January is Cervical Cancer Awareness Month, however with all the news surrounding poor maternal health among black women and how black women are 243% more likely to die during childbirth and post childbirth than white women, I found it appropriate to focus this month’s inaugural POC Health Matters ICYMI on black maternal health. After learning about the death of Shalon Irving, a Centers for Disease Control and Prevention employee’s death after giving birth to her daughter, my initial thoughts were that we just can’t seem to catch a break and how the American system seems so well designed to fail us in every aspect of our lives. Though appalled and quite frankly disgusted, the ingenious design of this “peculiar system” to continuously fail communities of color is the very reason why I chose a career in public health, what gave life to POC Health Matters, and what motivates me each and every day toward the improved health and well-being of our people and communities.
In recent years, as high rates of maternal mortality in the U.S. have alarmed researchers, one statistic has been especially concerning. According to the CDC, black mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health. Put another way, a black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition.
That imbalance has persisted for decades, and in some places, it continues to grow. In New York City, for example, black mothers are 12 times more likely to die than white mothers, according to the most recent data; in 2001-2005, their risk of death was seven times higher. Researchers say that widening gap reflects a dramatic improvement for white women but not for blacks.
The disproportionate toll on African-Americans is the main reason the U.S. maternal mortality rate is so much higher than that of other affluent countries. Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan, the World Health Organization estimates.
Weathering & How Racism is Killing Us Inside Podcast
When Arline Geronimus was a student at Princeton University in the late 1970s, she worked a part-time job at a school for pregnant teenagers in Trenton, N.J. She quickly noticed that the teenagers at that part-time job were suffering from chronic health conditions that her whiter, better-off Princeton classmates rarely experienced. Geronimus began to wonder: how much of the health problems that the young mothers in Trenton experienced were caused by the stresses of their environment?
It was later, during her graduate studies, that Geronimus came up with the term weathering — a metaphor, she thought, for what she saw happening to their bodies. She meant for weathering to evoke a sense of erosion by constant stress. But also, importantly, the ways that marginalized people and their communities coped with the drumbeat of big and small stressors that marked their lives.
At first, lots of folks in academic circles rolled their eyes at her coinage, arguing on panels and in newspapers that poor, black communities had worse health outcomes than better-off white communities because of unhealthy life choices, and immutable genetic differences. But as the science around genetics and stress physiology became better understood, Geronimus’ “weathering” hypothesis started picking up steam in wider circles.Read the entire NPR article here .
“Weathering” and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States
After listening to the Code Switch podcast , I became curious and wanted to learn more about Arline Geronimus’ weathering effect hypothesis. Geronimus et al. (2006), weathering hypothesis is essentially the premise that we (Black/African Americans) experience earlier health deteriorations that are usually seen in old age as a result of social or economic adversity and political marginalization. According to the study, living in a race conscious society negatively impacts our health down to the very cellular chemistry of our bodies, shortening the telomeres at the end of our chromosomes. Geronimus et al. (2006) considered poverty, race, and gender relative to poor health at earlier ages and found that we are consistently more likely to experience cumulative wear and tear on our bodies as a result of dealing with the acute and chronic stress of being Black in America. The study also found that black women have a higher probability of earlier health deteriorations compared to black men and white women and regardless of income levels we still fare worse than white men and women. Geronimus et al. (2006) article reminds me of another article that I read last semester for my Health Disparities and Social Determinants of Health course (shout out to Dr. Alicia Best for a well taught class and really good reading assignments) on aging and cumulative inequality. Ferraro & Shippee (2009) cumulative inequality theory states that structural social systems generate inequality in our demographic and developmental processes.
Both of these referenced articles demonstrate that living in a race conscious society negatively impacts our health and just like the game of Jenga, we can only stand strong for so long. Though we strive to thrive in a society that would much rather see us wither and we continue prove to be resilient within this “peculiar system”; according to these articles we cannot overcome the physical effects of racism and discrimination, hence the high infant mortality rates, low-weight babies, and maternal death among black women.
Though the information in this post seems a bit doom and gloom, we should never lose hope in addressing such issues and improving the health of our communities. One such organization that I believe deserves some shine is the Black Mama’s Matter Alliance out of Atlanta, Georgia (I see you ATLiens). A non-profit organization, the mission of BMMA is to advance the human right to safe and respectful maternal health care. I highly encourage you to visit their website if this is a cause that you’re passionate about. There you will find a listing of their values which include: fighting for and demanding racial and reproductive justice, recognizing intersectional oppression, and demanding government accountability and policy change. On their website they also provide a toolkit with talking points and state policy frameworks for the right to safe and respectful maternal health care for advocates.