Medical Inequalities and Infant Mortality Rates

Mark Mwandoro
​Marketing Director

In 1903, W. E. B. Du Bois prophetically stated: “The problem of the twentieth century is the problem of the color line (Jung, 2019).” We are well into the 21st century and we are still experiencing the problem of racial segregation in America. The lines of racial segregation in America were drawn in big bold lines. In St. Louis, racial segregation was institutionalized by intent, accident, or benign neglect throughout its history, affecting the nature of race relations in the city today (Louis, 2020).

​Racism corrupts the fabric of morality of the US healthcare system. Centuries of racism have a direct impact on the black community as these discriminatory practices barred black students from enrolling and studying medicine, nursing, pharmacy, and dentistry. The effects of this discrimination have bred mistrust in the black community as they are always on the receiving end of mediocre and substandard treatment.  

The infant mortality rate in the United States varies widely by state and county and on average is
​higher than in the rest of the world’s first world countries. The survival of infants is used as a benchmark for societal overall health because they are very vulnerable. Despite the government spending more money than any other country in the world on healthcare, more than 23,000 infants die before celebrating their first birthday (Carpenter, 2017). Across the country, black infants die at a rate that’s twice that of white infants. 

Black women, even those highly educated and in well-paying jobs are twice as likely to lose their infants than white women who haven’t even graduated high school (Flourish, 2020). More than 6,200 babies born in Missouri between 2002 and 2012 lost their lives before their first birthday. One-third of those deaths occurred in the Bootheel and St. Louis alone (Foundation, 2020). 

In St. Louis, black infants are three times likely to die as compared to white children. Pregnant black women have a 243% chance of succumbing to pregnancy-related issues in comparison to white women. According to Peristats, the infant mortality rate in St Louis city declined by more than 17% between 2008 and 2018. The leading causes of death are birth defects, sudden infant death syndrome, maternal complications of pregnancy, and respiratory distress syndrome.

The high infant mortality rate in the Black community begs the question, what is killing America's Black children?

For many years, researchers attributed the following as what black mothers were doing wrong; smoking or drinking during pregnancy, obesity, diabetes, lack of prenatal care, poor eating, underage pregnancies, and smothering newborns in their sleep (Carpenter, 2017). As a result of highlighting these problems, more women took better care of themselves and got better care but still, there was little improvement in birth outcomes. Black women who received prenatal care starting in their first trimester were still losing their infants at higher rates than white women who did not get antenatal treatment during their pregnancies.

Another school of thought proposed that  black women were genetically predisposed to poor birth outcomes, and began to hunt for “preterm birth genes.” Well, we know that the genetic variation in humans is too minuscule to be attributed to infant mortality in the black community. Others suggested that high poverty levels and lack of education in black women were the cause of the deaths. But, educated women in well-paying jobs were still losing their children more than uneducated white women, so where does the problem lie? 

Racial discrimination rather than race itself plays a major role in why black infants are dying in such big numbers. Black women complain of physicians being dismissive, impatient, and condescending when dealing with them. This systemic racism puts them in three times more chances of losing their children as compared to white mothers. Many black women express their desire to be attended to by a black medic, but that is not entirely possible. We need to reduce systemic racism for all patients to be comfortable getting treated by the doctors available. 

The golden rule says do unto others as you would have them do unto you so that the heart of a doctor needs to be that kind of heart where you are taking care of folks the way you would want to be treated or want your family treated (Zaragovia, 2021).

References
Carpenter, Z. (2017, March 6). What’s Killing America’s Black Infants? Retrieved from The Nation: https://www.thenation.com/article/archive/whats-killing-americas-black-infants/
Flourish. (2020). Racial Disparity in Health. Retrieved from Flourish: https://www.flourishstlouis.org/problem/equity/
Foundation. (2020). Reducing Infant Mortality. Retrieved from Missouri Foundation of Health: https://mffh.org/our-focus/infant-mortality/
Jung, S. (2019). The Endurance of the Color Line. Retrieved from Othering and Belonging: https://www.otheringandbelonging.org/endurance-color-line/
Louis, S. (2020). A Preservation Plan for St. Louis. Retrieved from St Louis-MO Government: https://www.stlouis-mo.gov/government/departments/planning/cultural-resources/preservation-plan/part-i-african-american-experience.cfm
Zaragovia, V. (2021, May 28). Trying To Avoid Racist Health Care, Black Women Seek Out Black Obstetricians. Retrieved from NPR: https://www.npr.org/sections/health-shots/2021/05/28/996603360/trying-to-avoid-racist-health-care-black-women-seek-out-black-obstetricians