From AzPHA Member Bre Thomas at Affirm
The CDC suspended data collection through the Pregnancy Risk Assessment Monitoring System (PRAMS) last week. PRAMS is a federal population-based surveillance system “designed to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress towards goals in improving the health of mothers and infants.”
Developed in the 1980s as part of a concerted effort to better understand why Black and Native American/Alaskan Native mothers and infants consistently experienced worse health outcomes than their white counterparts, the PRAMS questionnaire includes questions about racism, discrimination, and socioeconomic status.
Because the current survey and research protocol include questions about race, sexual orientation and gender identity, and class status, an overhaul is necessary to comply with the President’s executive order ending government diversity, equity, and inclusion (DEI) programs.
CDC employees who work on PRAMS have reported that the program will eventually continue without survey questions about race/ethnicity and other social determinants of health. However, the ability of a revised PRAMS questionnaire to support the program’s goal of finding groups of pregnant people and infants at heightened risk for adverse health outcomes is still unclear.
Furthermore, these revisions to the survey’s questions — some of which have been asked consistently since 1988 — will diminish the ability of program administrators, policymakers, and advocates to watch changes over time.
Currently, 26 Title X grantee agencies (all state health departments) take part in the PRAMS program, and both programs are often co-located in the same bureau or division. Even more family planning and sexual health service providers rely on PRAMS data for program planning.
Of note, PRAMS data is used to calculate unintended pregnancy and birth rates; access to and receipt of prepregnancy, prenatal, and postpartum care; patterns of health insurance coverage before, during, and after pregnancy; and performance measures on access to postpartum contraception.
