On March 10, 2022, the National Council of Urban Indian Health (NCUIH) submitted comments to the Health Resources Services Administration (HRSA) Advisory Committee on Infant and Maternal Mortality (ACIMM). The comments were submitted in advance of the ACIMM’s March 15-16 meeting focusing on program updates, race-concordant care, health of Indigenous mothers and babies, and the impact of violence on infant and maternal mortality. In the comments, NCUIH reiterated the need for an Urban Confer policy at the Department of Health and Human Services (HHS) and the importance of collaborating with urban Indian organizations (UIOs) for accurate data collection. NCUIH also recommended that the ACIMM include a Tribal and UIO representative among the ACIMM’s membership and create an ACIMM subcommittee on American Indian/Alaska Native (AI/AN) infant and maternal health disparities.
The Advisory Committee on Infant and Maternal Mortality
Formed in 1991, the ACIMM advises the Secretary of Health and Human Services (HHS) on department activities, partnerships, policies, and programs directed at reducing infant mortality, maternal mortality and sever maternal morbidity, and improving the health status of infants and women before, during, and after pregnancy. The ACIMM consists of public and private members and provides advice on how to coordinate governmental efforts to improve infant mortality, related adverse birth outcomes, and maternal health, as well as influence similar efforts in the private and voluntary sectors. With its focus on underlying causes of the disparities and inequities seen in birth outcomes for women and infants, the ACIMM advises the Secretary on the health, social, economic, and environmental factors contributing to the inequities and proposes structural, policy, and/or systems level changes.
American Indian and Alaska Native Infant and Maternal Mortality
According to HHS Office of Minority Health AI/ANs have almost twice the infant mortality rate as non-Hispanic whites. AI/AN infants are also 2.7 times more likely than non-Hispanic white infants to die from accidental deaths before the age of one year and AI/AN infants are 50 percent more likely to die from complications related to low birthweights as compared to the same group. AI/AN mothers are also disproportionately represented in maternal mortality. In 2019, AI/AN mothers were almost three times as likely to receive late or no prenatal care as compared to non-Hispanic white mothers.
NCUIH has engaged in extensive advocacy on behalf of AI/AN mothers and infants and for increased funding and support to the UIOs which provide maternal health, infant health, prenatal, and family planning services to AI/AN mothers and infants. In its comments to the ACIMM, NCUIH made the following recommendations:
- Advise the Secretary of HHS (Secretary) to lead the establishment of an Urban Confer policy to ensure that urban AI/ANs can provide pertinent guidance to HHS on department activities, partnerships, policies, and programs directed at reducing infant and maternal mortality, severe maternal morbidity, and improving the health status of infants and women before, during, and after pregnancy.
- Advise the Secretary to collaborate with UIOs to gather accurate data on urban AI/AN infant and maternal health
- Improve AI/AN representation on the ACIMM by including a tribal and UIO health provider representative on the ACIMM to complement the work of the standing IHS ex-officio member
- NCUIH recommends that there be two seats, a Tribal and a UIO seat, so that ACIMM can receive a variety of viewpoints regarding the provision of health care to diverse AI/AN communities
- Create an ACIMM subcommittee dedicated to addressing AI/AN infant and maternal health disparities
In addition to submitting comments, NCUIH attended the ACIMM’s session on the health of Indigenous mothers and babies. During this session Alexandra Payan, NCUIH’s Federal Relations Associate, connected with several ACIMM members regarding their interest in improving AI/AN maternal and infant health. NCUIH will continue to closely follow the ACIMM’s important work on AI/AN mothers and infants and seek opportunities for collaboration.