Maternal Health and Combating Racism
Spring Newsletter
To anyone paying attention to the maternal child health space over the last two decades (or more), the extent and impacts of structural racism in America on maternal health outcomes are clear, staggering, and uncontroversial. For us, the crisis of racial inequality has been raging for too long.
Back in 2007, six months out of college and a few weeks into my first public health job, I attended the MCH Epidemiology Conference (now hosted by CityMatch). During the keynote talk, three state epidemiologists presented in the dry, straightforward language of data how higher rates of maternal and infant mortality as well as low birthweight among Black women and infants persisted even when controlling for confounding influences like education and income.
While I was seeing this data for the first time, I was struck by the feeling that for other people in the room, preeminent experts, city and state health workers, government officials, and activists, this was not new information.
It was racism, not race, that shaped differences in these health outcomes.
Ten years before that, in 1997, Dr. James Collins in Chicago, published research that compared birthweights of US infants delivered among African born women, White American born women, and Black American born women. His analysis showed that the incidence of low birthweight was significantly higher among Black American born women than African born and White American born women. Through this study and his subsequent research, he concluded that the compounded daily stress of being Black in America made women and their newborns sick. That it was racism, not race, that shaped differences in these health outcomes.
That study was published 23 years ago.
In many ways racial disparities in all parts of the US health system have worsened since then, including in maternal child health. The pandemic has further highlighted the health impacts of racism as Black people die as a result of the novel coronavirus at two and a half times the rate of White people.
To my Black colleagues on the front lines, I promise to elevate your experience and expertise, follow your lead, not be afraid to ask hard questions, and not let another 23 years pass without change.
These health disparities are another manifestation of the brutality Black people experience as a result of systems built on racism. Racist histories, assumptions, and access have created these disparate outcomes. Let’s recognize and accept this fact, so we can begin the hard task of rebuilding our systems.
This work often feels impossibly huge and outside our grasp as individuals. But the coronavirus pandemic has taught us that in a crisis we can make big systematic change happen quickly, even lightyears faster, than we thought. Telemedicine, for example, increased by over 4000% in some health systems in a single month. We restructured our PPE and ventilator supply chains in a few short weeks.
This crisis has been raging for decades and has reached a boiling point, as we have seen over the last few weeks with the deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery. So, let’s use the tools at our disposal as public health professionals, care providers, administrators and innovators, to transform and rebuild our system.
I’m ready to roll up my sleeves and do the hard, uncomfortable work of rooting out my own bias and to challenge our health care leaders to do the same.
I’m ready to roll up my sleeves and do the hard, uncomfortable work of rooting out my own bias and to challenge our health care leaders to do the same within themselves and the hospitals, clinics, and health plans they oversee. I’m ready to listen to the women who have lived these disparities, like at Black Mamas Matter Alliance or National Birth Equity Collaborative, and follow their lead. I’m ready to take the grief and rage I feel today and channel it into a commitment to our Black communities.
Finally, to my Black colleagues on the front lines, I promise to elevate your experience and expertise, follow your lead, not be afraid to ask hard questions, and not let another 23 years pass without change.
In solidarity,
Brynn