BackgroundAccurate small-area estimates of vaccination rates and disease burden can inform public health interventions. ObjectiveThis study aimed to compare population denominators derived from census data and electronic health record (EHR) data from a statewide collaboration in Minnesota and examine concordance between Centers for Disease Control and Prevention and EHR-based estimates of diabetes and hypertension prevalence at the census tract level. MethodsA retrospective study was conducted using EHR data from 2018 to 2022 from the Minnesota EHR Consortium (MNEHRC), population estimates from the 2020 census, and disease prevalence estimates among adults from the Centers for Disease Control and Prevention Population Level Analysis and Community Estimates (PLACES) project. Patients were included if they had a Minnesota address and a clinic visit in the last 3 years. Patients with hypertension and diabetes were identified based on the presence of at least 1 diagnosis code in the Observational Medical Outcomes Partnership condition occurrence table in the last 5 years or an elevated outpatient blood pressure (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) on 2 or more days in the last 3 years for hypertension or at least 1 hemoglobin A1c value of ≥6.5 in the last 3 years for diabetes. ResultsThe 2020 census estimate for the population of Minnesota was 5,707,254. A total of 5,271,191 (92.4% of the census estimate) unique individuals visited 1 of the 11 MNEHRC health care systems in 3 years (2018-2020). The ratio of MNEHRC patients to the Minnesota statewide 2020 census estimate was higher for female individuals (0.97) than for male individuals (0.88) and higher for older age groups (individuals aged 65 years and older: 1.05) than for younger age groups (individuals aged 0-17 years: 0.83). The MNEHRC patient-to-census ratio also differed by race—the ratio was the highest for Black Minnesotans (1.17) and the lowest for American Indian and Alaska Native Minnesotans (0.68). According to MNEHRC data, the percentage of adults in Minnesota with diabetes in 2022 was 9.5% (415,914/4,376,805), and the percentage of adults in Minnesota with hypertension in 2021 was 32.2% (1,365,413/4,234,000). Estimates from PLACES for diabetes were 9.9% (435,481/4,389,028) and for hypertension were 29.9% (1,311,459/4,389,028). The percentage of census tracts where the MNEHRC estimate was within 10% of the PLACES estimate was 40.3% (605/1500) for diabetes and 42.3% (635/1500) for hypertension; 77.9% (1168/1500) of census tracts for diabetes and 79.7% (1195/1500) for hypertension were within 25% agreement. ConclusionsOur analysis suggests that there are both similarities and important differences between small-area estimates derived from EHR and survey data. Such differences suggest that further research is needed to determine the optimal collection method for local estimates of health conditions.

PurposeA case example describing a teen-led council convened by an integrated health system. We seek to share the approach and impact of this work with the broader health services and promotion field.Approach or DesignA stakeholder-informed formative evaluation.SettingIntegrated health system in Upper Midwest.ParticipantsProgram staff, a program alumna, external program partners, subject matter experts, and current council members.MethodThis evaluation was informed by a literature review, data previously collected by the program, key informant conversations, and a participatory data collection activity with current council members. Rapid qualitative analysis was used to describe council framework and stakeholder-identified outcomes.ResultsInformed by best practices in authentic youth engagement and youth-adult partnership, this council has had a positive impact on participants, the convening health system, and the community served by the health system, in service of adolescent health and well-being.ConclusionThis formative evaluation demonstrates how youth are able to take on a leadership role and have a positive impact on adolescent care delivery and health promotion.

PurposeThe impact of gun violence on mental health is not limited to individuals who have experienced a shooting. This report enumerates, for the entire US population, the prevalence of anxiety and stress about gun violence. It also describes evidence-informed interventions that may improve these symptoms by reducing gun violence.DesignSurveys representing the US population.SettingUnited States.SubjectsAdults and adolescents.MeasuresSelf-reported anxiety and stress.AnalysisDescriptive frequencies.ResultsOn 3 surveys of adults (N sizes 2015 to 3192), between 27% and 38% selected "extremely anxious", 26% to 35% selected "somewhat anxious", and 12% selected "not at all anxious" when asked about gun violence concerns. When asked, 37% of respondents stated that they had avoided going somewhere over the past 6 months due to fear or anxiety about gun violence. In a survey of teens (N = 743) and their parents (N = 1058), 25% of teens selected "very worried" and another 32% "somewhat worried" about the possibility of a shooting happening at their school. In response to the same question, 24% of parents selected "very worried" and another 39% "somewhat worried".ConclusionAnxiety and stress about gun violence are pervasive in America. Secure gun storage, universal background checks and extreme risk protection orders are among the interventions that reduce gun violence and may thereby reduce the anxiety and stress it generates.

