Title: Investigating Racial/Ethnic Disparities in Maternal Health Outcomes at the Health System Level

Pregnancy-related deaths and severe maternal morbidity (SMM) are increasing in the United States, with racial/ethnic disparities in outcomes for women of color persisting for decades. Both poor overall maternal health outcomes and disparities are attributable to a broad range of socioeconomic factors as well as differences in the quality of care provided by individual health systems. An estimated sixty percent of all pregnancy-related deaths and SMM cases are considered preventable with timely and appropriate care. Limited understanding of the underlying mechanisms that result in poorer quality of care for women of color represent a major impediment to advancing equity in maternal care. In addition to implicit bias, prior research suggests inequities can be designed into healthcare through the use of biased clinical decision support algorithms, discriminatory processes and policies, and integration of unreliable biomedical technology. As these factors can directly lead to disparate outcomes in maternal care and other clinical areas, health systems must take an active role improving equity in care. However, characterizing and alleviating inequities in clinical care is difficult due to the lack of a well-defined conceptual model to facilitate investigation, limited or lack of accessible race/ethnicity data, and insensitive equity measures. Using maternal health disparities as the paradigm, my research applies sociotechnical systems analysis approaches to uncover embedded inequities in clinical systems, and analyze and monitor disparities in outcomes. My research also uses human-centered and participatory design approaches to support the redesign of clinical systems for equitable care. This work exemplifies the type of multilevel effort needed to eliminate health disparities at both the population and health system levels.

Bio: Myrtede Alfred is an Assistant Professor in the Mechanical & Industrial Engineering Department at the University of Toronto. She directs the Safety, Equity, & Design (SĒD) Lab which conducts patient safety research in several area, including CPR feedback efficacy, application of extended reality in patient education, and retained foreign objects. Her research also leverage sociotechnical systems analysis approaches to examine clinical system contributions to healthcare disparities. Prior to joining University of Toronto, Dr. Alfred was a research assistant professor at the Medical University of South Carolina where she spent three years applying her expertise to improve the delivery of care in the hospital through both research and practice. She worked closely with the risk and patient safety teams and conducted direct observation on medical floors, intensive care units, and operating rooms. Dr. Alfred has published over 20 peer-reviewed articles and has given eight invited talks. Her research has been funded by the Agency for Healthcare Research and Quality (AHRQ), the Natural Sciences and Engineering Research Council (NSERC), and the Canadian Institutes of Health Research (CIHR). Dr. Alfred obtained her PhD in industrial engineering from Clemson University (2017) where she held the Southern Regional Education Board Dissertation and the Janine Bowen Graduate Fellowships and earned multiple awards for teaching and outreach, including the MLK Jr. Excellence in Service Award. Beyond academic research, Dr. Alfred leads her STEAM education nonprofit, Marie’s Kids, in North Charleston, South Carolina.

The Departmental Seminar Series is open to all. U-M Industrial and Operations Engineering graduate students and faculty are especially encouraged to attend. There will be a reception to follow the seminars in the IOE commons from 4 -5 p.m