By Kimberly Seals Allers
Friday, September 18, 2009
During Infant Mortality Awareness Month, Kimberly Seals Allers would like to spur a public conversation about racial health disparities and reducing the pressures on black motherhood.
(WOMENSENEWS)--If African American, Latino and Native American babies are too often in jeopardy, that means that this country is miserably failing women of color, and black women in particular, in the process of birthing healthy babies.
That's the message that we should be sending this September, during Infant Mortality Awareness Month.
"In countries where mothers do well, children do well," Charles MacCormack, president and CEO of Save the Children, said in 2006, upon issuing the group's most recent report on infant mortality around the globe.
It ranked the United States near the bottom of industrialized nations, tied with Hungary, Malta, Poland and Slovakia, with an infant mortality rate of 5 deaths per 1,000 live births.
Included in that report (and subsequent others by various organizations) were even more distressing statistics about African American babies.
African Americans have 2.3 times the infant mortality rate as non-Hispanic whites, according to the Atlanta-based Centers for Disease Control, or the CDC. In 2000, the United States had a national average of 6.9 deaths per 1,000 live births, but the rate among blacks was 14.1 deaths. Compared to non-Hispanic white infants, black babies are four times as likely to die as infants due to complications related to low birth weight, the CDC also said.
This month, and every one after, we have to ask what is going on with black women and teens.
What factors may affect our general health or the care we receive during pregnancy such that our pregnancies and babies are so adversely impacted?
As black women we have to look at our nutrition and our lifestyles to see where we can do our personal best to bring healthy babies into the world.
However, black women alone cannot improve our own and our infants' survival rates -- there are larger forces at play. Researchers say lifelong conditions of high stress and low support may contribute to poor nutrition and physical responses that put fetuses at risk.
Systemic forces are rooted in how black women process the stress of gendered racism and the "carrying role" they have historically played as central figures in their communities.
And while we're at it, let's also ask the broader question of why racial disparities regarding health continue to exist in this country.
Mortality rates for African American women are higher than any other racial-ethnic group for nearly every major cause of death, including heart disease and breast cancer, according to recent government data.
Nearly every major cause of death? How can this be?
The truth is that whatever health measure or disease you look at, black Americans, both male and female, tend to have higher disease incidences and higher death rates.
How can we explain that? It's a sobering question for those of us who believe that racism doesn't exist anymore, or that talking about race is what creates the issue.
And when it comes to babies who never make it to their first birthday at an alarmingly disproportionate rate, I'd hope that all women agree that the cause is worth, perhaps, an uncomfortable conversation.
Saving babies is worth taking an honest look at viewpoints and unintentional biases, and asking our medical researchers, doctors, politicians, journalists and educators to do the same. Broadening our ideas of what affects health is an important start.
That's why I love the work of Dr. Camara Jones, the research director on social determinants of health and equity at the National Center for Chronic Disease Prevention and Health Promotion. The center is a division of the CDC.
Jones, who spoke at our last Women's eNews conference on African American Maternal Health and left jaws dropped at the depth of her findings, frequently argues for rethinking our understanding of what determines good health.
"In this country, we have for a long time thought of our individual behaviors as the main determinants of health," said Jones in a recent speech at the University of Georgia. But encouraging individuals to adopt healthier habits is not the key to ending health disparities.
"People's choices are either constrained or facilitated by what we now call social determinants of health," she said. These social determinants can include everything from education and income to housing, transportation and public safety.
"If we are interested in eliminating racial disparities in health," said Jones, "we need to examine the fundamental causes of those racial disparities." That includes an awareness of the systems that make race an important distinction and acknowledging the existence of racism in practices and organizations.
Racism is not some vague thought or practice, it operates through identifiable and addressable mechanisms, says Jones.
One example I've found in my readings: a woeful lack of research on the racial and ethnic differences affecting certain diseases and their treatment. Could this be why we are needlessly dying more often? Or why nobody seems to be addressing why?
Beyond the problem of diseases, there's also what isn't known about black maternal health. In the course of interviewing obstetrics-gynecologists I have found many who aren't aware that their black patients are at a greater risk during pregnancy, regardless of their socioeconomic status.
When we can lift the veil off the truth of our experiences as women and mothers, even when it involves uncomfortable conversations and uncomfortable realizations about our own belief systems and institutional processes, only then we can really move forward.
As a country we have to figure out how to address this problem.
As a black woman, who can't afford to wait for the government or medical community to figure out how to save our babies, I have to search for answers and solutions and ask black women all over the world to do the same.
And as mothers and women of all races, whose lives are all interconnected, we have to figure out how. It's the least we can do. Newborn lives are at stake.
Kimberly Seals Allers is the editorial director of the Black Maternal Health series of Women's eNews and founder of www.mochamanual.com, an online magazine for African American moms. An award-winning business journalist, she previously served as a writer at Fortune and a senior editor at Essence and is the author of The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins) and two other Mocha Manual books.