Medical experts say social inequality and racism in medicine can be deadly for Black infants, mothers and families.
by Nomin Ujiyediin, Kansas News Service
Black and Native American babies in Kansas die at almost twice the rate as white infants in their first year of life.
Out of every 1,000 live births, 11.8 Black and 10.4 Native American babies die before their first birthdays in Kansas. Meanwhile, only 5.6 out of every 1,000 white babies die in that period.
The data from 2013 to 2017 — originally gathered and published by the Centers for Disease Control and Prevention, and newly collected in a report from the National Collaborative for Health Equity — suggests that race can be a major factor in a community’s health.
The report collects and publishes numerous health measures gathered by government surveys over the past decade. It shows Black people and other people of color in Kansas are also more likely to live in areas with a high density of liquor stores and a greater frequency of robberies and homicides.
Those factors can cause stress that can damage the health of mothers and their babies, said Gail Christopher, executive director of the National Collaborative for Health Equity.
“Safety is a very important factor in terms of the perception of health and well-being,” Christopher said. “Fear translates into a physiological, biochemical stress reaction.”
Black mothers may also have trouble getting to doctor’s appointments because they live too far from hospitals and other medical providers and because they don’t have reliable access to transportation or can’t take time off of work. People’s income, education level or neighborhood can also impact whether they can even choose healthier behaviors, she said.
“Behavior is driven by environment. It’s driven by context,” she said. “If there are no grocery stores within your vicinity that sell produce, how are you going to make sure that you’re getting in five servings of vegetables a day?”
Those factors may also have affected COVID-19’s disproportionate impact on Black, Latino, Asian and Native American communities across the U.S.
In Kansas, Black people were more likely to die of coronavirus-related causes in the early days of the pandemic, when most cases were in urban parts of the state. Now that cases have risen in rural counties, the death rate among Black Kansans lags slightly behind that of white Kansans.
The pandemic has especially highlighted the impact that housing and food insecurity have on health, Christopher said. Black Kansans are about half as likely to own their homes when compared to white Kansans, and more likely to spend a large portion of their incomes on housing expenses.
Interpersonal and structural racism
Higher rates of illnesses and death can also be the result of racism in medicine, Christopher said.
“Everyone in our society carries biases,” she said. “How do we create ways of delivering care that help to mitigate the possibility that those biases are actually driving our decisions and our outcomes?”
A legacy of racism exists not only in society as a whole, but also among medical providers who may treat Black patients differently, said Dr. Michelle Ogunwole, a physician and health disparities researcher at Johns Hopkins University. Studies show that doctors are less likely to take Black patients’ pain seriously.
“If you feel like something’s wrong, but that people don’t listen to you,” Ogunwole said, “that has implications for outcomes.”
Hospitals that mostly treat Black patients tend to have fewer resources, Ogunwole said. That also leads to poorer health outcomes for patients at those hospitals, regardless of race.
One possible solution: increasing the number of Black physicians. A 2020 study found that the increase in mortality rates for Black babies dropped by half when the children were cared for by Black physicians.
Black physicians can also be more effective at educating Black patients about their health, Ogunwole said. She said she sometimes uses her own experiences as a Black person to relate to her patients.
“I will definitely lean into that identity,” she said. “It ends up being way more effective.”
But medical schools at historically Black colleges and universities have been less well funded than medical schools at historically white colleges. And Black medical students can be affected by the same racism and lack of access to care that have impacted their patients’ lives.
“Those people have to be supported in a different way,” Ogunwole said, “so they can make it through the pipeline.”
Ultimately, Ogunwole said, Black mothers and patients don’t necessarily need to be treated by Black doctors, but by people who respect and value them, regardless of race.
“(Women) just want to be cared for and for people to value them and their children,” she said. “They just want what everybody wants, which is to live healthy and full lives.”
Nomin Ujiyediin reports on criminal justice and social welfare for the Kansas News Service. You can email her at nomin (at) kcur (dot) org and follow her on Twitter @NominUJ.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.
See more at https://www.kcur.org/news/2020-11-23/black-babies-in-kansas-are-twice-as-likely-as-white-kids-to-die-before-their-first-birthday.