No Quality Without Equity: The 2021 Maternal and Child Health Equity Virtual Summit Proceedings

Updated on Nov 14, 2025 | BFWHRI, Engagement, Women's Health

Elizabeth Howell, MD, MPP

“Systemic racism has taken an extraordinary toll on the health and wellness of Black women and babies. We are here today to develop actionable items to improve maternal and infant health equity.”

This powerful sentiment is how Elizabeth Howell, MD, MPP, Chair of the Department of Obstetrics and Gynecology at the Perelman School of Medicine and the University of Pennsylvania Health System, opened the Maternal and Child Health Equity Virtual Summit on January 12.

The five-hour summit was held on the New York Academy of Medicine Zoom platform and included featured presentations and panels of diverse members including leaders in medicine, nursing, community-based-organizations, and perinatal and maternal health research.

Dr. Howell, the previous Director of Mount Sinai’s Blavatnik Family Women’s Health Research Institute, partnered with the New York Academy of Medicine, the Institute, and the University of Pennsylvania to establish this important educational summit as the final phase of her NIH-funded research investigating the contribution of hospital quality to racial and ethnic disparities in maternal and infant health. Dr. Howell co-chaired the summit with Danielle Laraque-Arena, MD, a senior scholar-in-residence at the New York Academy of Medicine.

Dr. Howell presented the findings of her research to the more than 450 attendees of the virtual summit, outlining the interactions between structural racism, system factors, clinician factors, patient factors, and community or neighborhood to influence racial and ethnic disparities in maternal and infant morbidity and mortality.

According to their findings, there were clear themes between hospitals that outlined high and low performance of maternal health outcomes. High performing hospitals had a stronger focus on standards and standardized care, stronger nurse-physician communication, and a higher awareness that disparities and racism may be present in hospital settings and could lead to differential treatments.

Dr. Howell’s group went further to analyze within-hospital disparities. After calculating similar risks of severe maternal morbidity for patients within the same hospital insured by Medicaid or commercial insurance, they found that Black women as compared with White women had higher maternal morbidity rates (after adjusting for insurance, obesity, etc.). Dr. Howell and her research clearly demonstrate the health care crisis for moms of color, and the rest of the day’s programming helped bring diverse voices to the conversation and plan action steps to reduce these disparities.

The summit was divided into three parts: Maternal Health, Infant Health, and the Mom-Baby Dyad, each with one featured speaker and a panel of diverse experts. The featured speaker for Maternal Health was  Karen A. Scott, MD, a leading OB/Gyn from UCSF School of Medicine, who outlined the “sacred birth” movement.

“Sacred birth is a radical attitude towards human births, specifically Blackness, Black bodies, and Black births. The movement advocates for safer, respectful more dignified and higher quality participatory birth care,” she said.

Dr. Scott powerfully stated at the summit, “We need to shift power to generate and disseminate knowledge of the QI space that has been usually excluded to hospital administrators and executives over to Black mothers, birthing people, community members and scholars.”

The Maternal Health panel, moderated by Wendy Wilcox, MD, (NYC Health+Hospitals) included Sascha James-Conterelli, DNP, (Lecturer in Nursing, Yale School of Medicine), Chanel Porchia-Albert (Founder, Ancient Song Doula Services), Natalie D. Hernandez, PhD, (Assistant Professor, Morehouse School of Medicine) and Dr. Allison Bryant, MD, (Massachusetts General Hospital). The panel discussed diversification of the labor and delivery workforce, anti-racist medical models, and quality improvement. Dr. Bryant stated one of the most salient quotes of the day: “No quality without equity.”

The second part of the summit, Infant Health, began with Dr. Howell conveying her research findings on infant morbidity and mortality. Dr. Howell led the next section of the summit: Infant Health Inequities.

“Very preterm births account for only 2 percent of all births but 53 percent of all infant deaths, and Black infants are three times more likely than white infants to be born very preterm,” she said. Based on Dr. Howell’s findings, up to 40 percent of the Black-White disparity in very preterm birth morbidity and mortality was due to the difference in which hospital the child was born in.

Jeffrey Horbar, President of Vermont Oxford Network, was the featured speaker and built upon Dr. Howell’s research, noting that white infants are overrepresented at high-quality hospitals in New York City and black infants are underrepresented at those same hospitals. Dr. Horbar’s theme throughout his presentation was clear: the importance of following through for patients.

“Our responsibility to NICU infants and their families extends beyond hospital walls, following through to address their social determinants of health, which will ultimately determine the health and well-being of infants and their families,” he said.

Dr. Horbar also outlined his organization’s new innovation grants to promote health equity, “Take Action to Follow Through,” which can jump start equity and quality improvement programs in NICUs around the country.

