This post is part of “Inequities in Maternal Mortality in the U.S.,” a blog series hosted by the MHTF.
We’ve heard it all before. Health disparities continue to affect people of color at disproportionate rates, and disparities in deaths related to pregnancy and childbirth are no exception. The leading causes of maternal mortality among Black women include preventable chronic conditions such as hypertension, heart disease, diabetes and obesity, as well as conditions such as depression and inadequate nutrition. In the United States, African-American women are nearly four times more likely to die from pregnancy-related complications than white women: Half of these deaths could be prevented if women had access to quality health care before, during and after pregnancy. Well-meaning people ask me every day, “What aren’t they doing? What is it about Black women?”
What do we know?
- Women of color are nearly three times more likely to live in poverty.
- Fifty-five percent of non-elderly people who don’t have health insurance are people of color.
- Low-income women, no matter their race or ethnicity, have much less employment and childcare flexibility, and are often not able to make regular preventive care or prenatal appointments.
- Women of color, particularly Black women, report significant racial discrimination and provider bias.
Based on the 2013 National Healthcare Disparities Report, the report “Reproductive Injustice” reveals African-Americans and Latinos received worse care than whites for 40 percent of health quality measures. In addition, Black women experience chronically higher cortisol levels, a response to stress, than white women, which trigger disease-producing inflammatory responses. Black women face higher stress in their lives due to systemic racism, poverty and hardship.
We also know this: It’s not the women – it’s not genetics or biology.
The lived experiences of Black women and the impact these stressors have on their mental, physical and emotional well-being before, during and after pregnancy are creating the deep disparities in pregnancy-related deaths and morbidities.
But it doesn’t have to be that way. We know how to improve the health of Black women and save the lives of mothers.
If we are going to turn the tide and save lives, we must find new ways of working together. Leaders from multiple sectors, including health care delivery, education, business, community and philanthropic, must come together to share, collect and analyze how best to address the social, economic and political barriers that impact maternal health. In order to do things differently, we need workplace policies that allow women the flexibility to get the care they need. For example, employers must allow time away for prenatal visits without penalty and create safer work conditions for expectant women. We need community health access points to reduce travel time for well-woman and prenatal care. We need care coordination between nurses, caseworkers, obstetricians and specialists to prevent pregnancy complications and to ensure quality care when they do exist. And we need to include the lived experiences of Black women and low-income women into clinical research to further understand how bias and discrimination impact maternal mortality.
To this end, the Black Women’s Health Imperative, in collaboration with the researchers of the Black Women’s Health Study, will release IndexUS: the Black Women’s Health Index in 2016. This will be the first ever index of Black women’s health based on healthy Black women. The Index will be used to elevate the discussion of Black women’s health and wellness in the U.S., to frame our understanding of their health as it relates to social, economic and political barriers and to chart the course for how best to invest in communities to improve their health. We will take what we learn from healthy Black women and apply it to all women.
Every woman should go into her pregnancy as healthy as possible so she and her baby can thrive during and after pregnancy. Healthy mothers tend to have healthy babies.
That I know.