Tuesday’s Perinatal Health Conference featured keynote speakers Dr. Michael Lu & Dr. James Collins, who presented us with evidence for the root causes of the huge disparity between birth outcomes in black and white American women.
As you can see here, there is a huge percentage point differential between pre-term birth rates of black women than other racial groups – in fact it is nearly half again as much as white women. This chart shows that black American infant mortality rates are more than double white American rates. America’s scores on maternal-fetal health are poor across the board – we are 26th among industrialized countries, but we tend to not see the breakdowns by population when the numbers get released.
When I see graphs like this, I tend to think about how poor health care access, institutionalized racism, poverty and hunger lead to pre-term birth & low birth weight infants. You probably think about that too, but it turns out we are wrong. We should be thinking about something much harder to measure.
On Tuesday I saw with my own eyes data indicating white women with only a high school education have better birth outcomes than black women with a college education. I found this disturbing and a little hard to believe. It was even more disturbed when I saw the chart that indicated women immigrants from Africa and the Caribbean had birth outcomes as good as the white population here but that their daughters, in exactly one generation of living in the United States, carried the same risks as black women whose mothers were born here.
One generation of growing up black and female in America takes a bigger health toll than the pregnant body can bear. Our speakers shared the findings from recently conducted research connecting instances of interpersonal racism and preterm labor. This suggests that the allostatic load of black girls and women in America is so high that their bodies are suffering the consequences of racism. The flight or fight response is the body’s gift in times of danger, but it is not meant to be on at all times. When it is stuck in the on position, the body loses immune function, becomes prey to heart disease, high blood pressure and insulin-resistance – all risk factors for early delivery.
I will write more tomorrow about the effect this early programming has on the fetal development. If you want to look up epigenetics, you will be ahead of the class.
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