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Study finds that health equity is a critical component when caring for children and pregnant women in the era of COVID-19

PITTSBURGH (January 31, 2023) — Since the onset of the pandemic, individuals worldwide have felt the effects of COVID-19. A study published this month, led by Dr. Whitney Perkins Witt, vice president of the social determinants of health at Highmark Health, provides new recommendations when caring for children and pregnant women facing a generation-defining disruption from the COVID-19 pandemic. In this paper, Dr. Witt and her co-authors Nicole Harlaar, PhD of Westat, and Ashley Palmer, MPP, PhD of NORC at the University of Chicago, show that the impact of the pandemic on children and pregnant women has exposed and exacerbated pervasive inequities in health and healthcare. The study was published online on January 16, 2023, in the American Journal of Health Promotion.

The multi-faceted impact of COVID-19 highlights the need to consider the pandemic from societal and life course perspectives. This model recognizes that one's health combines multiple influences at the individual, family, community, and societal levels with new pressures created by the pandemic at each level. In many cases, these pressures are driven by social determinants of health (SDoH) which differentially and disproportionately impact individuals from minority and marginalized communities. SDoH are the conditions in which people live, work, learn, and play that can impact up to 80 percent of an individual's health before the healthcare system can intervene.

At this stage of the pandemic, researchers continue uncovering new information and establishing best practices when caring for children and pregnant women, who have borne some of the highest indirect impacts of the pandemic.

"In particular, a holistic approach like Highmark Health's 'Living Health' strategy that integrates physical, behavioral, and social care is needed to mitigate the deleterious impact of COVID on pregnant women and children," says Dr. Witt.

Dr. Witt's research provides three critical categories for equitably caring for children and pregnant women during and beyond the pandemic to improve their health and well-being while eliminating preventable COVID-related health disparities.


  • Promote timely identification and treatment of mental health and substance abuse disorders, adverse childhood events, and SDoH
  • Improve measurement of whole-person care and include the SDoH
  • Expand the use of telehealth and promote health and digital literacy
  • Facilitate continuity of Medicaid coverage
  • Promote value-based payment approaches


  • Ensure providers can identify COVID-19-related trauma and are trained in trauma-informed care
  • Improve childcare access and quality measurement


  • Ensure community representation and equity in all aspects of research
  • Use rapid cycle and longitudinal study designs and innovative data sources
  • Link to innovative data
  • Use appropriate data analytics and tools
  • Invest in implementation science and research

In each priority area listed above, health equity is a central and critical component of all the recommendations found in this study.

"We have identified opportunities to improve health equity and to enhance the promotion of prenatal and child health and well-being during the pandemic and beyond. Importantly, whole-person healthcare and social welfare systems are uniquely positioned to help address adverse outcomes associated with COVID-19, reduce inequities, and foster lifelong health and well-being," said Dr. Witt.

A complete copy of the study is available in the American Journal of Health Promotion.

Citation: Witt WP, Harlaar N, Palmer A. The Impact of COVID-19 on Pregnant Women and Children: Recommendations for Health Promotion. American Journal of Health Promotion. 2023;37(2):282-288. doi:10.1177/08901171221140641e

Corresponding Author: Whitney Perkins Witt, PhD, MPH, Highmark Health, Pittsburgh, PA 15222, USA.

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Highmark Health, a Pittsburgh, PA-based enterprise that employs more than 37,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, and enGen. Highmark Inc. and its subsidiaries and affiliates provide health insurance to approximately 6.8 million members in Pennsylvania, West Virginia, Delaware and New York as well as dental insurance, and related health products through a national network of diversified businesses. Allegheny Health Network is an integrated delivery network comprised of 14 hospitals, more than 2,500 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. Founded in 2014 as HM Health Solutions (HMHS), enGen is a wholly owned subsidiary of Highmark Health whose dynamic ecosystem of smart automation, and technology supports and streamlines complex operations for health plans and their provider partners. Lumevity, a wholly owned subsidiary of Highmark Health, helps companies transform in ways that drive direct financial benefits while improving quality and increasing employee engagement. To learn more, visit

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