{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:43:43Z","timestamp":1777859023357,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This commentary examines the complex maternal health landscape in rural America, highlighting the structural barriers to effective chronic disease management. We provide recommendations to center chronic disease management using a life course approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Women in rural areas face significantly higher maternal mortality and morbidity rates than their urban counterparts, largely due to a disproportionate burden of chronic disease conditions such as gestational diabetes, preeclampsia, cardiomyopathy, and mental health disorders. These disparities are deeply rooted in the unequal distribution of systemic and structural determinants of health. We call for a system-level approach related to primary, secondary, and tertiary prevention efforts to improve maternal health in rural areas, based on the life course perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319251404285","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T03:52:41Z","timestamp":1765857161000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Chronic Disease Prevention in Rural America: A Life Course Perspective"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9288-5795","authenticated-orcid":false,"given":"Kobi V.","family":"Ajayi","sequence":"first","affiliation":[{"name":"Texas A&amp;M University, College Station, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emesomhi","family":"Eboreime","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alva","family":"Ferdinand","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9746-9514","authenticated-orcid":false,"given":"Ninfa","family":"Purcell","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7223-412X","authenticated-orcid":false,"given":"Robin","family":"Page","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2022.307134"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.70007"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000753"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305728"},{"key":"e_1_3_3_6_2","unstructured":"CDC. Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States 2020. Maternal Mortality Prevention. 2025. Accessed August 6 2025. https:\/\/www.cdc.gov\/maternal-mortality\/php\/data-research\/index.html"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-013-1284-z"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.0247"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-41186-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-025-01738-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12801"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101249"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12349"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-00716"},{"key":"e_1_3_3_15_2","doi-asserted-by":"crossref","unstructured":"Butler SM. How the health system overlooks young adults with chronic conditions. JAMA Health Forum. 2021;2:e211685. Accessed August 8 2025. https:\/\/jamanetwork.com\/journals\/jama-health-forum\/fullarticle\/2780868","DOI":"10.1001\/jamahealthforum.2021.1685"},{"key":"e_1_3_3_16_2","unstructured":"Office of Population Affairs. General Supports for Youth with Chronic Conditions & Disabilities and Their Families. 2025. Accessed November 2 2025. https:\/\/opa.hhs.gov\/adolescent-health\/physical-health-developing-adolescents\/introduction-chronic-conditions-disability\/general-supports"},{"key":"e_1_3_3_17_2","unstructured":"Bureau of Labor Statistics. Women in the labor force. Bureau of Labor Statistics. 2025. 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