ArticleAmerican journal of preventive medicine2023
Associations Between State and Local Government Spending and Pregnancy-Related Mortality in the U.S.
Article in American journal of preventive medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
6 citing papers in PubMed.
- Accelerating birth equity using collaborative systems mapping.Health research policy and systems · 2025Article
- Geographic Age Cohort Study of Maternal Hypertensive Disorders.Journal of the American Heart Association · 2025Article
- State-Level Tax Policy, Cancer Screening, and Mortality Rates in the US.JAMA network open · 2025Article
- Pregnancy-Associated Mortality Due to Homicide, Suicide, and Drug Overdose.JAMA network open · 2025Article
- Epidemiological analysis of maternal hypertensive disorders of pregnancy.Frontiers in medicine · 2025Article
- Public funding and young children vaccination coverage: Evidence from Socialist-Oriented Market Economy.Health economics review · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
introductionThere is limited evidence on how government spending is associated with maternal death. This study investigates the associations between state and local government spending on social and healthcare services and pregnancy-related mortality among the total, non-Hispanic Black, Hispanic, and non-Hispanic White populations.
methodsState-specific total population and race/ethnicity-specific 5-year (2015-2019) pregnancy-related mortality ratios were estimated from annual natality and mortality files provided by the National Center for Health Statistics. Data on state and local government spending and population-level characteristics were obtained from U.S. Census Bureau surveys. Generalized linear Poisson regression models with robust SEs were fitted to estimate adjusted rate ratios and 95% CIs associated with proportions of total spending allocated to social services and healthcare domains, adjusting for state-level covariates. All analyses were completed in 2021-2022.
resultsState and local government spending on transportation was associated with 11% lower overall pregnancy-related mortality (adjusted rate ratio=0.89, 95% CI=0.83, 0.96) and 9%-12% lower pregnancy-related mortality among the racial/ethnic groups. Among spending subdomains, expenditures on higher education, highways and roads, and parks and recreation were associated with lower pregnancy-related mortality rates in the total population (adjusted rate ratio=0.90, 95% CI=0.86, 0.94; adjusted rate ratio=0.87, 95% CI=0.81, 0.94; and adjusted rate ratio=0.68, 95% CI=0.49, 0.95, respectively). These results were consistent among the racial/ethnic groups, but patterns of associations with pregnancy-related mortality and other spending subdomains differed notably between racial/ethnic groups.
conclusionsInvesting more in local- and state-targeted spending in social services may decrease the risk for pregnancy-related mortality, particularly among Black women.
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