Elizabeth A Howell
Biographic Data
| ID | 5535762 |
|---|---|
| NAME | Elizabeth A Howell |
| GIVEN NAMES | Elizabeth A |
| FAMILY NAME | Howell |
| SIGNATURE | HOWELL E A |
| AFFILIATIONS | Marian F. MacDorman is with the Maryland Population Research Center, University of Maryland, College Park. Marie Thoma is with the School of Public Health, University of Maryland. Eugene Declercq is with the Boston University School of Public Health, Boston, MA. Elizabeth A. Howell is with the Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia. |
| VERIFIED | No |
| TOTAL WORKS | 26 |
| TOTAL CITATIONS | 36 |
| AUTHOR COUNT | 26 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2023 |
| H-INDEX | 3 |
The influence of racial-ethnic discrimination on women's health care outcomes
Introduction
Improving Postpartum Care
Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA)
Pandemic Birthing
Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017
Objectives. To better understand racial and ethnic disparities in US maternal mortality. Methods. We analyzed 2016–2017 vital statistics mortality data with cause-of-death literals (actual words written on the death certificate) added. We created a subset of confirmed maternal deaths that had pregnancy mentions in the cause-of-death literals. Primary cause of death was identified and recoded using cause-of-death literals. We examined racial and e…
Double Disadvantage in Delivery Hospital for Black and Hispanic Women and High-Risk Infants
Racial and Ethnic Disparities in Severe Maternal Morbidity
This study highlights missed opportunities for improved clinician communication and continuity of care to address emotional trauma when severe obstetric complications occur, particularly for Black and Latina women. Enhancing communication to ensure that women feel heard and informed throughout the birth process and addressing implicit bias, as a part of the more systemic issue of institutionalized racism, could both decrease disparities in obstet…
Timely Postpartum Visits for Low-Income Women
A health care system and a Medicaid payer partnered to develop an educational intervention and payment redesign program to improve timely postpartum visits for low-income, high-risk mothers in New York City between April 2015 and October 2016. The timely postpartum visit rate was higher for 363 mothers continuously enrolled in the program than for a control group matched by propensity score (67% [243/363] and 56% [407/726], respectively; P
Just Because You Have Ears Doesn’t Mean You Can Hear”—Perception of Racial-Ethnic Discrimination During Childbirth
Perceived racial-ethnic discrimination during childbirth influences patient-provider communication and is an important and potentially modifiable aspect of the patient experience. Interventions to reduce obstetric health care disparities should address perceived discrimination, both from the provider and patient perspectives
Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention
Objectives. To examine the relationship between adolescent pregnancy–prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. Methods. We modeled time-series data on …
Reducing Disparities in Severe Maternal Morbidity and Mortality
Significant racial and ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are 3 to 4 times more likely to die a pregnancy-related death as compared with white women. Growing research indicates that quality of health care, from preconception through postpartum care, may be a critical lever for improving outcomes for racial and ethnic minority women. This article reviews racial and ethnic disparities in s…
Evaluation of a Multilevel Intervention to Reduce Preterm Birth Among Black Women in Newark, New Jersey
Examining Trends in Obstetric Quality Measures for Monitoring Health Care Disparities
BACKGROUND: Elective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade. OBJECTIVE: To estimate trends and differences in obstetric quality measures by race/ethnicity. RESEARCH DESIGN: We used 2008-2014 linked birth certificate-hospital discharge data from New York City to measure ED before 39 ge…
Room for improvement in breast milk feeding after very preterm birth in Europe
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined…
Delivery and Payment Redesign to Reduce Disparities in High Risk Postpartum Care
Maternal Depressive Symptoms and Parenting Practices 3-Months Postpartum
Views of Women and Clinicians on Postpartum Preparation and Recovery
Overuse and Systems of Care
BACKGROUND: Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE: To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services. DATA SOURCES: Articles published in MEDLINE between 1978, the year of publication of the first framework to measure quality, and…
Social Support During the Postpartum Period
Measurement invariance of the SF-12 across European-American, Latina, and African-American postpartum women
Availability of Over-the-Counter Emergency Contraception in 2 Disparate New York City Neighborhoods
We conducted a telephone survey of pharmacies in 2 New York City neighborhoods on same-day availability, type, and cost of over-the-counter emergency contraception. There was no difference in availability of over-the-counter emergency contraception between Upper East Side and East Harlem pharmacies (93% vs 94%; P = .71). Average cost of medication was less in East Harlem than in the Upper East Side ($45.16 vs $51.64; P
The Contribution of Geography to Black/White Differences in the Use of Low Neonatal Mortality Hospitals in New York City
BACKGROUND: Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. OBJECTIVES: We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. RESEARCH DESIGN: Retrospective analysis of Vital Statistics and administrative databases. SUBJECTS: VLBW …
Approaching NIH Guideline Recommended Care for Maternal–Infant Health
Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms
OBJECTIVE: To explore racial differences in reporting of early postpartum depressive symptoms. To explore whether racial differences in early postpartum experience (such as mother's health status and social context) might account for racial differences in reported postpartum depressive symptoms. METHODS: This was a telephone survey of 655 white, African-American, and Hispanic mothers between 2 and 6 weeks postpartum. Mothers reported on demograph…
Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017
Objectives. To better understand racial and ethnic disparities in US maternal mortality. Methods. We analyzed 2016–2017 vital statistics mortality data with cause-of-death literals (actual words written on the death certificate) added. We created a subset of confirmed maternal deaths that had pregnancy mentions in the cause-of-death literals. Primary cause of death was identified and recoded using cause-of-death literals. We examined racial and e…
