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Geographic Access to Primary Care and Racial and Ethnic Disparities in the Prevalence of Maternal Chronic Conditions 2020–2024
ORIGINAL RESEARCH — Volume 23 — October 15, 2026
PEER REVIEWED
Six maps of the contiguous US show empirical Bayes smoothed distribution of mean county-level prevalence of prepregnancy obesity, chronic hypertension, and diabetes among non-Hispanic White and non-Hispanic Black women having a live birth. Overall, the prevalence of all chronic conditions was higher among Black women who had a live birth than among White women who had a live birth. The prevalence of all chronic conditions was higher in the southern and southwestern regions, regardless of race.
Figure 1. Empirical Bayes smoothed distribution of mean county-level prevalence of prepregnancy obesity, chronic hypertension, and diabetes among non-Hispanic White and non-Hispanic Black women having a live birth, National Center for Health Statistics Restricted-Use Natality Files, US, 2020–2024. Maps show 1,374 counties in the contiguous US with >50 births. A) Prepregnancy obesity among non-Hispanic White women having a live birth. B) Prepregnancy obesity among non-Hispanic Black women having a live birth. C) Chronic hypertension among non-Hispanic White women having a live birth. D) Chronic hypertension among non-Hispanic Black women having a live birth. E) Diabetes among non-Hispanic White women having a live birth. F) Diabetes among non-Hispanic Black women having a live birth.
Four maps of the contiguous US show the distribution of primary care health provider shortage areas, density of primary care providers, and live births to non-Hispanic White and non-Hispanic Black women. Primary care HPSAs were more concentrated in the southern and midwestern regions, with lower provider density showing similar patterns.
Figure 2. Distribution of primary care health provider shortage areas, density of primary care providers, and live births to non-Hispanic White and non-Hispanic Black women, National Center for Health Statistics Restricted-Use Natality Files, US, 2020–2024. A) Primary care HPSAs. B) Density of primary care providers per 100,000 persons (quartiles). C) Percentage of live births to non-Hispanic White women (tertiles). D) Percentage of live births to non-Hispanic Black women (tertiles). Abbreviation: HPSA, health provider shortage area.
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