The Infant Health panel, moderated by Deborah Campbell, MD, (Albert Einstein College of Medicine) included Dr. Horbar, Teresa Janevic, PhD, MPH, Assistant Professor of  Obstetrics, Gynecology and Reproductive Science, and Population Health Science and Policy at Icahn Mount Sinai, and a member of the Blavatnik Family Women’s Health Institute, and Adrienne Mercer, EdD, (Northern Manhattan Perinatal Partnership). Panelists discussed paid-parent advisor positions to work with physicians, structural racism, and the significance of doulas in supporting birthing people. Dr. Mercer shared the sentiments of one of the women that her organization worked with. In describing her doula, the woman said, “Having a woman I can talk to made me feel supported and that I matter.”

The final part of the summit called “Mom-Baby Dyad” began with Jennifer Zeitlin, MA, DSc, an epidemiologist who has been a co-investigator in much of Dr. Howell’s research. She discussed how Black and Latina mom-baby dyads face a double threat, a domain in health care that needs actionable change.

Her research specifically showed that severe maternal morbidity is an independent risk factor for very preterm mortality. She stated that efforts to integrate and strengthen quality improvement in both obstetric and neonatal care at hospitals where Black and Latina women deliver may be a critical step to reduce the co-occurrence of disparities for maternal and child health outcomes.

The final panel of the day, moderated by Lynn Roberts, PhD, (CUNY), included Mary D’Alton, MD, (Columbia), Colette Sturgis (Urban Health Plan), and Jochen Profit, MD, (Stanford) who discussed their own institutions’ efforts to reducing maternal and child morbidity and mortality. Dr. D’Alton discussed the specific significance of maternal mental health as absolutely integral to the overall health of the mother, and Colette Sturgis, the Program Director at Urban Health Plan, discussed how their Maternal and Infant Community Health Center has adapted through the pandemic to support mothers.

Dr. Laraque-Arena of NYAM began the closing remarks of this important event, stating “We have a lot of work to do in deconstructing the entities that have supported inequities in maternal and infant health.”

And Dr. Howell concluded by summarizing action steps for the future, including improving workforce diversity, integrating Black and Brown women’s lived experience into health care, supporting doulas through Medicaid coverage, and engaging community members in quality committees and improvement. Dr. Howell encouraged leaders in executive and administrative positions to be proactive and vocal about these significant issues.

“It takes bold leadership to take a strong stance and say: we have to do better,” she said.

The New York Academy of Medicine has more information on the Maternal and Child Health Equity Virtual Summit, including PDFs of speaker’s presentations and a recording of the entire event.

Mahima Krishnamoorthi, BA, is the Clinical Research Coordinator at Blavatnik Family Women’s Health Research Institute, where she develops and fosters her passion for women’s health and reproductive justice.

 

 

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Helping New Yorkers With Disabilities Through the Pandemic

Updated on Nov 14, 2025 | Community, Engagement

Jonathan Novick, Outreach Manager for the Mayor’s Office for People with Disabilities

Under normal circumstances, people with disabilities face discrimination, inaccessibility to services, and other challenges to independent living.  The COVID-19 global pandemic has added more hurdles for people with disabilities and caregivers, said Jonathan Novick, Outreach Manager for the Mayor’s Office for People with Disabilities (MOPD). Mr. Novick discussed the office’s efforts to address these issues in a virtual talk.  The talk, intended to provide information to the Mount Sinai community on the services and resources available through the MOPD, can be viewed here.

“As a result of COVID-19 pandemic, a lot of activities for institutions were forced to go online,” Mr. Novick noted. “And if I had to pick out one bright spot at least for the disability community, it enabled a level of social interaction that was not there before.”

The virtual talk, titled “Providing Resources for People with Disabilities during the Pandemic,” was held in observance of Disability Awareness Month, part of a series featuring speakers from around the Mount Sinai Health System as well as the community to raise awareness and promote an inclusive and equitable health care environment for people with disabilities.

MOPD is a liaison between New York City government and the disability community and works to ensure that the rights and concerns of people with disabilities are addressed in all of the city’s initiatives, programs, and policies. This includes equal access to everything the city has to offer, including housing, employment, transportation, benefits, arts, culture, and parks.

Resources Available in Toolkit, and on Mount Sinai ODI Site

According to the Center for Disease Control and Prevention, people with disabilities are not inherently at higher risk for becoming infected with or having severe illness from COVID-19.  However, some people with disabilities might be at a higher risk of infection or severe illness because of their underlying medical conditions.  For example, adults with disabilities are three times more likely to have heart disease, stroke, diabetes, or cancer than adults without disabilities.

