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. 2025 May 20.
doi: 10.1007/s40615-025-02453-2. Online ahead of print.

The Voice Unheard: Women's Perception of Maternal Health Care Post-Flint Water Crisis

Kionna L Henderson  1   2 , Ashton M Shortridge  3 , Richard C Sadler  3 , Caitlin Canfield  4 , Alan L Mendelsohn  4 , Mahbuba Khan  5 , Kent D Key  6
Affiliations

The Voice Unheard: Women's Perception of Maternal Health Care Post-Flint Water Crisis

Kionna L Henderson et al. J Racial Ethn Health Disparities. .

Abstract

Background: Eleven years have passed since the 2014 Flint water crisis (FWC), yet many voices still go unheard. There is limited evidence of the impact of the FWC on maternal health. This paper used a cross-sectional study design to survey 152 women enrolled in the Supporting Parents and Raising Resilient Kids (SPARRK) study in Flint, Michigan to examine racial differences in women's perceptions of their overall health pre- and post-FWC, perceived maternal health services, and explore the interaction of race and living in Flint on maternal morbidity.

Methods: Perceived maternal health was defined using the Centers for Disease Control and Prevention's 21 Severe Maternal Morbidity (SMM) diagnosis codes. SMM were obtained via questionnaire. Logistic regression analyses were performed to identify factors associated with SMM within two domains: (1) overall health pre- and post-FWC and (2) perceived maternal health care received during birth.

Results: There were 17 cases of SMM in which Black women accounted for 62.5% of these cases. Perceived quality of care was overall positive; yet, perceived overall health decreased post-FWC for all women. The odds of SMM were 6 times higher for those who had a college degree or higher.

Conclusion: In the predominately Black city of Flint, race was not a significant factor in the perception of health and quality of care. Surprisingly, educational attainment was significantly associated with a 6-time increase in odds of experiencing an SMM. More research is needed to examine the association of patient-provider perception of quality care and education on maternal health outcomes.

Keywords: Flint water crisis; Healthcare discrimination; Maternal health disparities; Maternal health effects; Maternal morbidity.

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Conflict of interest statement

Declarations. Ethics Approval: This research was approved and compliant with the Institutional Review Board of NYU Grossman School of Medicine (s18-01347), Michigan State University (STUDY00000795), and Hurley Medical Center (16692711). All aspects of this study follow the ethic requirements for the stated university and institution above. Consent to Participate: Informed consents were obtained from all participants in this study. Consent for Publication: Individual and/or personal identifiable data was not used in this work. Participants signed a consent form stating that a portion of the data gathered would be published. Competing interests: The authors declare no competing interests.

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