Accurate small area estimates of vaccination rates and disease burden can inform public health interventions. To compare population denominators derived from census data and electronic health record (EHR) data from a statewide collaboration in Minnesota and examine concordance between CDC and EHR-based estimates of diabetes and hypertension prevalence at the census tract level. Retrospective study utilizing EHR data from 2018-2022 from the Minnesota EHR Consortium (MNEHRC), population estimates from 2020 census data, and disease prevalence estimates among adults from the Centers for Disease Control and Prevention (CDC) Population Level Analysis and Community Estimates (PLACES) project. Patients were included if they had a Minnesota address and a clinic visit in the last 3 years. Patients with hypertension and diabetes were identified based on the presence of at least one diagnosis code in the OMOP condition occurrence table in the last five years or an elevated outpatient blood pressure (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) on two or more days in the last three years for hypertension or at least one A1c ≥6.5 in the last three years for diabetes. There were 5,271,191 unique individuals who had a visit in the last three years (2018-2020) at one of the 11 MNEHRC healthcare systems. This represents 92% of the 2020 census estimate for Minnesota (5,707,254). The ratio of MNEHRC patients to the Minnesota statewide 2020 census estimate was higher for females (0.97) than males (0.88) and higher for older age groups (age 65 years and older: 1.05) than younger age groups (age 0-17 years: 0.83). The MNEHRC patient to census ratio also differed by race – the ratio was highest for Black Minnesotans (1.17) and lowest for American Indian/Alaska Native Minnesotans (0.68). According to MNEHRC data, the number of adults in Minnesota with diabetes was 415,914 (9.5%) and the number with hypertension was 1,365,413 (32%). Estimates from PLACES for diabetes was 435,481 (9.9%) and for hypertension was 1,311,459 (30%). The percent of census tracts where the MNEHRC estimate was within 10% of the PLACES estimate was 40% for diabetes and 42% for hypertension 78% and 80% were within 25% respectively. Our analysis suggests that there are both similarities, as well as important differences between small-area estimates derived from EHR and survey data. Such differences suggest further research is needed to determine the optimal collection method for local estimates of health conditions.

INTRODUCTION:Although preventable, dental caries remains highly prevalent. Many children do not receive preventive dental services routinely in clinical settings. This review examined the effectiveness of school (preschool through high school) fluoride varnish delivery programs in preventing caries. METHODS:Community Guide systematic review methods were followed. In 2024, databases were searched for studies published through December 2023 on school flouride varnish delivery program effectiveness in increasing fluoride varnish receipt and decreasing caries. Included studies had to be written in English, published in peer-reviewed journals, and conducted in upper-middle- or high-income countries. Data synthesis conducted in 2024 used median RR and interquartile interval (IQI) to summarize findings across studies. RESULTS:Of 31 included studies with 60,780 students, 25 were randomized controlled trials-20 with good quality of execution. Most studies were conducted in low socioeconomic status areas among students at elevated caries risk. School flouride varnish delivery programs reduced caries initiation by 32% (IQI: 21%, 37%) in permanent teeth (19 studies, 25,826 students) and by 25% (IQI: 4%, 37%) in primary teeth (12 studies, 4,304 students). Stratified assessments indicated findings were largely applicable to different settings, populations, and intervention characteristics. Two studies found school flouride varnish delivery programs significantly increased the number of annual flouride varnish applications and 2 found that school flouride varnish delivery program effectiveness was inversely related to socioeconomic status. DISCUSSION:About 30% of states report having no school flouride varnish delivery programs. Possible barriers to implementation include that Medicaid in some states only reimburses dental and medical professionals and does not reimburse non-dental providers for flouride varnish delivered to children older than age 6 years.