In one constructive response to the pandemic, Mr. Novick said, MOPD has created a Virtual Activities Toolkit, which offers accessible resources and information in one centralized location. The pandemic also highlighted the importance of communication, such as digital access to COVID-19-related briefings and Department of Health and Mental Hygiene public health guidance and materials.

Weekly calls were set up between MOPD and advocates and organizations to address the needs to people with disabilities during the pandemic. Among the many concerns addressed were access to medical care, personal protective equipment, food/supplies, fear of losing home health providers due to social distancing guidelines, mental health and domestic violence support, and anxiety over health care rationing due to disability.

Access-A-Ride Paratransit Services Adjusting to the COVID-19 Pandemic

Updated on Nov 14, 2025 | Community, Engagement, Rehab Medicine

Donna Fredericksen, Deputy Director of the MTA’s Transit Access-A-Ride (AAR) Paratransit Outreach, with Kevin Funney, Operator, Maggies Paratransit Corp.

The COVID-19 pandemic has affected many parts of city life, including the safe access of New Yorkers with disabilities to services and care. During a talk, Donna Fredericksen, Deputy Director of the MTA’s Access-A-Ride (AAR) Paratransit Outreach, described how the program has adjusted to the pandemic and continued to safely provide paratransit service to New Yorkers. The virtual talk can be viewed here.

The session, “Proactive Measures During COVID-19 and Beyond,” was the second in the new Raising Disability Awareness Virtual Talk Series, featuring speakers from around the Mount Sinai Health System as well as the community, in honor of Disability Awareness Month in October. During this time, ODI hosted events to educate, raise awareness and promote an inclusive and equitable health care environment for people with disabilities.

“Access-A-Ride trips are available—24-7 and 365 days a year—for people with disabilities who cannot use the subway or the bus,” Ms. Fredericksen said. “This could be a temporary setback, perhaps a new knee or a new hip, or it might be something more long term.”

Talk on Disability Awareness

During the COVID-19 pandemic, AAR has adjusted its procedures: Riders and drivers must wear masks. All dedicated vehicles are disinfected, and temperature checks are required for drivers. And to allow for social distancing, shared rides are discontinued—though people with disabilities can be accompanied by a personal care attendant (PCA). Applicants are still required to go to an assessment center as part of the eligibility determination process. The sites are open at 25 percent capacity, with COVID-19 safety protocols in place. For many months during the pandemic, fares were suspended, but they resumed on Tuesday, January 19.

The AAR fare for most eligible riders is $2.75, the same as subway or bus fare. If they have a PCA, that person travels free, and AAR customers who are enrolled in the Fair Fares program, which aids lower income New Yorkers, pay $1.35.

AAR is the largest paratransit service in the country, with 160,000 riders. Pre-COVID, it made 24,000 trips a day, Ms. Fredericksen said. Now the weekday trips remain steady at about 70 percent of that level.

Meeting Essential Travel Needs

Ms. Fredericksen and two team members outlined how to apply for eligibility—the required first step—and how to schedule a ride, access language and interpretation services, navigate through the AAR web page, and access the MYmta app, which is available at the Apple App Store and Google Play. Access-A-Ride answers to “a higher authority,” Ms. Fredericksen said, in this case, being in compliance with the FTA (Federal Transit Administration) and the ADA (Americans with Disabilities Act) and prioritizing the needs of people with disabilities. “We want to focus on essential travel, such as taking you to dialysis or chemotherapy appointments, or if you are an essential worker, or you need service immediately,” she said.

“If you have any questions about AAR, please call. Someone is there Monday through Friday from 9 to 5 to help you out.” For the latest information, including a guide to AAR and the AAR newsletter, visit https://new.mta.info/accessibility/paratransit.  Or call 1-877-337-2017.

Why Testing New Medicines in a Diverse Population Is Important

Updated on Nov 14, 2025 | COVID-19, Engagement, Featured, Research, Vaccines

Companies are working to develop new vaccines for COVID-19, and one of the many challenges is ensuring that clinical trials required to test the new medicines reflect the population at large in order to determine how effective the vaccines will be when offered to tens of millions of people throughout the United States.

In this Q&A, Lynne D. Richardson, MD, Professor and Vice Chair of Emergency Medicine, Professor of Population Health Science and Policy, and Co-Director of Mount Sinai’s Institute for Health Equity Research, talks about the latest COVID-19 vaccines, why it is important for clinical trials to include a diverse population, and how well the pharmaceutical industry has done that.

Based on data you have seen about the most advanced COVID-19 vaccines in development, do you think the pharmaceutical companies have done a good job including a diverse group of people in their clinical trials?

