According to the Centers for Disease and Prevention ( CDC ) US infant and maternal mortality failed to improve between 2000 to 2005. This plateau represents the first time since the 1950s that infant mortality has seen no improvement. The US spends more than any other country in the world on health care and yet is only 33rd in the world in infant mortality. A baby born in Cuba, Slovenia, the Czech Republic or South Korea has a greater chance of living for the first year than a baby born in the US. In fact, a baby born in Singapore has twice the survival rate of a US baby.
The infant mortality among non-Hispanic black women is 2.4 times what it is among non-Hispanic white women. One of the chief contributing factors to infant mortality is premature birth. In 2005, 36.5 percent of all infant deaths in the US were due to preterm-related causes; among the non-Hispanic black community nearly half (46%) of infant deaths were related to prematurity.
Global health care worker, Oya Kali, MPH, presented compelling research on the underlying causes of prematurity and infant mortality at the 7th International Black Midwives and Healers Conference. Her research at the University of California at Berkeley focused on the effect poverty has had on generations of African American families and how the trauma of generational poverty becomes biologically embedded in African American women.
To illustrate this embedding, Kali cited the concept of “weathering” as defined by Arline T. Geronimus, Sc.D, professor and senior researcher at the University of Michigan School of Pubic Health. The concept “weathering” suggests that the health of African Americans is subject to early deterioration as a consequence of social exclusion. In fact, as a race, African Americans suffer prematurely from poor health outcomes.
Kali talked of the cumulative health impact of socioeconomic disparity, cultural marginalization, and chronic psychological and biological stress. Since the 1990s we have had new tools to measure the high cortisol levels that indicate chronic stress. Many studies support the link between maternal stress and preterm labor. The baby’s hormones respond to the mother’s stress hormones and trigger early birth. According to Kali, fifty to 100 percent of women who birthed early describe themselves as being stressed.
Examples of the chronic stress caused by institutional racism were reported by both Kali and by Eleanor Hinton-Hoytt, president of the Black Women’s Health Imperative. Kali said, “My people accept the fact that the doctor does not want to touch you.” Hinton-Hoytt told of black women who reported that their white doctor would not touch them or look them in the eye.
Infant mortality for white college educated women is 4 in 1000; for black college educated women it is 12 in1000, worse than for white women who have not graduated high school.
Overall, 32 percent of mothers live in poverty; 40 percent for African American moms. Poverty affects where you live, your access to food, your social support and the health care available to you. It affects whether or not you feel safe walking down the street with your newborn baby. Social isolation further adds to the stress of poverty. Kali suggests that one solution is increasing social support to pregnant women and new moms; she calls this “sisters supporting sisters.”
When it comes to saving our babies, we are all sisters.