For the past 5 decades, African-American women have consistently experienced an almost 4-times greater risk of death from pregnancy complications than have Caucasian-American women. The literature has supported that this increased risk of pregnancy-related death among African-American women is independent of age, parity, or education. An increased risk of death from other conditions, such as breast and gynecological cancer, has also been reported for African-American women. African-American women are also more likely to die from complications of pregnancy, including hemorrhage, hypertensive disorders of pregnancy, and cardiomyopathy. However, the reasons for this excess mortality remain unclear.

We now know that excess mortality from a condition can be caused by a higher prevalence of the condition, a higher case-fatality rate, or a combination of these factors. Several factors may contribute to the elevated case-fatality rates among African-American women, including patient attributes, such as disease severity, coexisting medical conditions, and the timing of entry into care, and health system factors, such as access to care and the quality and consistency of care. Although researchers have increasingly accepted the idea that race is more of a social rather than a biological construct, race can have biological consequences, when operating through a variety of factors, that we were unable to measure in this study.

Nonetheless, our lack of knowledge about what factors cause the disparity in pregnancy-related mortality between African-American and Caucasian-American women impedes our ability to formulate appropriate research and to design interventions to eliminate this disparity.

Discussion: Carefully examine and discuss one (1) biological or health services factor that has contributed to increase disparity in case-fatality rates for the pregnancy-related conditions. Cite and reference statistics and or case examples if necessary.