NJ study links municipal spending with maternal health outcomes

An analysis of more than 1 million birth records throughout New Jersey has determined that mothers may have a better shot at remaining healthy during and after the labor and delivery process when they live in towns that spend more money on certain services.

In a study published in the Journal of the American Medical Association Network Open, researchers out of Rutgers University found a robust association between spending and life-threatening maternal outcomes.

"What we found is that mothers in municipalities that spend more per person on public health, transportation, libraries, and fire and ambulance, were less likely to have life-threatening outcomes at delivery or within 42 days of the delivery," lead author Felix Muchomba, an assistant professor at the Rutgers School of Social Work, told New Jersey 101.5.

With each additional $1,000 spent per capita in these categories, the study found the odds of having a bad maternal outcome fell by 35% to 67%.

"It's really a huge association we are finding," Muchomba said. "This research is really showing that municipal investments are important."

The same association was not recorded when researchers looked at municipal governments' spending on police. In fact, mothers in municipalities that spent more per capita on police were more likely to have a bad maternal outcome. The research did not determine why, but the authors suggest that higher police spending may divert money from other services that promote maternal health, and said that modern models of policing that involve more frequent interactions with civilians may be more stressful and traumatic for individuals.

Researchers looked at 1,001,410 birth records from 2008 through 2018 in all New Jersey municipalities, and linked each birth record to the mother's discharge records, with the goal of identifying cases with at least one of 16 different life-threatening outcomes, such as heart failure, kidney failure, severe complications from anesthesia, and needing a blood transfusion.

Muchomba said these outcomes are "very predictive of death." New Jersey has created a goal to reduce its maternal mortality rate, one of the highest in the nation, by 50% over five years.