Studies Plumb Depths of Black Maternal Health Woes
by Molly M. Ginty
"The health problems of black women and black
infants stem not just from inadequate medical care but from stress, racism,
poverty and other social pressures."
This
article originally appeared in Women's
News.
Black women
are twice as likely as white women to give birth prematurely and five times
more likely to do so in Southern states such as Mississippi. A black woman is
3.7 times more likely to die during pregnancy than a white woman and six times
more likely to do so in some urban areas such as New York City.
Researchers at the Atlanta-based Centers for Disease
Control and Prevention found college-educated black women twice as likely as other
women to deliver premature or underweight babies. Scientists found subjects'
birth outcomes resembled those of unemployed, uninsured white women with low
education levels.
"A black woman
is 3.7 times more likely to die during pregnancy than a white woman."
These are
among the findings of five landmark reports released by the Washington-based
Joint Center for Political and Economic Studies that draw together existing
data in a comprehensive
review that calls for an end to the inequities. The center concludes that African
American babies - who are twice as likely as white infants to die before their
first birthday - will have a better shot at life if the health inequities
plaguing black mothers, such as less prenatal care and adequate nutrition, are
corrected.
"The
health disparities affecting African American women are nothing less than
shocking, and we need to address the social causes behind them," says
Alexine Jackson, board president of the Black Women's Agenda.
Stress, Racism, Poverty Implicated
The
center's 19-member Courage to Love: Infant Mortality Commission - funded by the
W.K. Kellogg Foundation and partnering with the UCLA School of Public Affairs
and the University of Michigan's NIH Roadmap Disparities Center - says the
health problems of black women and black infants stem not just from inadequate
medical care but from stress, racism, poverty and other social pressures.
Released
during the Congressional Black Caucus Foundation Annual Legislative Conference
from Sept. 26 to 29, the reports also coincide with a meeting organized by the
Joint Center and the Washington-based Black Women's Agenda for 250
representatives of black women's organizations in Washington, D.C. Attendees
will discuss the reports and preview "Unnatural Causes: Is Inequality
Making Us Sick?" an upcoming PBS television series that explores race and
health.
In the five
reports - one on breastfeeding, one on nutrition, two on infant mortality and
one summarizing the others - commission members address the possible reasons
for black women's negative birth outcomes.
Only 75
percent of African American women have prenatal care compared to 89 percent of
white women.
Black women
are more likely than their peers to have hypertension and diabetes, which can
leave the fetus undernourished.
"Black women
are 50 percent less likely to breastfeed than white or Hispanic women."
Although
the American Academy of Pediatrics, in Elk Grove Village, Ill., says
breastfeeding protects against ear infections, diarrhea and other health
problems among infants - and though it recommends exclusive breastfeeding for
the first six months of life - black women are 50 percent less likely to
breastfeed than white or Hispanic women.
"Black
women's eating habits also play a role," notes commission member Dr.
Michael C. Lu, an associate professor of obstetrics and gynecology at the David
Geffen School of Medicine at UCLA. "Only 1 in 4 African American women
meets the recommended daily allowance for calcium, magnesium, zinc and vitamin
E and 1 in 3 does not meet the RDA for iron and folate. Among low-income women,
approximately 1 in 3 is anemic in the third trimester of pregnancy. And among
low-income African American women, only 40 percent enter pregnancy with normal
weight, and less than 30 percent achieve ideal weight gain during
pregnancy."
Economic, Social Factors
Joint
Center authors stress not only health factors, but economic and social
conditions.
Black women
are more likely to work part time and to go without health benefits. They are
20 percent more likely to be uninsured, and three times more likely to live
below the federal poverty line. Research shows black women are under more stress than their peers, and
that stress can compromise the immune system, disrupt the hormonal balance and
threaten vascular function.
"Black women
are under more stress than their peers."
The reports
also implicate racism.
For
instance, authors note recent studies at Chicago's Feinberg School of Medicine
at Northwestern University find African American women who deliver pre-term,
very low weight infants have a twofold greater lifelong exposure to racial
discrimination than African American women who deliver full-term, normal weight
babies. They cite a 2007 study from Atlanta's Spelman College in which black
women agree racism is a source of the stress they cite as their
"major" health risk.
"For
black women, the effects of racism, sexism and class are multiplicative rather
than additive," says Vijaya Hogan, director of the Health Disparities
Curriculum at the University of North Carolina at Chapel Hill, who was not
involved in the Joint Center reports. "Each increases the individual
effect of the other and together they add up to more than the sum of their
parts."
Contributions to Overall Crisis
Experts say
the same problems causing poor birth outcomes for black women are likely
contributing to an overall crisis in their health.
Black women
are twice as likely as white women to be overweight, have heart attacks,
develop diabetes or fail to get the recommended 30 minutes of exercise daily,
reports the CDC. They
account for 72 percent of new AIDS cases even though they represent just 6
percent of the population, reports the Los Angeles-based Black AIDS Institute. Their life expectancy is 69 years,
eight years less than for white women, reports the Census.
"Black
women account for 72 percent of new AIDS cases even though they
represent just 6 percent of the population."
Black-white
health disparities explain why 40,000 African American women die of treatable
causes each year, notes the office of the U.S. Surgeon General.
Authors of
the center's reports call for better health care access and education to
improve birth outcomes. They also call for sweeping social change such as
legislation that will work to end economic and educational disparities.
On Sept.
29, the Chicago-based advocacy group African American Women Evolving held its
own 100-member symposium on black women's health at Malcolm X College in
Chicago.
"We
need to pay attention to - and address - high infant mortality and other health
problems affecting black women," says Gina E. Wood, deputy director of the
Joint Center's Health Policy Institute. "This is broader than a medical
issue. It's about the total environment - and the total life - of African
American women."
Molly M. Ginty is a freelance writer based in
New York City.
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