NEW JERSEY · COMMUNITY PRIORITIES

One statewide message.
Care that reaches
each community.

Start with Black maternal health equity. Connect pregnancy history to a real appointment, a responsible care team and follow-up through midlife.

Evidence reviewed October 26, 2026. Outreach locations and targets below are proposals. Named organizations are examples to approach, not confirmed partners.

THE STATEWIDE NEED · 2019–2023

Black women face
the largest disparity.

64.7Black, non-Hispanic women
23.8Hispanic women
8.5White, non-Hispanic women

Pregnancy-related deaths per 100,000 live births. The Black–white ratio was 7.6 to 1. These are statewide deaths during pregnancy or within one year; they are not postpartum-only or cardiac-only rates.

The NJ review identified discrimination or interpersonal/structural racism as contributing at least partly to 27.6% of pregnancy-related deaths. The response must improve how care listens, responds and follows through.

NJ Department of Health · January 2026 update ↗

The heart-health connection is especially relevant.

In a separate, older NJ review covering 2016–2021, 14 of 41 pregnancy-related deaths among Black, non-Hispanic women were attributed to cardiomyopathy (7) or other cardiovascular conditions (7). That combined count is calculated from Table 4; it is not a current annual rate.

NJMMRC report · Table 4, page 13 ↗

WHERE DEATH RATES WERE HIGHER

The detailed state report
compares three regions.

In the detailed 2019–2021 report, northern New Jersey had the highest pregnancy-related mortality ratio.

Pregnancy-related deaths, NJMMRC 2019–2021 · All racial/ethnic groups
RegionDeathsPer 100,000 live birthsCounties in the report’s grouping
North3524.4Bergen, Essex, Hudson, Morris, Passaic, Sussex, Union, Warren
South1118.9Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Salem
Central1515.6Hunterdon, Mercer, Middlesex, Monmouth, Ocean, Somerset

This is a pandemic-period regional comparison, not a current county or town ranking. It does not establish that every northern county has a high rate. County names describe health-consortium regions, not congressional boundaries. Small numbers and different periods limit comparisons.

NJMMRC report · Table 2, page 12 ↗

A SPECIFIC OUTREACH PROPOSAL

Begin where need and
local networks meet.

New Jersey’s 2023 Healthy Women, Healthy Families award identifies eight priority cities across three regional grantees. They give the campaign an existing delivery network; they do not constitute a current maternal-death ranking.

ESSEX + PASSAIC + UNION

Newark. Paterson.
Elizabeth. Plainfield.

Start with: paid Black parent advisers, community health workers, doulas and primary care teams. Offer an in-person or telephone route as well as the QR code.

Local route to explore: Partnership for Maternal & Child Health of Northern New Jersey; Perinatal Health Equity Initiative in East Orange for Black-led co-design.

First practical job: identify the clinician receiving each pregnancy history and confirm that the indicated appointment happened.

CAMDEN + ATLANTIC

Camden.
Atlantic City.

Start with: maternal/NICU discharge teams and community hosts, with a separate care plan for the mother and feeding support that respects her goals.

Local route to explore: The Cooperative and the community-designed NAACP Maternal Experience Survey approach.

First practical job: pair the handout with a named follow-up contact; ask families what prevented a return visit and help resolve it.

MERCER + MIDDLESEX

Trenton.
New Brunswick.

Start with: community health workers, safety-net primary care and obstetric services. Offer interpretation and translated materials in the languages participants actually use.

Local route to explore: Central Jersey Family Health Consortium and its local network.

First practical job: confirm postpartum appointments, indicated glucose testing and a primary care handoff.

ADDITIONAL ACCESS & MIDLIFE SITES

Bergen. Sussex. Warren.
Cumberland. Salem.

Start with: a small access assessment through existing regional networks. Ask about travel, work hours, childcare, insurance, language and reliable phone access.

Why include them: test whether the campaign works beyond the priority cities and reaches women whose pregnancies were years ago.

First practical job: bring pregnancy and menopause history into routine primary care. These are proposed expansion locations, not counties shown here to have the highest death rates.

Sources: NJ HWHF award, named cities and regional coverage · Perinatal Health Equity Initiative, East Orange · NAACP Maternal Experience Survey, Atlantic/Essex/Camden implementation.

Another reason to prioritize NICU outreach in Passaic, Camden and Essex

The 2025 March of Dimes report card shows 2024 preterm-birth rates of 12.2% in Passaic, 10.9% in Camden and 10.2% in Essex, compared with 9.4% statewide. These are preterm-birth rates, not maternal mortality rates. They support testing a maternal-care message around neonatal care; they do not measure the campaign’s potential to prevent deaths.

