Improving maternal health through digital health
The importance of supporting low income and minority women to address the health inequities around maternal morbidity
May 3, 2021

Sunday is Mother’s Day, and the U.S. is projected to spend approximately $26.7 billion this year on cards, gifts, and meals to help celebrate and appreciate moms across the country. 

To show our appreciation for our own mothers, Wellth is turning its attention to the healthcare gaps many mothers face—and how Wellth is supporting its members with improved digital health offerings.

The inequalities mothers of racial and ethnic minorities and low-income populations face today

The U.S. Census Bureau released statistics around the increase in racial and ethnic diversity, showing that the 2020 Census will likely reveal the first decline in the white population. According to the statistics, one in four Americans identify with a racial or ethnic minority, and that number is predicted to rise in the coming years. 

Yet while diversity increases, the care that minority populations receive is slow to follow. For mothers of Black, Hispanic, Latino, Native American, and Asian dissent, quality of care still falls behind what is received by white mothers. For example: 

  • Women of racial and ethnic minorities experience 28 percent more cases of severe maternal morbidities when compared to white women
  • Women of indigenous or black descent are more than twice as likely to die of a pregnancy-related condition
  • Asian American infants are 40 percent more likely to die of maternal complications compared to white infants

Compared with non-Hispanic white women, adjusted failure-to-rescue ratio: Black women, 1.79; Hispanic women, 1.08; Other or multiple race/ethnicity, 1.39
Source: Helio

While some policy work has been done to try and address this, room remains for improvement.  Jean Guglielminotti, MD, PhD, of the department of anesthesiology at Columbia University Vagelos College of Physicians and Surgeons, explains: 

“The Affordable Care Act helped expand health insurance coverage and improve prenatal care among pregnant women. Nonetheless, the racial and ethnic disparities persist, which suggests that interventions tailored for racial and ethnic minority women are needed, such as programs aimed at addressing structural racism in the health care system.” 

Wellth programs are designed and tailored to help meet the medical, mental health and temporal needs of marginalized populations—including mothers—by supporting better maternal care, better mental health, and better quality of life through meaningful incentive programs. 

Supporting mothers during pregnancy 

Mothers struggling with existing chronic conditions are often at heightened risk of complications during pregnancy—including higher rates of cesarean sections, babies born premature, hypertension and more. 

Studies have shown that one in every five pregnant women have an existing chronic condition, or 20 percent of the U.S. population. In low-income and minority populations, where chronic conditions are 1.5 to 2.0 times more common, that statistic is likely even higher. 

Implementing programs that are designed to help these individuals—taking into account the social determinants of health that many of them face—can help improve maternal health. 

Addressing gestational diabetes in mothers

Gestational diabetes costs the U.S. $636 million a year and, unmanaged, can lead to hypoglycemia or preeclampsia for the mother—causing further complications like an early or difficult delivery. In addition, unmanaged gestational diabetes in the mother can directly impact the baby beyond delivery through low blood sugar, macrosomia, or development of Type 2 diabetes later in life. 

Better care plan adherence at the onset of gestational diabetes reduces the cost of care and improves the health of these mothers and their babies. 

However, care plans often include managing a strict diet, careful glucose monitoring before and after meals, regular insulin injections, and/or oral medications and treatments. As a result, less than 7 percent of mothers diagnosed with gestational diabetes achieve even 73 percent care plan adherence. 

Incentivizing care plan adherence for mothers

Wellth supports mothers with gestational diabetes by breaking down complex care plans into simple, manageable steps—and incentivizing those steps with flexible rewards that can be used to cover prescription costs, food, or baby needs. With behavioral-economics based incentives, and a dedicated member support team, expecting mothers are empowered to stay on their care plans and improve their health and the health of their babies. 

For more information on Wellth’s gestational diabetes program, check out our blog post— “Managing gestational diabetes through better care plan adherence: Why it’s difficult, and what to do about it.”


