of the maternal deaths nationwide, 60% are preventable.

Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"