March of Dimes · County birth outcomes

Why we are not calling these counties “maternity care deserts”

March of Dimes’ August 2026 classification lists no NJ counties as maternity care deserts or low/moderate-access counties. That county-level classification cannot establish that every patient has timely, affordable care. The pilot should measure actual travel, appointment and coverage barriers.

2026 NJ access classification and definition

DESIGN WITH COMMUNITIES

Make the response
as specific as the need.

Black women & families

Pay community advisers for their time. Let Black-led organizations shape the wording, imagery, distribution and feedback process. Build a clear escalation route when a concern is dismissed. Use the disparity to improve the care system; do not turn race into a biological risk multiplier.

Spanish-speaking and other language communities

Use trained interpreters, professionally reviewed translations and teach-back. Ask each participant’s preferred language. Spanish drafts are prepared for review; language preference should never be inferred from ethnicity.

Women facing practical barriers

Offer paper and telephone options, flexible visits and help checking transportation and plan benefits. When home BP monitoring is indicated, confirm access to the device and the clinical team reviewing readings.

Women in midlife

Use primary care, gynecology, pharmacies and workplace/community education to ask about old pregnancy complications, menopause timing and current risk factors. Participation should not depend on remembering a diagnosis or having an online account.

These are proposed service-design choices to test with local participants. Outreach remains available to women from every community and to people whose histories fall outside these examples.

ADOPT WHAT HAS A CLEAR JOB

National visibility.
Local delivery. Measured care.

ExampleWhat it contributesHow to improve this campaign
California quality collaborativeA 99-hospital study found severe morbidity among patients with hemorrhage fell from 22.1% to 18.5%; the absolute reduction was larger among Black patients. This was quality improvement, not an education-campaign trial. StudyPair the message with a standard care process and report results by race. Do not attribute hemorrhage outcomes to a heart-history handout.
NJ MOPP, Pennsylvania UPMC, UK POP-HTPublished postpartum BP programs provide evidence about ED use, readmissions or later BP, with different study designs. They do not prove mortality reduction. Study details and limitationsA cuff must connect to a staffed clinical response and appropriate treatment. Fund the follow-up workflow.
Australia Heart FoundationEducation connects reproductive history and menopause to heart health. Women’s risk factorsKeep one recognizable visual identity across postpartum, years later and midlife materials.
Breast-cancer campaigns / CDC Hear HerMemorable visual messages, practical action prompts and formats that community hosts can distribute. Visual examples reviewedUse one repeated call to action: know your history, share it, leave with a plan. Link to established urgent maternal warning signs.

PREGNANCY + MIDLIFE + HEART HISTORY

Include the history.
Use the right risk assessment.

Yes: include a pregnancy-to-midlife pathway. Keep the clinical history visible even when a calculator does not contain those inputs.

1 / Prepare the history

Heart Story organizes pregnancy complications, current information and questions for the visit. Include personal/family heart history and menopause timing. The current public tool is a visit organizer, not a validated risk calculator.

2 / Assess risk appropriately

For eligible adults, a clinician can use an unchanged validated model such as PREVENT and interpret pregnancy/reproductive history alongside it. The 2026 AHA clinician summary specifically calls for asking about adverse pregnancy outcomes, early menopause before 45 and PCOS. A low long-term score does not assess the safety of current postpartum symptoms.

3 / Agree on the next step

Record what needs review, who owns the follow-up and when it is due. Depending on the person, this may involve blood pressure, lipids, glucose, medication review or referral. A checklist alone does not determine tests or treatment.

For the proposed calculator: do not add an unvalidated pregnancy multiplier, hormone multiplier or extra “heart-age years” to PREVENT. QR4 includes some pregnancy-related predictors, but UK validation does not establish accuracy for US postpartum patients or comprehensive midlife assessment. Test a new model separately with an academic team before using it for individual care.

Sources: 2026 AHA women’s health clinician summary · AHA PREVENT · QR4 development and validation.

A CONCRETE FIRST ASK

Back a 12-month
New Jersey demonstration.

Propose six participating hosts across North, Central and South Jersey, pairing clinical care with community outreach. Begin with paid community design and clinical review; confirm sites, budget and data governance before enrollment.

90%

Proposed target: participating patients have relevant pregnancy history recorded.

90%

Proposed target: an indicated next step has a named clinician and due date.

80%

Proposed target: due follow-up actions are confirmed completed within the treating team’s recommended time.

Planning targets, not achieved results or clinical standards. Establish denominators and baseline performance in the first three months; revise targets with participating sites. Report completion and gaps by race, language, insurance, age and geography, with small-cell privacy protection. Assess whether disparities narrow. Evaluate severe morbidity/readmissions with an appropriate comparison; mortality needs a larger, longer study.

The national case: turn a clear message into a repeatable, evaluated route from pregnancy history to ongoing care.