4:08
- wellness
- May 5, 2021
Why Black infants are more at risk of death
Dr. Sharon Ingram's son A.J. died of SIDS at 4 months old.
4:08
The top five causes of infant mortality in the U.S. are birth defects, preterm birth and low birth weight, maternal pregnancy complications, sudden infant death syndrome and injuries, according to the CDC.
At least two of those causes -- preterm birth and low birth weight and maternal pregnancy complications -- often start with the type of care the mother receives during pregnancy, according to Rachel R. Hardeman, Ph.D., an associate professor at the University of Minnesota School of Public Health and founding director of the Center for Antiracism Research for Health Equity.
\"What we know is that the stress and the cumulative disadvantage of racism throughout the life course brings Black women into pregnancy at less than optimal health,\" she told \"GMA.\" \"It’s literally sort of the wear and tear on the body, a chronic stress that’s taking a toll on the body and prompting these biological changes in many women that then affect their health and the health of their babies.\"
Hardeman continued, \"And not only that, but then they come into a health care system that historically has not provided equitable care to Black people.\"
The issue of disparities in health care for Black women and Black babies was front and center at the highest level of government this week when the White House issued its first-ever presidential proclamation marking Black Maternal Health Week.
\"Over the years, I've heard many stories,\" said Vice President Kamala Harris, who hosted a round table on the issue Tuesday. \"Stories of women who are experiencing postpartum depression, only to be dismissed. Stories of women telling their doctors they were experiencing pain, only to be ignored. Stories of women who could not hold their newborn baby because that child had to be on life support or receive a blood transfusion after blood transfusion after blood transfusion.\"
\"Black women deserve to be heard. Their voices deserve to be respected, and like all people, they must be treated with dignity,\" said Harris, who described what Black women face as a \"maternal health crisis.\"
In her remarks at the round table, Harris cited the primary reasons for the maternal health crisis as \"systemic racial inequities and implicit bias.\"
Today during Black Maternal Health Week, the Biden-Harris Administration announced a series of initial actions to address the maternal health crisis in the U.S. We’re committed to ensuring quality, equitable health care is a right — not a privilege. https://t.co/mEsVShBbXv
— The White House (@WhiteHouse) April 13, 2021
President Joe Biden has proposed $200 million for racial bias training for health care providers and reproductive health services. The American Rescue Plan, which Biden signed into law in March, included $30 million in funding for implicit bias training.
Implicit bias -- when people associate stereotypes or have attitudes toward other people without consciously doing so -- and institutional racism are primary drivers of unequal care buried deep in the health care system, according to Hardeman.
In a study co-authored by Hardeman that was published last year, Black newborns’ in-hospital death rate was found to be 58% lower when Black newborns were cared for by Black physicians rather than white physicians, but remained higher than that of white newborns.
\"We’re not talking about individual racist physicians who are doing bad things to Black infants. That’s not at all what we’re seeing here,\" Hardeman told \"GMA.\" \"What I think we’re seeing are health care delivery systems where racism is baked into all aspects of the system.\"
\"It’s hard to identify, but it shows up in the ways that patients are cared for or not cared for in those systems,\" she said.
Hardeman this week began offering online education courses for perinatal providers focused on implicit bias, part of new training requirements in California under a law that went into effect last year.
She describes the education curriculum as one of the ways that health care systems can start to make the big changes needed to shift the outcomes for Black moms and Black babies.
In addition to making sure medical students and medical professionals are mandated to learn the health effects of structural racism and implicit bias, Hardeman wants to see health care systems meet standards of addressing structural racism and achieving equity in health outcomes in the same way they must meet safety and performance standards.
Making sure the health care staff is diverse is also critical, according to Hardeman, as well as giving Black providers the power to create new systems that suit the needs of the patients and families they serve.
\"We have to be willing to reimagine what care should look like for Black birthing people and for everyone,\" Hardeman said. \"I think there’s a real opportunity to rethink how we’re doing things versus sort of plugging the holes or stopping the bleeding.\"
For Ingram, she said that going through the death of her son made her a better physician, one who is more compassionate and more empathetic and who sees her patients as whole people.
![\"PHOTO:](\"http://a.abcnews.com/images/GMA/ingram-ht-kk-210415_1618543250019_hpMain_4x3t_384.jpg\")
She said health care providers have to \"do better\" when it comes to recognizing and understanding their implicit bias so that patients' needs are met and heard, and so that Black women and Black babies are kept alive.
\"I explain it to my [OBGYN] partners like this, ‘Do you and your [sibling] view the world the same? Do you think the same?’ and they say, ‘No, I don’t view the world the same as my brother,'\" said Ingram. \"This is what it is. Everyone views the world differently. It’s not a right or wrong, you just view it differently.\"
\"As practitioners, it means we have to step back, take a minute, kind of readjust ourselves and make sure that we’re looking at every patient that comes in the door for what are their risk factors? What are they bringing to the table? What do I need to educate them on? What are they high risk for? What do I need to take a little bit more time to talk with them about? What's the data here?\" added Ingram. \"It’s important to just be aware.\"
Editor's note: This story was originally published on April 16, 2021.
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