As a senator, Kamala Harris didn’t sit on any major health committees. In the 2020 primary, the pervasive debate over “Medicare for all” often appeared as a stumbling block for the candidate.
But Harris’ addition to the Democratic ticket could amplify attention to another, long-ignored national health crisis. Since 2018, Harris has made a name for herself in health policy circles as a vocal champion for solutions to the country’s disastrous maternal mortality rates.
In 2018, 17.4 maternal deaths were recorded for every 100,000 live births, according to data from the federal Centers for Disease Control and Prevention. The United States lags well behind other developed countries — it’s virtually alone amongst its peers in seeing its death rates increase since 2000 — with race playing a critical role in outcomes. In 2018, maternal deaths among Black people were 2.5 to 3.1 times as common than White ones. Native American people were also at significantly higher risk — between 2007 and 2016, the most recent years for which CDC tracks that disparity, they were 2.3 times more likely to die because of pregnancy.
If past is any guide, Harris — the California senator and now, the nation’s first-ever non-White woman to run as part of a major party presidential ticket — could, if elected vice president, shine new light on a crisis to which the White House has devoted little energy. And experts say that focus could be transformative.
“As someone who knows and is from the communities that experience maternal mortality, she has a voice that no one else at that level of leadership has ever had before,” said Katy Kozhimannil, an associate professor at the University of Minnesota who has advised Harris’ staff on maternal health bills. “There’s an open ear for opportunities for change with her in this role, that there hasn’t been before ever in history.”
And that experience takes on new weight as the coronavirus pandemic continues to worsen. Maternal health researchers are worried that COVID-19 — which appears to bring higher risks for pregnant people, and is hitting Black and Latino people harder across genders — could only build on the existing crisis.
A 2017 ProPublica investigation brought national attention to the U.S. maternal mortality rate. Since then, President Donald Trump’s main response to the crisis has been to authorize $60 million over five years to improve data collection.
How a White House administration divides up responsibilities varies, so it’s no sure thing that Harris as vice president would oversee health care. (Vice President Biden spent less time on health policy, and far more on areas such as disengaging from the Iraq War, or implementing the federal stimulus package from 2009.)
Still, the relationship between president and veep is powerful, noted Joel Goldstein, a scholar of vice presidents at St. Louis University. That has the potential to elevate issues that otherwise might not make it to the national agenda.
“They’re going to be sitting down privately with the president every week, and they’ve got a great time to put these issues on the agenda,” Goldstein said. “The issues that matter to the vice president are going to matter to other people in the administration.”
On Capitol Hill, Harris has used her senatorial platform to highlight Black maternal health in particular. It’s also an issue she — along with Sens. Cory Booker, Elizabeth Warren and Kirsten Gillibrand — highlighted early on in the 2020 Democratic primary.
In 2018, she was among the first lawmakers to introduce legislation specifically targeting racial disparities in maternal health. That bill addressed implicit racism in medicine — specifically targeting obstetrics and gynecology — and would have developed pilot projects to focus on improved pregnancy outcomes with a focus on Black people.
Emphasizing implicit bias, though not sufficient on its own, could play a powerful role in undermining some of the root causes of maternal health disparities, said Dr. Elizabeth Clayborne, an emergency medicine physician at Prince George’s Hospital Center, just outside of Washington, D.C.
Clayborne, who is Black, gave birth just two months ago. She was acutely aware of the systemic factors that put her at higher risk for complications, she said.
“If you don’t listen to Black women when they have issues and pain, then interventions come too late,” Clayborne said. “Implicit bias is a huge issue, and it will be wonderful to have someone who encourages everyone to look at where their blind spots exist.”
This past year, Harris was the Senate’s lead sponsor on the so-called “Momnibus” bill. Among other policy prescriptions, it focused on addressing social factors that influence maternal health — such as housing, environment and transportation — as well as funding community-based organizations that support positive health outcomes for Black pregnant people. Those include improving data collection around pregnancy and pregnancy outcomes, expanding and diversifying the workforce that treats pregnant people, and investing in maternal mental health.
“She has been one of the strongest and most consistent and loudest voices to address this issue, and to address it from a perspective that digs into the issues that addresses structural racism,” said Sinsi Hernández-Cancio, the vice president for health justice at the National Partnership for Women and Families, which advocates for maternal health.
Simply being a Black woman gives Harris a valuable perspective — one that often hasn’t been elevated in national health policy making, argued Kelly Dittmar, the director of research at Rutgers University’s Center for Women in American Politics. “When you say representation matters, we’re really talking about that perspective, lived experience and attention to otherwise silenced voices,” she said.
That matters especially in the case of maternal health. Harris’ work positions her to address it in a way that many other lawmakers have struggled to.
“She has brought issues like maternal mortality to the table, and brings it not only as a woman, but as a woman of color — and brings all of that perspective and lived experience and engagement with particular communities to the table,” Dittmar said. “To say, ‘First of all, we need to address this issue — and second of all, we need to do so with attention to those who are most affected.’”
Biden, in his “Agenda for Women,” outlined one potential response to the maternal mortality crisis: replicating strategies used in California, the only state where death rates fell between 2006 and 2013. That emphasis could suggest an openness to taking on the issue, experts said.
“Vice President Biden is proud to stand with her in taking this fight nationwide in the Biden-Harris administration,” said Symone Sanders, a senior adviser to the Biden campaign.
Meanwhile, the persistence of the COVID-19 pandemic adds further significance to the maternal health crisis, experts said, and increases its likelihood of emerging as a priority.
“We obviously can’t speak to what her particular plans are, but it’s hard to imagine that — given her leadership in the Senate on this issue — she would suddenly, if she were to become vice president, set that aside,” Hernández-Cancio added.