February 11, 2022

Ron McGarvey

A Mizzou Engineer has teamed up with an interdisciplinary research group in Montana to research disparities in obstetric care, work that could someday help policymakers and health care providers improve access to critical services.

Ronald McGarvey, associate professor of industrial engineering and public affairs, is working alongside sociology and business faculty from Montana State University and Kaiser Permanente Northern California on the research. In their latest paper, the team found that American Indian and Alaskan Native women in rural Montana are driving significantly further to give birth than their Caucasian counterparts.

“There are a lot of places in Montana where any woman is far from facilities that are designed to support childbirth,” McGarvey said. “That’s a trend in rural areas across the U.S. as more hospitals are closing or closing down their obstetric units.  Our research is arguing that policymakers investigate how they are allocating dollars and resources to see what they can do to incentivize hospitals to provide care that’s closer to where these women live.”

For the paper, published in the Journal of Rural Health, the team examined variation in travel time and access to different levels of obstetric care using Montana birth certificate data from 2014 to 2018.

They found that American Indian and Alaskan Native women traveled 24.2 minutes farther on average to give birth than White women and five to 13 minutes farther after controlling for sociodemographic characterization, risk factors and health care utilization. Additionally, American Indian and Alaskan Native women were 20 times more likely to give birth at a hospital without obstetric services.

Now, the research group is focusing on why that’s the case.

“One rationale is that women are bypassing hospitals, which means they might choose to drive further because of, for example, insurance status or perhaps other reasons hospitals are making different groups of women feel more or less welcome,” McGarvey said. “That’s an issue we’re examining in current work and hope to have results published sometime this year.”

The research is a good example of how industrial engineering spans disciplines. In general, industrial engineers address ways to most efficiently allocate resources; and in this case, that means ensuring women have access to the medical services they need.

“Pretty much any activity or any organized system people are operating in has to answer questions about how we allocate dollars, people and equipment,” McGarvey said. “Health care is obviously more complicated, because it can’t just be about profit and loss. We know that longer driving time and giving birth at facilities without an obstetrics unit increase the likelihood of poor outcomes, especially for high-risk deliveries. That’s something that makes these health care applications in industrial engineering even more urgent for society to address.”

The research team includes Maggie Thorsen from the sociology and anthropology department at MSU, Sean Harris and Andreas Thorsen from the College of Business and Entrepreneurship at MSU, and Janelle Palacios, a certified midwife in the Department of Obstetrics and Gynecology at Kaiser Permanente Northern California.