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NYU Langone Health’s institute receives US$12.5m in funding to address maternal mortality crisis

In 2021, Black pregnant women in the US died at a rate 2.6 times higher than their white counterparts, research shows

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NYU Langone Health’s Institute for Excellence in Health Equity has received US$12.5m for new digital intervention to address the “growing” maternal mortality crisis. 

The maternal mortality rate in the US, which has doubled in the past 20 years, is higher than in any other industrialised nation.

At least half of these deaths are preventable, and many are driven by systemic racism and social determinants of health such as poor access to quality and culturally appropriate care; gaps in insurance coverage before pregnancy; food insecurity, housing, and others, researchers say.

In 2021, Black pregnant women died at a rate 2.6 times higher than their white counterparts. Although Hispanic women experience relatively lower maternal mortality, this rate has jumped sharply in recent years, particularly during the pandemic.

To reverse this alarming trend, the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health (NIH), created in 2021 the Maternal Health Community Implementation Project (MHCIP).

MHCIP aims to engage communities to implement interventions targeted at poor maternal outcomes such as hypertension, obesity and gestational diabetes in minoritised populations.

As part of the four coalitions supported by MHCIP, the Institute for Excellence in Health Equity was awarded US$12.5m over five years with Natasha Williams, associate professor in the department of population health, as principal investigator.

The programme will adapt and implement the Starting Early Program (StEP), an individual and group-based supportive nutrition and lifestyle counselling programme for pregnant women.

According to the Institute for Excellence in Health Equity, Williams will lead adaptation of StEP to meet the needs of diverse patient populations and to facilitate implementation in low-income practices that serve minoritised populations.

The newly adapted programme, called JustMothers, will be delivered digitally by community health workers using culturally relevant text messaging and video links. Community health workers are lay members of a community, who have similar ethnicity, language, socioeconomic status, and/or life experiences with the people they serve.

Williams said: “We are excited and honoured to offer this first-of-its kind digital intervention to Black and Hispanic pregnant women in New York City, where there is a high burden of maternal health inequities.

“This research programme enables us to move beyond descriptive accounts of health inequities, by implementing practical, and sustainable solutions to address the crisis of maternal morbidity.

“We are deeply appreciative to our community partners and people with lived experience who will play a critical role in not just our ability to engage with pregnant persons, but also in building lasting community engagement networks to achieve health equity.

“This grant will contribute to NYU Langone’s efforts to promote maternal health equity and health justice.”

The research team will evaluate adoption and dissemination of JustMothers across NYC Health + Hospitals, the largest municipal health system in the country, and the Family Health Centers at NYU Langone in Sunset Park and Flatbush in Brooklyn, New York.

Isaac Dapkins, chief medical officer of the Family Health Centers at NYU Langone, said: “The Family Health Centers at NYU Langone has a longstanding commitment to providing comprehensive women’s health services in Brooklyn.

“This proposal builds on that commitment to offer enhanced services to the pregnant people receiving care in Sunset Park, Brooklyn.”

Wendy Wilcox, chief women’s health officer at NYC Health + Hospitals, said: “Addressing social determinants of health, such as food insecurity and unstable housing, is an essential part of addressing social justice and advancing the health equity of our pregnant and postpartum patients.

“Nutrition is medicine, as it can help manage or even reverse chronic conditions like high blood pressure and diabetes. We are proud to serve all New Yorkers, and we look forward to partnering with NYU Langone Health on this important study.”

This first year of the award is dedicated to building the infrastructure to support the research. The investigators are planning to enrol 900 pregnant women, with the enrolment set to start by December.

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Women with endometriosis face fourfold higher risk of ovarian cancer, study finds

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The risk of developing ovarian cancer could jump about fourfold among women with endometriosis compared with women without the condition, a new study has found.

A landmark study from researchers at the University of Utah and Boston University Chobanian & Avedisian School of Medicine found that women with severe endometriosis are 10 times more likely to get ovarian cancer compared to women who do not have the disease.

