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Tuesday
Sep282010

Racism and Low Birth Weight 101

By Jill Arnold

September is National Infant Mortality Awareness Month. As the month comes to a close, we will feature a few interviews on the topic with a commitment to not isolating such an important issue to merely one calendar month.

In recent years, both traditional journalism and social media have illuminated the United States’ shockingly low infant mortality rank. The United States Department of Health and Human Services published these facts last month.

United States ranked 28th in the world in infant mortality, in 2006.

In the United States in 2006, 28,509 infants died before reaching their first birthday, an infant mortality rate of 6.7 per 1,000 live births.

African American infants are more than two times more likely to die during the first year of life than white infants.

Infant mortality rate by race per thousand live birth
o Asian – 4.3 
o Blacks – 13.1 
o Native American – 8.3
o White – 5.7 
o Total – 6.7

The United States infant mortality rate was more than 3 times as high as the infant mortality rate in Hong Kong (1.8 per 1,000 live births), the country with the lowest reported rate in 2006.

It is almost incomprehensible that African American babies are dying at this rate. How is that even possible in this day and age, we all ask.

For decades, OB-GYNs, midwives, epidemiologists and other health experts have focused on the prenatal period to improve the health of pregnant women and babies. While this remains a crucial window for education and personal responsibility, it has proven to be just one piece of the puzzle.

I’ve assembled a slide show of sorts for you to click through at your own pace that will, I hope, inspire you to start doing your own reading and research on the topic. Please consider this an oversimplified Racism and Low Birth Weight 101.

 

 

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Reader Comments (59)

This data is sobering and infuriating no many how many times I look at it. But you've also made it accessible (while at the same time giving people a place to deepen their understanding), and that, my friend, is quite the feat.

Hot. Damn.

You rock, Jill.

September 28, 2010 | Unregistered CommenterKristen

I really think it is definitely reaching to claim that babies of one race die at a faster rate than babies of another rate, solely because the women were at some point exposed to racism. I am not buying it. It really comes off as flashing the race card. You have a lot great on your site. This is the first time I have seen something so far off and out there. I hope you consider removing it. You never even listed reasons for these babies to die. Did they die in that first year due to child abuse? Improper care? Murder? Domestic abuse? Malnutrition? In all my years of working with women whose children died, and from my own experience of my own dying, I have never ever seen race as an issue. People of certain races may have higher incidents of abuse or crime, which may contribute to the deaths, but simple racism does not explain away this. If you factor in things such as car seat use, formula vs breastfeeding, age of parent, baby sleeping on front or back, alcohol or drug use in the home, families (single parents vs married, dad or grandparents in the picture), education of the parents, etc etc etc, then you will find a better explanation behind the infant deaths. It is not just as simple as the race card.

September 28, 2010 | Unregistered CommenterLisa

Thank you so much for such a wonderful slide show. It addresses all of the popularly professed confounders that racism apologists wish were the real culprits. I got into it with some commenters on Alas, A Blog explained and linked to here a year ago when they tried to trot out the "it's class!" "it's SES!" excuses. It's too bad that people struggle so hard to deny the real, documentable effects of racism.

September 28, 2010 | Unregistered CommenterMomTFH

Lisa, it sounds like you need to do some reading! Check out the links and read those studies and articles so you can see what they controlled for.

"In all my years of working with women whose children died, and from my own experience of my own dying, I have never ever seen race as an issue."

I think that says it all. You just don't see it. Or you don't want to.

September 28, 2010 | Registered CommenterJill

@Lisa, did you see the slide show and read the research it refers to? It actually answers what you say pretty clearly. Did you see the study where they adjusted for forty factors, including education level, etc, and there was still a huge disparity? We are not talking about your own opinion or your own anecdotal experience. There is a significant amount of good research on racial disparity in health outcomes, and it is really sad to see people denying it exists.

And, really? Race card? That is such an offensive term.

September 28, 2010 | Unregistered CommenterMomTFH

Lisa, you should really delve into the study itself, and the Alas A Blog discussion MomTFH linked.

Obviously, time will tell if the results can be reproduced, or if the stats will change.

But try to address the study on its merits, not on your own experience--if you read you will see they controlled for issues like malnutrition, class, and income.

This is not about how *you* treat people of other races, but the experiences of those people themselves, over a lifetime.

September 28, 2010 | Unregistered Commenteremjaybee

I think we're seeing comments like this because we tend to believe most people are like us. Therefore, if we aren't racist, most people probably aren't racist. That's the logic I see here. I don't know that these death rates are necessarily due to racism. I think we need to hear more before we come to that conclusion, though unfortunately it isn't one we can entirely throw out. It's fascinating that so many controls were done, and we still don't understand why this is happening. I truly hope that it turns out to be something a little more controllable than the nebulous "racism."

September 28, 2010 | Unregistered CommenterHeather

Most fascinating talk I ever attended at a conference was a research doctor presenting slide after slide after slide illustrating this issue. Like Lisa, I sat there thinking "Yeah, but what about....?" and the next slide would counter that. I found it particularly compelling that the effect only applies to babies of women who were themselves gestated in the USA. Women gestated and born in Africa who moved to the US at an early age did not have such a profound increase in risk of poor outcome. I also found it compelling that even affluent African American professors had a higher risk of poor outcome than their white colleagues.

At the time, the only remaining rational explanation was racism.

Since then, I have come up with one more "Yeah, but what about...?" that I don't recall being addressed at the conference, and I'm too lazy to go dig through the links to answer myself....what about Vitamin D? People with dark skins living a US lifestyle are more susceptible to vitamin D deficiency. There seems to be growing evidence that vitamin D levels can influence pregnancy outcomes. Could being gestated in a vitamin-D poor uterus produce lifelong impacts on that baby?

September 28, 2010 | Unregistered CommenterLiz Chalmers

Well, Liz, as far as know, about 70% of the US population is vitamin D deficient, not just African Americans. So, why is it an issue in particular for African Americans? And why doesn't it apply to African born blacks in cities who live a modern lifestyle?

I would also ask why people, not Lisa in particular but in general, are so eager to find another explanation? Racism is very well documented in some of these studies and in studies on other negative health outcomes. It is a understandable stressor. It is prevalent in our society. I think that the concerted efforts to apologize for or deny the effects of racism by searching around for more palatable explanations are partially responsible for entrenching it further.

September 28, 2010 | Unregistered CommenterMomTFH

@Liz Chalmers and others - health disparities along these lines occur in more areas than just maternal and child health. I've read some articles that I believe addressed cardiovascular health and blood pressure where they were able to correlate experienced racism with worse health. I'm at work now, but will check my facts when I get home and report back in!

September 28, 2010 | Unregistered CommenterJMT
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