PurposeClinical firearm safety counseling can help prevent firearm injuries, yet many clinicians have not adopted this practice. We collected practical tips from physicians who do such counseling to help others interested in conducting such counseling while perhaps feeling insecure about how to implement it.DesignQualitative interview study.Setting/ParticipantsSixteen physicians who had made clinical firearm safety counseling part of their practice.MethodsAn interview guide included questions about how, when, and with whom participants were undertaking firearm safety counseling, motivations, experiences with the counseling, patient reactions, and barriers and facilitators. The interviews were analyzed using inductive thematic analysis.ResultsMost (11 out of 16) physicians were in primary care/family medicine or pediatrics; 54% worked in urban, 27% in rural/small town, and 20% in suburban settings. Three takeaways were reported by virtually every participant: firearm safety counseling is not difficult; almost all patients react positively, and occasional skeptical reactions are easily defused; and this counseling does not take much time. Participants kept conversations nonjudgmental and focused on safety, not on firearm ownership itself. Participants' strong convictions that it was their responsibility to address firearm safety helped them overcome barriers such as lack of time, training, and guidelines.ConclusionParticipants shared actionable ideas on how to facilitate firearm safety counseling, exemplifying ways to encourage firearm safety behaviors.

Public health, personal/community health behaviors, health care delivery, and the scientific community have all been impacted by the COVID-19 pandemic and are consequently poised to consider substantial paradigm shifts that will enhance disease prevention and public health resilience. The current analysis compares the newly developed Lifestyle Health Index (LHI) to U.S. county-level COVID-19 vaccination, infection, and mortality rates. We linked Centers of Disease Control PLACES, the U.S. Community Profile Report, and Nationhood lab databases through common zip-code identifiers to determine the association between county-level LHI scores and COVID-19 outcomes and vaccination status against the backdrop of U.S. regions with distinct cultural phenotypes. There was a statistically significant relationship between a poor LHI, lower COVID-19 vaccination rates and higher COVID-19 infection and mortality rates. There were clear differences in outcomes across the U.S. regions, suggesting distinct regional cultural characteristics may significantly influence health behaviors and outcomes. In the U.S., a syndemic comprising unhealthy lifestyle, chronic disease, and COVID-19 resulted in unnecessary hospitalizations and deaths. Politicization of the pandemic, socioeconomic inequity and regional cultural values meaningfully contributed to the uneven distribution of poor outcomes during this syndemic. Components of the syndemic were avoidable and should not be repeated. Condensed Abstract: The unhealthy lifestyle - chronic disease - COVID-19 U.S. syndemic resulted in unnecessary hospitalizations and deaths. Politicization of the pandemic, socioeconomic inequity and regional cultural values meaningfully contributed to the uneven distribution of poor outcomes during this syndemic. Components of the syndemic were avoidable and should not be repeated.

BackgroundHealth systems support community health and well-being, and while many commit resources to convening in support of community-engaged communication interventions, they currently lack tools to evaluate this effort. This report describes one health system's mixed-methods stakeholder-engaged development of robust yet pragmatic convening assessment tools.MethodsSemi-structured interviews and web surveys with key stakeholders informed a taxonomy of quality convening and accompanying survey tool. Initial evidence of validity and item variability were assessed descriptively.ResultsA 3-item survey aligned with high-priority convening constructs was developed with adequate variability in initial item responses. A companion 21-construct taxonomy organized by domain and stakeholder also resulted.ConclusionThis project resulted in a taxonomy detailing the constructs of quality convening and an accompanying brief survey tool to meets the needs of groups convened by one health system. These tools provide a unique opportunity to measure the quality of community convening within the context of healthcare.

Background: Since the COVID-19 pandemic health systems have shifted necessarily from chronic to infectious disease treatment, but chronic disease remains critical. One large health system uniquely tracks member health behaviors. This analysis compares data from select months of an ongoing monthly cross-sectional survey before and during the pandemic. Methods: Responses in April 2019 (pre-pandemic), April 2020 (early pandemic) or April 2021 (later pandemic) were included in the primary analysis (N = 252). Differences in meeting health behavior guidelines were analyzed via logistic regression. Results: A significant decline was seen for physical activity (19% not meeting guidelines pre-pandemic vs. 41% later pandemic) but not fruit/vegetable, alcohol, or sleep from early to later pandemic. Prevalence of women not meeting tobacco guidelines increased from early (5%) to later pandemic (10%) while prevalence in men decreased (10% vs 4% respectively). The percent of people not thinking about the good things that happen to them fluctuated closely with reports of new COVID-19 cases. Conclusions: Findings show the nuance of changing health behaviors throughout the pandemic. Results should be used by health systems to tailor support based on insights from the pandemic experience.

