In 2024, the maternal mortality rate (MMR) in the United States and the United Kingdom will grow, although post-mortem studies have concluded that 80% of maternal deaths in high-income countries are preventable. Rates have fallen in high-income countries across Western Europe and Asia between 1990 and 2010, but in some of these countries, such as the UK, the MMR has risen over the past decade. The US MMR nearly doubled during the first decades of the 21st century.
Reasons to support the prediction of an increase in MMR include the ongoing consequences of the Covid-19 pandemic. However, the pre-Covid rise in MMR in the US and UK suggests that the pandemic has exacerbated deeper problems.
Systematic neglect and bias in medical care systems is one of them. In the United States, critical challenges to recovery include the lack of universal health insurance and an increasingly competitive health care system: the United States has cut maternity care providers to the extent that 36 percent of U.S. counties, mostly Villagers do not have any insurance. In the UK, healthcare is theoretically available to all, yet the NHS suffers from underinvestment in its facilities and equipment. Half of NHS maternity units are now substandard. The shortage of midwives has reached crisis proportions. Doctors and midwives in both countries suffer from burnout and choose to strike, practice abroad, retire or change careers.
Racial and class inequality is entrenched. The highest MMR and the largest increase are in minority, working class, or disadvantaged populations. As inadequate health care systems are devastating for these groups, the underlying causes of their health inequalities are the unfavorable living conditions, including the stigma and discrimination they face. There is strong scientific evidence that the multiple systemic assaults they must contend with in their daily rounds—material problems, environmental toxicity, decaying urban infrastructure, and structurally rooted psychosocial stressors—chronically suppress the human physiological stress response. activate
Collectively, stressors and their stubborn coping cumulatively damage health down to the cellular level and actually accelerate biological aging. Such erosion, called “weathering,” leaves marginalized, malnourished, or exploited individuals suffering from multiple infectious and chronic diseases, functional limitations, and even death, long before they are chronologically old. In populations most exposed to severe weathering, increasing childbearing at older ages increases the risk of adverse maternal and neonatal outcomes. Maternal mortality is a barometric measure of the contribution of weathering to excess mortality, as the physical stress of pregnancy is more difficult for the exhausted body to withstand, while other manifestations of weathering often become life-threatening only after childbearing years.
In 2024, weathering is still fueled by racism, classism, xenophobia, political polarization, resentment, white nationalism, and austerity budgeting. Brexit, one result of this discontent, is now exacerbating UK labor shortages, supply chain bottlenecks, inflation and falling GDP. Neither the United States nor Western Europe are fully welcoming of their minority or immigrant populations.
In 2024, this problem will be exacerbated by the rising tide of immigrants of color. Despite the facts, the UK Equality Secretary’s official position rejects systemic racism as a cause of health inequality. The 2021 report of the UK Commission on Racial and Ethnic Disparities devolves into victim-blaming instability, inferring that inequality results from the failure of marginalized populations to exercise representation and take advantage of seemingly abundant opportunities for health promotion. In the politically polarized United States of America, active and influential populist movements seek to whitewash American history.
In 2024, counter-movements to take racist and class histories seriously will continue against strong undercurrents of political victimization and zero-sum thinking in both countries, increasing the intensity and scope of the climate.
