Municipality-Level Variation in Severe Maternal Morbidity and Association With Municipal Expenditures in New Jersey

Key Points Question Are expenditures at the municipal level associated with severe maternal morbidity (SMM), a major determinant of maternal mortality? Findings This cross-sectional study including 1 001 410 births from 2008 to 2018 used birth files linked to maternal hospital discharge files from New Jersey and found that municipal expenditures on fire and ambulance, transportation, health, housing, and libraries were negatively associated with SMM, whereas expenditures on police were positively associated with SMM. Meaning These findings suggest that budget allocation decisions made by municipalities may have consequences for SMM rates and potentially maternal mortality.