Arena, Ross PhD, PT, FAHA, FRSM, FESC, FACSM; Pronk, Nicolaas P. PhD; Kottke, Thomas E. MD, MSPH; Woodard, Colin MA, FRGS Author Information

Arena, Ross PhD; Pronk, Nicolaas P. PhD; Kottke, Thomas E. MD, MSPH; Woodard, Colin MA, FRGS Author Information

The HealthPartners Institute is a research and education division embedded within HealthPartners - a nonprofit, member-governed integrated health system. The Institute aims to generate and accelerate innovation for the HealthPartners health system, its patients and members, and the communities it serves. It has taken a formal, organized approach to building the necessary capabilities, infrastructures, relationships, and tools to do so. This article outlines an innovative approach by which the HealthPartners Institute created an environment conducive to accelerated system performance. Key components of building this organizational milieu include (1) integration, (2) strategic planning, (3) democratization of knowledge (especially internally generated knowledge), (4) funding, and (5) a capability to listen to diverse perspectives from both within the organization and the community at large. In recent years, based on a 2023 survey of the HealthPartners Senior Strategy team, nearly two thirds of 34 respondents (61%) have seen more connections between their work and the work of the Institute, and just over half (52%) report that the Institute has become more relevant to their work. Notably, care delivery is the area to which respondents (78%) find the Institute brings the most value, followed by our patients (74%), HealthPartners as a whole (70%), and our community (70%). In addition, a series of multiyear federally funded trials involving patients with uncontrolled hypertension collectively represent an example of clinical and financial impact. This collaborative effort involving system division partnerships through the Institute's core research department and centers of excellence compared usual hypertension care with an intervention that combined home blood pressure telemonitoring and pharmacist-led telephone care and found that the intervention group not only had lowered blood pressure and reduced cardiovascular disease events, but that for every US$1.00 spent the program realized US$1.82 in averted cardiovascular disease event costs. Efforts such as these advance system performance through a closer connection between the Institute and the health system's strategic multiyear goals, shared leadership among major research portfolios and the care delivery service lines, preprofessional clinical education aligned with workforce needs, systemwide implementation of clinical simulation, aligned and integrated financial operations, and compliance and integrity programs. Based on these experiences and results, the authors present several themes that may support acceleration of progress toward achieving a high-performing learning health system. Future development will include focus on the generation and quantification of value for internal and external stakeholders, strategic alignment of priorities to enhance value, and continued focus on workforce development.

Objectives There are numerous population health challenges confronting the United States (U.S.), including the unhealthy lifestyle – chronic disease pandemics. However, the impact of unhealthy lifestyle behaviors and the increased prevalence of chronic diseases that result from them affect many facets of life outside of the health domain, and their scope remains under-appreciated. The current analysis contributes to addressing this knowledge gap by comparing the newly developed Lifestyle Health Index (LHI) to U.S. county-level voter turnout rates in the 2020 presidential election. Study Design Descriptive, cross-sectional, retrospective analysis. Methods County-level data on the LHI, percent voter turnout, and the American Nations regional cultures model schematic was used in the current analysis. Results Pearson correlations between county-level LHI scores and sub scores and Democratic, Republican, and overall voter turnout were all statistically significant and of similar strength (r>0.63, p<0.001). All counties in the worst performing LHI quartile had a voter turnout <60%. Higher LHIs were consistently assocaited with lower voter turnout across the regional cultures, although heterogeneity was evident across the American Nations. Conclusions A large percentage of the U.S. population is afflicted with poor health, and unhealthy lifestyle behaviors are a primary driver. Poor health does not occur in a vacuum and impacts many other facets of an individual’s life. The current study further demonstrates the potential detrimental impact of poor health on civic engagement, specifically participation in the electoral process (i.e, citizens’ health may influence voter turnout). Health care professionals and institutions in the U.S. should uniformly embrace the recent policy brief by the American College of Physicians on participation in the electoral process for patients receiving care. This paradigm shift has the potential to substantially improve voter turnout during U.S. elections.

