Introducing the US Maternal Vulnerability Index

The first national, community-level index that shows where and why mothers are vulnerable to poor health, and helps combat US maternal mortality and bridge the racial maternal health gap

  1. Overall maternal vulnerability is highest in the South, Midwest, and for rural communities, but there are pockets of concern across the US. Rural areas, the South, and the Midwest have particularly high concentrations of counties where pregnant women and mothers are exposed to harmful neighborhood conditions across MVI themes. The average woman of reproductive age lives under higher vulnerability conditions in the South than in any other region.
  2. Each county has a unique maternal vulnerability profile, with the majority of counties vulnerable in at least one dimension. Most counties are vulnerable in at least one dimension, even if their overall vulnerability score is low. In fact, 59% of US counties score “Very High” on at least one theme. For more detailed summaries of how counties fare across the six themes, download the full report.
  3. Black and American Indian and Alaska Native (AIAN) women of reproductive age are more likely to live under conditions that are not conducive to good maternal health — a sign of structural racism. Individual characteristics like age, income, and education cannot fully explain why these women experience such high risk from pregnancies: for example, the most educated Black women are still more likely to die from pregnancy-related causes than the least educated White women, according to the CDC. One driver of these disparities is structural racism, which affects maternal health outcomes by limiting access to health-promoting factors leading to worse maternal health conditions for women of color. One key pathway through which structural racism exerts its influence is residential racial segregation. The MVI shows that relative to the US average, Black and AIAN women of reproductive age are 1.6 and 2.6 times more likely to live under conditions not conducive to good maternal health, respectively.
  • Christy Turlington Burns, Founder of Every Mother Counts;
  • Dr. Ololade “Lola” Okito, MD, 2 Neonatologist, Children’s National;
  • Dr. Mary-Ann Etiebet, MD, Lead, Merck for Mothers; and
  • Michele Blackwell, Public Policy Manager, Uber.



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