Infant Mortality

Health Disparities and Infant Mortality
Improvements in hygiene, nutrition, and living conditions resulted in a precipitous drop in infant deaths in the United States from 1915 through the 1990s. That national decline has slowed. The U.S. is now ranked 32nd out of the 35th wealthiest nations in infant mortality, largely driven by infant deaths among Blacks. Black infants die at a rate more than double that of White babies. The story of Serena Williams, the number one female tennis player in the world, and her brush with death after delivering a baby emphasizes that the crisis of maternal death and near-death among Black women cuts across socioeconomic lines as well. Low birth weight of the infant is often the cause of death.
Data from the Centers for Disease and Control and Prevention provide a visual representation of the differences between various racial groups, as shown in FIGURE 18-8
There has been a growing body of academic research that attributes the Black-White disparity in infant mortality to the concept that societal and systemic racism play a role. The medical establishment continues to purport that racism causes toxicological and physiological stress that results in hypertension, pre-eclampsia, and other adverse prenatal conditions. Institutional racism in the health care system may also contribute in terms of dismissal of legitimate concerns and symptoms, as well as lack of access to quality care and support. Weathering, or coping with toxic stress over a long period of time, has been theorized to lead to poor pregnancy outcomes since factors such as poverty, drinking, and smoking have been discounted as causes in reports published in the American Journal of Public Health. Experts in the field also deny genetics as a predisposing factor. “So, there was something about growing up black in the United States and then bearing a child that was associated with lower birth weight,” says Richard David, a neonatologist at the University of Illinois of Chicago (Chatterjee & Davis, 2017, para. 24).

Discussion Questions
1. Examine statistics on infant mortality from the U.S. Centers for Disease Control and compare them to other countries. Document your findings.
2. What are possible ways to address this disparity. Hint: One community in New Orleans provides doulas (a person who is trained to assist during childbirth and may provide help after the baby is born) to pregnant mothers for continuous support and has achieved positive results. Would it make sense for other communities to adopt this approach? Why? What other initiatives could be implemented by health care systems to address the adverse outcomes among Black mothers and babies.
3. Is there a way to address the underlying causes of this disparity? What should health care policymakers pursue and invest in to help prevent this disparity?

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RESOURCES

All LM, Ely DM, Ailes EC, et al. Infant Mortality Attributable to Birth Defects — the United States, 2003–2017. MMWR Morbidity and Mortality Weekly Report 2020;69:25–29. DOI: http://dx.doi.org/10.15585/mmwr.mm6902a1

Casimir, L. (2018, June 26). Why are so many of San Francisco’s black mothers and babies dying? The Guardian. Retrieved from https://www.theguardian.com/world/2018/jun/26/
black-maternal-mortality-babies-san-Francisco-crisis

Centers for Disease Control and Prevention. (2019, March). Reproductive Health: Infant Mortality. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

Chatterjee, R, and Davis, R. (2017, December 20). How racism may cause black mothers to suffer the death of their infants. National Public Radio. Retrieved from https://www.npr.org/sections/health-shots/2017/12/20/570777510/how-racism-may-cause-black-mothers-to-suffer-the-death-of-their-infants

Kamal, R., Hudman, J., and McDermott, D. (2019, October). Peterson-KFF Health System Tracker: What do we know about infant mortality in the U.S. and comparable countries? Retrieved from https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/#item-start

US Department of Health and Human Services Office of Minority Health. (2019, November). Infant Mortality and African Americans. Retrieved from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=23

Villarosa, L. (2018, April 15). Why are black mothers and babies in the United States dying at more than double the rate of white mothers and babies? The answer has everything to do with the lived experience of being a black woman in America. The New York Times Magazine, page 31. For more information on Infant Mortality check on this: https://en.wikipedia.org/wiki/Infant_mortality

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