They are all committed to trying to include a diverse population into their trials. I think there have been substantial efforts to improve the diversity of the participants in the vaccine trials. From the data I’ve seen, I think they did an okay job, though ideally, the makeup of the folks in the trials would be the same as the distribution of the disease.

Why is it important to have a diverse group of people in the clinical trials for COVID-19 vaccines?

Trials are a way of getting information about how something works. So if you want to know that it works for people of all ages, people of all races, people of all ethnicities, people who have lots of other medical conditions, these people must be in the trial. This is always true, not just for vaccines. In addition, participation in the trials must be representative of the population that is suffering from whatever condition is being targeted by the vaccine, or the treatment. There are certain communities, specifically Black and Hispanic communities, who we know are being harder hit by COVID-19, both in the chance they contract COVID-19, and the severity of the disease if they do get it. That’s why it’s important to have a vaccine that is safe and effective for those communities.

Lynne D. Richardson, MD

In the past, how well have clinical trials included a diverse population, including people of color and those of different socio economic status?

If you go back 40 or 50 years, clinical trials consisted almost exclusively of white men between the ages of 25 and 65. They were considered the ideal subjects. The problem is, it is very hard to extrapolate the results and findings of the trial to types of people who are not participating in the trial. It was about 30 years ago that a big push to improve the gender diversity in clinical trials came with the establishment of an Office of Women’s Health at the National Institutes of Health, and that’s when the federal agencies that sponsored research started paying attention to who actually was participating in trials. It was about a decade later that significant attention to the racial and ethnic diversity in trial participation emerged. So it’s not a new issue. The degree of under-representation even a decade ago was staggering. About five percent of clinical trial participants were Black at a time when Black people accounted for 12 percent of the population. About one percent were Hispanic at a time when Hispanics were 16 percent of the population.

Why has ethnic and racial representation been so poor?

For patients, there is a legacy of mistrust of research, certainly among the African American population, but also mistrust of the health care system in general and of research, specifically among many disadvantaged populations. They are skeptical about the motives and intent of researchers. Also, there are access issues. Most clinical trial participants are recruited through their physicians, and often companies did not include physicians and practices that serve diverse patient populations.

What can be done about that?

Project Impact of the National Medical Association, a national association of Black physicians, has been working to diversify participation in clinical trials for more than a decade by speaking with Black physicians, who often have a group of patients that is much more diverse. They have published results that show that when Black people are approached in the same way, when they are encouraged to participate by a physician with whom they have a relationship, and whom they trust, they participate at the same rates as other groups. But you have to reach out to the physician and the physician practices, where they have those sorts of relationships.

How has the situation changed during the pandemic?

In the era of the COVID-19 pandemic, with Black people and Hispanics being disproportionately impacted by the virus, it’s essential to engage them in vaccine trials. Yet the level of public distrust in the research process and government has never been higher. So we have a lot of work to do if we’re going to get this pandemic under control.  Building trust means developing relationships and that takes time. This is an ongoing challenge in some of the trials and is why Mount Sinai has been approached by many of the pharmaceutical companies because we do have access to this diverse population.

What is Mount Sinai doing?

At the Mount Sinai Institute for Health Equity Research, we have been approached by various entities, asking us to help recruit more diverse populations into their studies. We start by talking about the things you have to do. First, you have to talk with some of our community partners and you have to accept their input, such as the language you use in the materials you distribute to participants. You need to look at how burdensome the trial will be. If we are going to combat mistrust, we must behave in a trustworthy manner.  The Institute is ready to work with researchers who are serious about building the relationships needed to recruit diverse populations into clinical trials.

 

Read more about what Mount Sinai experts say about vaccines
Get COVID-19 vaccination information from Mount Sinai

Disparities in Rehabilitation Medicine Are Focus of Inaugural Disability Awareness Talk

Updated on Nov 14, 2025 | Community, Engagement

Miguel Escalon, MD

“Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States,” was the subject of a wide-ranging talk on Disability Awareness by Miguel Escalon, MD, Associate Professor of Rehabilitation Medicine and Human Performance, Icahn School of Medicine at Mount Sinai. The virtual talk can be viewed here.

Black Americans aged 30 to 64 have a higher stroke mortality compared with all other groups, and also the  highest incidence of hypertension, diabetes, and peripheral artery disease, all strong risk factors for stroke, Dr. Escalon said. There also are disparities in rehabilitation care of such patients after a stroke, he said, citing a survey of research from 2009 to 2019, which he and a team published in October 2020 in  PM&R: the Journal of Injury, Function and Rehabilitation.