Prior studies have shown a causal connection between endometriosis and ovarian cancer but in using the Utah Population Database, a repository of linked health records housed at Huntsman Cancer Institute at the University of Utah, investigators were able to analyse the incidence rates of different types of endometriosis and subtypes of ovarian cancer for the first time.

Their research, which included a cohort of over 78,000 women with endometriosis, found that women with severe forms — either deep infiltrating endometriosis, ovarian endometriomas or both — have an overall ovarian cancer risk that’s “markedly increased,” at about 9.7 times higher, relative to women without endometriosis.

Women with deep infiltrating endometriosis, ovarian endometriomas or both, on the other hand, appear to face nearly 19 times the risk of type I ovarian cancer, which tends to grow more slowly, compared with women without endometriosis, according to the study.

In their calculations, researchers also found that women with any kind of endometriosis have a 4.2-fold risk of developing ovarian cancer compared to those who do not.

“These are really important findings,” said Jennifer Doherty, investigator and professor of the population health sciences department at the University of Utah.

“This impacts clinical care for individuals with severe endometriosis, since they would benefit from counselling about ovarian cancer risk and prevention.

“This research will also lead to further studies to understand the mechanisms through which specific types of endometriosis cause different types of ovarian cancer.”

However, women with endometriosis should not panic about the findings, researchers noted, because ovarian cancer itself is still rare. About 1.1 per cent of US women will be diagnosed with ovarian cancer at some point in their lifetime, according to the National Cancer Institute.

“Because of the rarity of ovarian cancer, the association with endometriosis only increased the number of cancer cases by 10 to 20 per 10,000 women,” Karen Schliep, senior author of the study and an associate professor in the Division of Public Health at the University of Utah School of Medicine, told CNN.

“We would not recommend, at this point, any change in clinical care or policy. The best way of preventing ovarian cancer is still the recommendation of exercise, not smoking and limiting alcohol.”

Women with endometriosis could pursue surgeries, such as hysterectomies or removal of the ovaries, investigators said. However, since these are invasive procedures, more research is needed to know if these are the right measures, they concluded.

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Study exposes gaps in menstrual health education in English schools

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A new study has revealed significant inadequacies in menstrual health education provision in English schools.

New research, led by the University of Bristol and Anglia Ruskin University, has highlighted a lack of practical information being offered, pupils being taught too late, and attitudes that perpetuate stigma across English schools.

Ten per cent of young women surveyed in the study, which sought to understand what and how menstrual health education information was delivered in English schools, did not receive or remember receiving any menstrual health education. Of those pupils who did, up to one in five did not receive education until after they had started their period.

Researchers surveyed 140 young women aged 18-24, who had attended either a private or state-funded primary and secondary school, on their menstrual health education. Of these, 99.3 per cent had experienced menstruation.

Participants were asked to take part in online surveys and in-depth interviews to share their experiences including what and how information was provided at school and reflect on their thoughts and feelings about their education.

From the survey results, researchers found lessons focussed on biological content with a lack of practical information needed to help students manage menstruation and menstrual health, with nearly seven in ten participants having reportedly received no practical information. None of the participants were taught about menstrual health conditions and only 3.2 per cent learnt about abnormal symptoms.

Serious long-term impacts were reported, as several participants put off seeking medical attention for debilitating symptoms because they thought their pain was normal, only to be later diagnosed with conditions such as endometriosis.

Overall, participants left school lacking basic knowledge and feeling ill-equipped with 62.4 per cent rating their education as “poor” or “very poor” in preparing them for managing menstruation.

In extreme cases, some were so unprepared that when they started their periods, they thought they were ill or even dying.

While schools were seen as an important source of information, many participants admitted that they had to rely on other sources, particularly the internet and social media.

Poppy Taylor, PhD researcher in population health sciences at the University of Bristol, and corresponding author, said: “Given the evidence that girls are starting their periods at ever-younger ages, there are concerns this will be too late for an increasing number of people. Denying young people with information about their bodies risks significant long-term harm.

