There is a killer on the loose in black communities all across America.
The victims are its most vulnerable members and their lives are often snuffed out without a whisper of complaint even though the deaths are often preventable.
The killer is particularly vicious and busy in Michigan; largely in Detroit, Flint and the Saginaw regions of the state. The victims are exclusively women and infants. The killer is a toxic combination of stress from racism, poverty, lack of access to healthcare and medical bias.
These factors together create medical conditions for pregnant women that too often lead to difficult pregnancies due to stress and unhealthy underweight babies who have trouble thriving because of the mothers’ high stress levels adversely affect her hormones. This has led to a virtual epidemic of high infant mortality rates among black babies all across the country.
“We define infant mortality as an infant that does not survive to see their first birthday,” said Dr. Kimberlydawn Wisdom, senior vice president of Community Health & Equity and Chief Wellness and Diversity Officer at Henry Ford Health System. “And the rate is extremely high in the city of Detroit and the Detroit metropolitan area. Within the city of Detroit, it varies but we see about 130 to 150 and some years 200 infants die before their first birthday.”
She said the rates are similar to other urban areas, but the number exceeds many developing countries. “There are developing countries that don’t have statistics as poor as ours.”
In fact, premature births are the No. 1 killer of babies in Detroit, which has the highest infant mortality rate among major U.S. cities. According to the Michigan Department of Community Health, the infant mortality rate in the United States was 5.8 deaths per 1,000 live births nationwide. However, among African Americans, it was 11.4. In Michigan, it was 6.6 per 1,000 births statewide, but there was a wide and persistent disparity between white and black babies’ death rates in Michigan. In 2018 the white infant mortality rate was 4.5 per 1,000 live births while the black rate was 15.1 per 1,000 live births.
And a few years ago, The Detroit News reported that children 18 and younger die at a higher rate in Detroit than elsewhere in the U.S., “most often the victims of illnesses and conditions of infancy, and secondly by violence.”
Stacey Scott Ph.D., a public health expert and founder and President of the Global Infant Safe Sleep Center (GISS) in Toledo said the key factor that contributes to the disparities in the infant mortality rates between black and white babies – especially in Michigan – is racism.
“Social determinants of health are factors that we see contributing to all types of health disparities, not just infant mortality,” she said. “It goes into housing, the criminal justice system,
unemployment … the residual impact of all these systems is that black people fare far worse than their counterparts.”
Scott pointed out that studies have even shown that professional, middle-class, African American women who make more than $50,000 a year compared to African American women who are in welfare, birth outcomes are still almost the same.
“So it’s not necessarily social-economic issues that contribute to poor birth outcomes as many would want us to believe,” she said. “We attribute it to chronic stress as a direct result of racism.”
“Chronic stress can impact hormones which we see triggers early labor and leads to premature labor and low birth weight,” Scott added. “Racism is not going anywhere so what do black people do?”
Dr. Wisdom from the Henry Ford Health System says it’s going to take aggressive community-based programs that offer a holistic approach in supporting expectant mothers to deal effectively with this crisis.
She noted Henry Ford Health System is a sponsor with the Detroit Regional Infant Mortality Reduction Task Force and has been working to fix the social safety net so women in need of support can more effectively access services. This includes connecting at-risk women and neighborhood advocates to clinical and social services in or near their neighborhood before women present with poor birth outcomes.
The Women Inspired Neighborhood (WIN) Network: Detroit is also part of this coalition. Dr. Wisdom said it focuses on three of the city’s neighborhoods: Brightmoor, Chadsey-Condon, and Osborn. And although infant mortality rates are higher in these neighborhoods, residents are surrounded by a strong network of organized services that offer resources, accessible medical care, and assistance for everyday life.
“Our Community Neighborhood Navigators (CNNs) are based in community centers in each of these areas,” she said. “WIN Network: Detroit connects women in these neighborhoods to the programs and resources that exist to serve them.”
“The program has been so successful that we have won several awards last year,” Dr. Wisdom proudly noted. “We won the American Hospital Association Dick Davidson NOVA Award, which honors effective, collaborative programs focused on improving community health status. And a second recognition we received in Modern Healthcare, we were one of the top 25 innovators in the country because of this program.”
She stressed other collaborators in this effort include are Ascension, DMC, and Oakwood hospitals among others.
Scott, from the GISS Center, lauded the work of Dr. Wisdom and others working to address the crisis. However, she stressed an equally important component in dealing with risk factors for black women is dealing forthrightly with the attitudes and biases of physicians and other healthcare professionals which often contributes to the stress of black women.
“If you are going to see a physician and you are having problems and they are not paying attention to you because you are aback woman, that is a problem,” she said.
Scott said it’s going to take more than just helping black women gain access to a proper level of prenatal healthcare. There is a need to challenge the behaviors and assumptions of institutions as well as medical professionals.
“You have to combat racism in the healthcare system,” she said. “These institutions have to move from being non-racist to anti-racist. And to do so is going to take these hospital accreditation people to call it out. There have to be policies in place to help overcome the explicit and implicit bias you see in the healthcare system that impacts health outcomes for black women.”
By Whitney Grehsam