Supporting the mental health of marginalized mothers during a pandemic 

The Kaiser Family Foundation found that roughly 40 percent of American adults faced some sort of anxiety or depression as a result of the COVID-19 pandemic. Of those adults, additional studies have shown increased percentages in clinically diagnosable anxiety and depression for parents, with Nicole Rachine, PhD of the department of psychology at Alberta Children’s Hospital Research Institute sharing: 

“One group that has been particularly affected by the social and financial ramifications of the COVID-19 pandemic are parents, especially mothers. In addition to working to maintain a livelihood, some parents have adopted caregiving or homeschooling roles. Cross-sectional studies of maternal mental health problems during the COVID-19 pandemic have found approximately 30 percent of mothers reporting clinically significant symptoms of depression or anxiety.” 

In minority populations, more than half of Black, Latino, and Native American adults hold “essential” jobs that require in-person contact—leading to higher risk of exposure and additional stress and anxiety for these individuals.  


Supporting our mothers means being to support both their physical and their mental health—providing programs that address behavioral health conditions and support better overall health.

Behavioral health and Wellth

Wellth supports our members struggling with mental health by providing a program that accounts for “bad days” and helps individuals make good choices—even when they are stressed by outside circumstances. 

The Wellth platform leverages behavioral economics to overcome challenges that prevent members from adhering to care plans. As one Wellth member shares: 

“It's good to be reminded to take your medication and also try to keep up with my blood pressure because those are two main things that will keep my heart going… This program not just benefited me with the reward part, but benefited me mentally, so thank you so much for finding me! It is helping me, it's rewarding with the money and on top of that it's rewarding for me to watch my weight, watch my sugar, and make sure I take my pills, and watch my blood pressure because if you don’t know how to keep your blood pressure down, it can send you down a wrong direction...”

Case study: Coordinated Behavioral Care

Like many care management programs, Coordinated Behavioral Care’s “Pathway Home Program” was struggling to maintain engagement with its members facing behavioral health conditions—leading to condition exacerbation and unhappy patients. Each member’s own support system varied, and lack of treatment adherence continued to keep many members from seeing potential improvements.

By implementing Wellth, CBC was able to incentivize patients to follow care plans—including medication and appointment adherence—leading to 85 percent average care plan adherence and a 93 percent increase follow-up appointment attendance. 

Learn more about CBC’s program by reading our case study today. 

Providing ongoing support to vulnerable populations through incentives that address health equity

Wellth member Rosemary and her family

Many Wellth members belong to Medicaid or Medicare populations—facing numerous social determinants of health including food insecurity, insufficient housing, and difficulty covering the cost of certain prescription medications. This creates stress as many mothers struggle to not only provide for their own needs but also the needs of their children. As a result, they may not take the time to prioritize their own health, leading to further condition exacerbation. 

As Wellth member Rosemary shares: 

“When you are a mom, your priority is to take care of your kids—especially when they are ill as in my case. My oldest daughter, Anna, has a severe kidney problem. I take her to dialysis three times a week. Some weeks, I need to go more often if they need to change the catheter, or do some minor surgery. We leave home around five in the morning. 

After her treatment is done, I need to take care of my other daughters, cook, clean, and go to work. This is a very difficult situation and I had trouble finding time to take care of myself, even when it came to just taking my medications. I started feeling tired, so I decided to drink energy drinks to keep up with my busy schedule, without thinking that it was really unhealthy…”

Wellth reminds its members to take their medications—and incentivizes adherence with flexible rewards that members can use to cover the cost of daily necessities. In fact, 68 percent of Wellth’s rewards are spent directly on food and meals, and the remaining 32 percent are spent on a mixture of household items, home repairs, and transportation costs. 

When members receive the resources they need to cover social determinants, health equity improves. And as members earn these rewards through adherence, their motivation to continue prioritizing their health improves. Rosemary continues: 

“Wellth taught me that it’s important to take care of myself in order to take care of my family.

My daughters were so happy because they saw that I was finally doing something for myself. They were worried that my illness would get worse and take away our time together. My husband was also excited, he works so hard to provide us as well.

I completed the program already, but I will not forget to take my medication going forward. Now, I put my medication into my purse everyday and I take it religiously.

This experience was so rewarding because it taught me to not only take my pills, but also helped me understand that my family is the most important thing in my life and that I need to take care of myself first to be able to support my family.”

To read more about Rosemary, check out her article: “A Great support system brings better health outcomes.”