“Our research provides strong evidence that the education system has been failing young girls and people who menstruate. We were shocked and disappointed, but sadly not surprised, with our findings.”

Globally, menstrual health is a key issue for gender equality. When menstrual needs are unmet, it can create barriers to education and employment, pose long-term health risks and threaten human rights.

Evidence suggests that persistent stigma and lack of public understanding about menstruation is preventing such needs from being met in the UK.

“Our findings suggest that for many young people, the menstrual health education they received failed to prepare them physically, mentally, or socially for their first period,” Taylor explained.

“We recommend that menstrual health education is improved through the delivery of earlier, more inclusive lessons with more practical content to ensure all young people are equipped to manage their menstrual health in a supportive environment.

“To support the UK government’s target of eradicating period stigma and poverty by 2030, universally accessible and comprehensive menstrual health education must be prioritised.”

The authors acknowledged that the reported experiences in the study, particularly from older participants, may not reflect current practices.

Due to the small sample size, they said, further research is needed to explore the experiences of students who are currently in the schooling system and to understand whether and how practices have changed.

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Maternal mental health start-up bags US$10.9m in series A funding

Seven Starling aims to help women navigate critical periods in their lives with evidence-based mental health support

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The US start-up Seven Starling has secured US$10.9m in series A funding to address unmet needs in women’s mental health.

More than 90 per cent of women do not seek help for perinatal mood and anxiety disorders due to high barriers including a shortage of therapists, limited in-network coverage and mental health stigma.

These conditions affect one in five women during the motherhood journey, yet only 20 per cent are screened for mental health issues, and 75 per cent of those who need treatment do not receive it.

Seven Starling aims to address these challenges by making its services accessible through its in-network coverage, integrated group therapy model, and partnerships with referring providers to make the process of getting started easier for patients.

The investment round, led by RH Capital, is hoped to expand access to essential mental health services for women going through critical periods, such as infertility, miscarriage and loss, pregnancy, postpartum and motherhood.

“We are thrilled to have successfully raised this round of funding, which will allow us to expand our reach and help more women who need support during critical life transitions,” said Tina Beilinson Keshani, co-founder and CEO of Seven Starling.

“This investment is a testament to the demand for a dedicated women’s mental health solution and our commitment to providing accessible, high-quality care. With the new funding, we will continue to successfully reduce the stigma around women’s mental health and ensure that every woman has access to the care she needs, when she needs it.”

The capital raised from this round, Keshani said, would be used to “fuel” national expansion, partnering with Medicaid plans, and developing innovative technology to further integrate with healthcare partners.

Alice Zheng, principal at RH Capital, said: “We are proud to partner with Seven Starling in this new chapter to expand access to maternal mental healthcare, an area of significant need.

“We are excited by the comprehensive and scalable offerings, including group therapy to expand access. As a recent mum of two myself, I have been shocked by the lack of perinatal mental health support available relative to need and am thankful to see Seven Starling filling that gap.”

Mar Hershenson, founder of Pear VC, added: “Seven Starling is addressing a huge problem not just around motherhood but the entire female lifespace from adolescence to menopause.

“Women are nearly twice as likely as men to be diagnosed with depression or an anxiety disorder in their lifetime, but lack a tailored solution designed to meet their unique needs. Pear has partnered with Seven Starling since day one and we are excited to double down on them.”

Kelly Ernst, March of Dimes SVP, chief impact officer, said mental health conditions, such as depression and anxiety, are among the most common complications for women during pregnancy and the postpartum period.

“However, many do not receive treatment they desperately need, which can lead to long lasting clinical, social, and economic consequences,” she explained.

“When these conditions are effectively treated and managed, everyone benefits. We’re proud to be investors in Seven Starling and look forward to seeing how their innovative and comprehensive approach improves the mental healthcare needs of women across the country.”

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