Purpose: To identify "headlines" that would engage recipients to consider plant protein over red meat. Design: Mail and web survey. Setting: Urban Minnesota community. Subjects 144 survey respondents from our health plan and community program distribution lists who live with at least 1 other person and eat meat. Intervention: We asked respondents how likely they would be to click on each of 24 headlines with a motivator (eating plant protein for health vs for environmental reasons) and a barrier (family preferences, knowledge about plant proteins, or cooking skills). 16 headlines contained the word "beans". Measures: We created categorical variables for each headline construct: (1) motivator, (2) barrier, and (3) reference to beans. Using a mixed model with random effects, we compared, for each construct, respondents' self-reported likelihood to click on a headline. Results: Health-related headlines performed significantly better than environmental headlines (P = .0019, 95% CI .01, .11). Family-oriented headlines performed slightly better than skills-oriented (P = .0927, 95% CI -.01, .11) and knowledge-oriented (P = .0960, 95% CI -.01, .11) headlines. Headlines containing the word "beans" performed significantly worse than those not containing "beans" (P < .0001, 95% CI -.22, -.12). Conclusions: The population represented by our survey respondents report being most likely to click on headlines that emphasize health and family. They report they are significantly less likely to click on headlines that promote beans.

BACKGROUND:Despite broad recognition of the physical inactivity pandemic, little to no progress has been made in the past decade in mitigating the problem. The current analysis builds upon previous research into the drivers of physical inactivity to assess the potential interactions with firearm violence in the United States. METHODS:We merged county-level data on firearm fatality rates, physical inactivity prevalence, the Social Vulnerability Index, and the American nations regional cultures schematic. RESULTS:Counties with a physical inactivity prevalence currently above the federal government's 2030 goal (ie, ≥21.8%) had a significantly higher firearm fatality rate per 100,000 population. This finding was consistent for both the overall rate and race-based subgroups. The overall White, Hispanic, and Black firearm fatality rates were also significantly higher in the American nations group comprising Greater Appalachia, Deep South, El Norte, New France, and First Nation. Stepwise linear regression analysis revealed that the Social Vulnerability Index, American nations dichotomous grouping, and firearm fatality rate were all retained (P < .001) in predicting physical inactivity prevalence as a continuous variable. CONCLUSION:In conclusion, the United States faces myriad health and societal challenges. Unhealthy lifestyles and gun violence are two of the leaders. The current analysis in conjunction with previous findings demonstrates that solving these challenges by interacting, create complexity to finding solutions that has not been thoroughly considered.

Introduction: This paper examined the recent evidence from economic evaluations of team-based care for controlling high blood pressure.Methods: The search covered studies published from January 2011 through January 2021 and was limited to those based in the U.S. and other high-income countries. This yielded 35 studies: 23 based in the U.S. and 12 based in other high-income countries. Analyses were conducted from May 2021 through February 2023. All monetary values reported are in 2020 U.S. dollars.Results: The median intervention cost per patient per year was $438 for U.S. studies and $299 for all studies. The median change in healthcare cost per patient per year after the intervention was -$140 for both U.S. studies and for all studies. The median net cost per patient per year was $439 for U.S. studies and $133 for all studies. The median cost per quality-adjusted life year gained was $12,897 for U.S. studies and $15,202 for all studies, which are below a conservative benchmark of $50,000 for cost-effectiveness. Discussion: Intervention cost and net cost were higher in the U.S. than in other high-income countries. Healthcare cost averted did not exceed intervention cost in most studies. The evidence shows that team-based care for blood pressure control is cost-effective, reaffirming the favorable cost-effectiveness conclusion reached in the 2015 systematic review.Am J Prev Med 2023;65(4):735-754. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

BackgroundThe COVID-19 pandemic affected health and well-being worldwide, but little is known about how the pandemic specifically impacted families with young children. Evidence suggests a relationship between well-being and health behaviors (diet, physical activity) and that preexisting health disparities were exacerbated during the pandemic.PurposeThis project sought caregiver perspectives on pandemic impacts, overall and by race, ethnicity, urbanicity, and household income.MethodsCaregivers of 4- to 11-year-olds were randomly selected to complete a mixed-mode survey in the winter of 2021-22 to evaluate ongoing community health education and programming. Qualitative content analysis of open-ended survey responses was conducted. Data were analyzed blind to demographic characteristics; later, differences by population were explored.ResultsSurvey analysis (n = 1,429, response rate 27%) identified positive and negative impacts of the pandemic on youth diet and physical activity. Caregivers, unprompted, provided responses about the interconnected impacts on mental and physical health and health behaviors. Pandemic stress was described, including reduced energy, social isolation, and "fear of spread." Significant differences by key characteristics were found.DiscussionThese findings reflect patterns that could underlie growing disparities.Translation to Health Education Practice: This work provides context for designing interventions that equitably promote healthy behaviors for young families.

