Mistreatment common in maternal health care

About one in five women experience mistreatment during pregnancy care, most of whom are women of color. 

A study published in Morbidity and Mortality Weekly Report Aug. 23 found that 30% of Black women, 29% of Hispanic women and 27% of multiracial women reported being mistreated during pregnancy care. In comparison, only 19% of white women experienced mistreatment, which included violations of physical privacy, ignored requests for help and verbal abuse.

Many of the women of color also said they experienced discrimination during pregnancy care based on race, ethnicity, weight or age.

Low-income women also reported higher rates of mistreatment. While only 16% of patients with private insurance said they had experienced mistreatment, 26% of those with public insurance and 28% who lacked insurance did.

Almost half of the women in the study said they held back from asking questions or airing concerns with their health providers during their pregnancy. Reasons included not wanting to seem difficult, feeling their health provider was rushed and not wanting to make a “big deal” out of something.

The findings are especially troubling considering increasing U.S. maternal death rates, according to the researchers, who were affiliated with the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion. 

As of 2021, the U.S. rate of maternal deaths was 32.9 deaths per 100,000 live births, a 40% increase from 2020. Black women have particularly high rates, with three times the risk of dying from a pregnancy-related cause than women who are white.

The researchers called on health providers to create an environment of trust so that pregnant women feel safe to communicate with them. They also advised providers to take the time to have open conversations with patients.

Drug overdose death rates higher for construction workers

Workers in the construction industry are more likely to die from drug overdoses than those in other jobs, a new study finds. 

Released Aug. 22 by CDC’s National Center for Health Statistics, the study examined data on overdose deaths among working-age people that occurred in 46 states in 2020. 

About 131 deaths per 100,000 workers occurred among construction industry workers, followed by about 100 deaths per 100,000 in the accommodation and food services industries. Other industries with more than 60 overdose deaths per 100,000 workers included mining and waste services.

Workers in the construction industry who died of drug overdoses were overwhelmingly male and white, according to the researchers, who were affiliated with NCHS’ Division of Vital Statistics. When broken down by census-defined occupations, the study found construction industry death rates were higher for roofers, drywall installers and painters and lower among equipment operators, electricians and pipelayers.

The lowest rates of overdose deaths overall by industry were among people who worked in education and public administration. People in health care and social services industries were  in the lower third of death rates.

While the reasons for the higher death rates by industry were not studied, the researchers noted that work-related injuries are more common in jobs that require physical tasks and that pain from those injuries is often treated with prescription drugs.

Across all of the industries examined in the study, 92% of the drug overdose deaths were unintentional. Almost 94,000 people in the U.S. died from drug overdose in 2020, with most deaths related to opioids, previous CDC research has found.

High temperatures linked to prison suicide watches

Suicide watches in prison jump an average of 30% during extreme heat, a recent study finds. 

Researchers examined suicide watch numbers at six state-run prisons in Louisiana, finding that rates increased 29% when the heat index reached 80 to 89 degrees. On extremely hot days, when it was 90 to 103 degrees, rates climbed 36% according to the study, which was published in JAMA Network Open.

Few U.S. jails and prisons have been built to withstand high heat, with concrete and metal construction and small windows that hinder air circulation, the researchers said. Very few spaces in the prisons evaluated in the study had air conditioning. Overcrowding in U.S. prisons, which house more than 2.1 million people, is also common and adds to stressors.

In July, the ACLU of Louisiana submitted an emergency legal filing in an ongoing lawsuit against the state, contending that children being held at an adult maximum security prison in Angola were subject to high heat levels that posed a serious risk of harm to their health.

Previous research has found that the risk of severe violence in prisons increases 20% on extremely hot days.

EPA data shows high PFAS levels in drinking water

Contamination of U.S. drinking water by “forever chemicals” is widespread, new data from the Environmental Protection Agency show. 

On Aug. 17, the EPA released data on chemicals in the nation’s drinking-water systems, finding that 8% of  the systems had high levels of two kinds of per- and polyfluoroalkyl substances, also known as PFAS. The levels exceeded new limits proposed by the EPA this spring that are aimed at protecting human health.

PFAS, which have been linked to cancer and developmental issues, are of high concern because they do not break down easily in the human body or the environment. The chemicals have been used in non-stick cookware coatings, furniture stain protectors, food packaging, firefighting foam and other products. 

The new EPA data also showed almost 22% of water systems had high levels of lithium, which is used in batteries, pharmaceuticals and other products and has been linked to kidney harm.

In March, the EPA proposed  standards to limit six kinds of PFAS in drinking water. If adopted, the standards will require public water systems to reduce levels of the chemicals, monitor them and notify the public if levels are high. In the interim, the EPA released health advisories on four of the chemicals to guide states and water systems.

The data is the first of 12 sets to be released through 2026 by the EPA on PFAS and lithium in drinking water.

The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.