The talk in October inaugurated the new Raising Disability Awareness Virtual Talk Series, featuring speakers from around the Mount Sinai Health System as well as the community, in honor of Disability Awareness Month. During this time, Mount Sinai hosted events to educate, raise awareness and promote an inclusive and equitable health care environment for people with disabilities.

Speakers also came from Mount Sinai’s Seaver Center for Autism Research and Treatment, and Language Assistance Program, and from external partners, including the National Multiple Sclerosis Society, the Mayor’s Office for People with Disabilities, MTA NYC Transit Access-A-Ride, the Lighthouse Guild, the Hearing Loss Association of America, the Adaptations Job Program, and the LBGTQ+ community. The talks were curated to bring awareness to the intersectionality of disability and race, ethnicity, and LBGTQ+ and educate on health disparities and the barriers to access to care.

Health disparities have been found for Black people with stroke, traumatic brain injury, spinal cord injury, hip/knee osteoarthritis, and fractures, as well as cardiovascular and pulmonary disease, Dr. Escalon said. Some contributing factors included socio-economic issues, low access to rehabilitation care, fewer referrals, lower utilization rates, perceived bias, and more self‐reliance.

Some sources also found that disparities are evident in the crucial months just after a stroke. “Most recovery happens in the first few months. You are never going to get more rehab than you get in acute inpatient rehab.”  Dr. Escalon said, adding the more study is needed to identify and address health disparities.

“It is important for health care professionals to understand the health risks within Black communities,” he said. “More research is needed to elucidate the outcomes—by race/ethnicity, gender, and gender within race/ethnicity—especially around what happens after the patient leaves the hospital.”

Two Mount Sinai Diversity Groups Honored by National Association

Updated on Nov 14, 2025 | Community, Engagement

For projects that informed, engaged, and uplifted the community, the Mount Sinai Beth Israel (MSBI) Diversity Council and the Corporate Services Center Heritage of Latino Alliance (HOLA) Employee Resource Group were recently honored by The Association of ERGs and Councils during its annual conference. The association—which provides resources to increase the impact, effectiveness, and recognition of employee resource groups (ERGs) and diversity councils nationally—ranked the MSBI Diversity Council No. 1 in the “Top 10 Diversity Action” awards. The Corporate Services Center HOLA Employee Resource Group ranked No. 7 in the “Top 25 ERG” awards at the virtual conference, which was held October 19-24.

HOLA members at the prom dress drive, from left, Karen Rivera, Sherrine Gonzalez, and Katari Lebron.

The MSBI Diversity Council was recognized for its annual “Go Red” event in February, during which it partners with Mount Sinai Heart to offer blood pressure screenings for patients and staff. In recognition of Black History Month, the council members focused on providing health and wellness information to the Black patient population due to the prevalence of heart disease in this community. The HOLA Employee Resource Group was recognized for its Prom Dress Drive for female students at the Esperanza Preparatory School in East Harlem. HOLA members collected and delivered more than 150 dresses to the school and assisted 50 young women in finding a dress for their prom. “We congratulate the MSBI Diversity Council and the Corporate Services Center HOLA Employee Resource Group, especially the leads of these groups—Donnette Truss and Lena Chang at MSBI and Frank Pabon and Shawn Lee of HOLA—who led the efforts to achieve these recognitions,” says Pamela Y. Abner, MPA, CPXP, Vice President and Chief Administrative Officer, Office for Diversity and Inclusion.

The Go Red event at Mount Sinai Beth Israel in February 2019.

To receive the awards, diversity councils and ERGs across the country were required to submit a video to the association describing an event or initiative they organized during 2019.  The association selected and evaluated honorees using the “Impact Model,” a data-driven model that shows how the initiative improved talent management, culture, and organizational vitality for the individuals, organization, and external stakeholders involved. The MSBI and HOLA groups were among 45 councils and ERGs nationally honored by the association for demonstrating the standards of excellence for organizations working to enhance their diversity, equity, and inclusion work. In addition, ERGs across the Health System are doing impactful work year round, says Shana L. Dacon, MPH, MBA, Director, Corporate Health System Affairs, Office for Diversity and Inclusion. “We want to thank all diversity council and employee resource group members for their ongoing commitment to diversity, equity, and inclusion and promoting a culture of belonging for all faculty, staff, students, trainees, patients, and the Mount Sinai Health System community,” she says. To learn more about diversity council and employee resource groups, contact the Office for Diversity and Inclusion at diversity@mountsinai.org. Visit the United in Solidarity website to learn about how the Mount Sinai community is promoting efforts to instill an anti-racist culture and promote anti-racist behaviors.

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