BackgroundThough prenatal nutrition information is critical, it is not known whether information is shared equitably by patient race, financial security, or English proficiency.PurposeTo evaluate whether delivery or receipt of ChooseYourFish.org nutrition information in the first prenatal visit differed by patient demographics.MethodsAnalysis of clinician-document electronic health record (EHR) or patient-reported surveys compared delivery and receipt of fish-related nutrition information in the first prenatal visit. Inferential statistics were used to compare delivery or receipt and race, ethnicity, payor, or interpreter use.ResultsEHR analysis (n = 2,329) revealed Medicaid patients who used an interpreter were half as likely to have the fish nutrition message in their after-visit summary compared to those with Medicaid who did not use an interpreter (OR = 0.54, 95% CL: 0.35-0.84). The same was not true for non-Medicaid patients. Survey analysis (n = 52) showed respondents identifying as Black or African American were 25% less likely to report receiving the after-visit summary compared to respondents who identified as white (p < .01).DiscussionThe results presented here illustrate how nutrition communication in the prenatal period can differ by patient race, financial security, and language.Translation to Health Education Practice: Culturally humble efforts to understand drivers of healthcare communication are needed to eliminate inequalities.

BACKGROUND:This study estimates reductions in 10-year atherosclerotic cardiovascular disease (ASCVD) risk associated with EvidenceNOW, a multi-state initiative that sought to improve cardiovascular preventive care in the form of (A)spirin prescribing for high-risk patients, (B)lood pressure control for people with hypertension, (C)holesterol management, and (S)moking screening and cessation counseling (ABCS) among small primary care practices by providing supportive interventions such as practice facilitation. DESIGN:We conducted an analytic modeling study that combined (1) data from 1,278 EvidenceNOW practices collected 2015 to 2017; (2) patient-level information of individuals ages 40 to 79 years who participated in the 2015 to 2016 National Health and Nutrition Examination Survey (n = 1,295); and (3) 10-year ASCVD risk prediction equations. MEASURES:The primary outcome measure was 10-year ASCVD risk. RESULTS:EvidenceNOW practices cared for an estimated 4 million patients ages 40 to 79 who might benefit from ABCS interventions. The average 10-year ASCVD risk of these patients before intervention was 10.11%. Improvements in ABCS due to EvidenceNOW reduced their 10-year ASCVD risk to 10.03% (absolute risk reduction: -0.08, P ≤ .001). This risk reduction would prevent 3,169 ASCVD events over 10 years and avoid $150 million in 90-day direct medical costs. CONCLUSION:Small preventive care improvements and associated reductions in absolute ASCVD risk levels can lead to meaningful life-saving benefits at the population level.

Perinatal communication is one factor driving racial disparities in maternal and infant morbidity. The murder of George Floyd in May 2020, in addition to the disproportionate impacts of the Covid-19 pandemic on communities of color, was a catalyst for American society to address racial injustices with a renewed sense of urgency. Drawing upon sociotechnical systems (STS) theory, this rapid review describes changes in the literature regarding the organizational, social, technical, and external subsystems that affect communication between perinatal providers and their Black patients. The goal of this work is to support health system optimization of health communication initiatives and, as a result, improve patient experience and parent and child outcomes. As part of a multi-year project designed to improve health communications about safe fish consumption during pregnancy, and in response to racial disparities among our health system's patient population related to receipt of nutrition messages during prenatal visits, we conducted a rapid review of literature on Black parents' experience of all communication while receiving perinatal care. A search of PubMed identified relevant articles published in English since 2000. Articles were screened to include articles that focused on Black people receiving perinatal care. Article content was then coded using deductive content analysis guided by STS theory to inform healthcare system improvement efforts. Differences in the prevalence of codes pre- and post-2020 are compared using chi-square statistics. The search in PubMed yielded 2419 articles. After screening, 172 articles were included in the rapid review. There was an increased recognition of communication as a key component of quality perinatal care after 2020 (P = .012) and of the limitations of standardized technical communication (P = .002) after 2020. Emerging literature suggests improving perinatal health communication and relationships with Black parents would address disparities in perinatal patient and baby outcomes. Healthcare systems must address the racial disparities in maternal and child outcomes. Since 2020, public attention and published research on this issue has increased. Understanding perinatal communication using STS theory aligns subsystems in service of racial justice.