Just Because You Have Ears Doesn’t Mean You Can Hear”—Perception of Racial-Ethnic Discrimination During Childbirth
Perceived racial-ethnic discrimination during childbirth influences patient-provider communication and is an important and potentially modifiable aspect of the patient experience. Interventions to reduce obstetric health care disparities should address perceived discrimination, both from the provider and patient perspectives
Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention
Objectives. To examine the relationship between adolescent pregnancy–prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. Methods. We modeled time-series data on …
Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms
OBJECTIVE: To explore racial differences in reporting of early postpartum depressive symptoms. To explore whether racial differences in early postpartum experience (such as mother's health status and social context) might account for racial differences in reported postpartum depressive symptoms. METHODS: This was a telephone survey of 655 white, African-American, and Hispanic mothers between 2 and 6 weeks postpartum. Mothers reported on demograph…
Correlates of Early Postpartum Depressive Symptoms
Approaching NIH Guideline Recommended Care for Maternal–Infant Health
The Contribution of Geography to Black/White Differences in the Use of Low Neonatal Mortality Hospitals in New York City
BACKGROUND: Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. OBJECTIVES: We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. RESEARCH DESIGN: Retrospective analysis of Vital Statistics and administrative databases. SUBJECTS: VLBW …
Social Support During the Postpartum Period
Measurement invariance of the SF-12 across European-American, Latina, and African-American postpartum women
Availability of Over-the-Counter Emergency Contraception in 2 Disparate New York City Neighborhoods
We conducted a telephone survey of pharmacies in 2 New York City neighborhoods on same-day availability, type, and cost of over-the-counter emergency contraception. There was no difference in availability of over-the-counter emergency contraception between Upper East Side and East Harlem pharmacies (93% vs 94%; P = .71). Average cost of medication was less in East Harlem than in the Upper East Side ($45.16 vs $51.64; P
Views of Women and Clinicians on Postpartum Preparation and Recovery
Overuse and Systems of Care
BACKGROUND: Current health care reform efforts are focused on reorganizing health care systems to reduce waste in the US health care system. OBJECTIVE: To compare rates of overuse in different health care systems and examine whether certain systems of care or insurers have lower rates of overuse of health care services. DATA SOURCES: Articles published in MEDLINE between 1978, the year of publication of the first framework to measure quality, and…
Maternal Depressive Symptoms and Parenting Practices 3-Months Postpartum
Room for improvement in breast milk feeding after very preterm birth in Europe
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined…
Delivery and Payment Redesign to Reduce Disparities in High Risk Postpartum Care
Reducing Disparities in Severe Maternal Morbidity and Mortality
Significant racial and ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are 3 to 4 times more likely to die a pregnancy-related death as compared with white women. Growing research indicates that quality of health care, from preconception through postpartum care, may be a critical lever for improving outcomes for racial and ethnic minority women. This article reviews racial and ethnic disparities in s…
Evaluation of a Multilevel Intervention to Reduce Preterm Birth Among Black Women in Newark, New Jersey
Examining Trends in Obstetric Quality Measures for Monitoring Health Care Disparities
BACKGROUND: Elective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade. OBJECTIVE: To estimate trends and differences in obstetric quality measures by race/ethnicity. RESEARCH DESIGN: We used 2008-2014 linked birth certificate-hospital discharge data from New York City to measure ED before 39 ge…
Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention
Objectives. To examine the relationship between adolescent pregnancy–prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. Methods. We modeled time-series data on …
Double Disadvantage in Delivery Hospital for Black and Hispanic Women and High-Risk Infants
Racial and Ethnic Disparities in Severe Maternal Morbidity
This study highlights missed opportunities for improved clinician communication and continuity of care to address emotional trauma when severe obstetric complications occur, particularly for Black and Latina women. Enhancing communication to ensure that women feel heard and informed throughout the birth process and addressing implicit bias, as a part of the more systemic issue of institutionalized racism, could both decrease disparities in obstet…
Timely Postpartum Visits for Low-Income Women
A health care system and a Medicaid payer partnered to develop an educational intervention and payment redesign program to improve timely postpartum visits for low-income, high-risk mothers in New York City between April 2015 and October 2016. The timely postpartum visit rate was higher for 363 mothers continuously enrolled in the program than for a control group matched by propensity score (67% [243/363] and 56% [407/726], respectively; P
Just Because You Have Ears Doesn’t Mean You Can Hear”—Perception of Racial-Ethnic Discrimination During Childbirth
Perceived racial-ethnic discrimination during childbirth influences patient-provider communication and is an important and potentially modifiable aspect of the patient experience. Interventions to reduce obstetric health care disparities should address perceived discrimination, both from the provider and patient perspectives
Pandemic Birthing
Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017
Objectives. To better understand racial and ethnic disparities in US maternal mortality. Methods. We analyzed 2016–2017 vital statistics mortality data with cause-of-death literals (actual words written on the death certificate) added. We created a subset of confirmed maternal deaths that had pregnancy mentions in the cause-of-death literals. Primary cause of death was identified and recoded using cause-of-death literals. We examined racial and e…
Introduction
Improving Postpartum Care
Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA)
Medicine (25 works) · Pregnancy (16 works) · Maternal and Perinatal Health Interventions (14 works) · Nursing (12 works) · Demography (11 works) · Environmental health (11 works) · Public health (11 works) · Population (10 works) · Ethnic group (9 works) · Maternal and fetal healthcare (8 works)