Let’s start with a fact that might shock you. America, one of the wealthiest nations in the world, has one of the highest infant mortality rates among developed countries. According to the CDC, we lag behind at least 27 of the wealthiest nations in the world when it comes to keeping our infants alive for the first year of life. Finland and Japan are at the top, and the United States is at the very bottom, right under Slovakia. (Check out this chart for a striking visual.)
In America, for every 1,000 babies born, an average of 6 die. Yes, some infant deaths are simply going to happen no matter what we do, and this is a sad and tragic fact of life. But many deaths are preventable, as evidenced by the fact that so many other developed countries have a rate about half as high as ours.
America’s infant mortality rate is embarrassing and unacceptable, especially in a country that is supposed to be on the cutting edge of life-saving medical expertise and treatments. As the CDC explains, a country’s infant mortality rate says a lot about where that country is in terms of overall health and well-being “because factors affecting the health of entire populations can also impact the mortality rate of infants.”
Now, as if this information weren’t upsetting enough, let’s look at the next statistic about infant mortality to come up, right there on the CDC’s information page: “There are significant differences in infant mortality by race and ethnicity; for instance, the mortality rate for black infants is more than twice that of white infants.”
Yep, you read that right. Black babies are twice as likely to die as white babies. That is a catastrophic difference, especially when you are talking about children — someone’s baby, someone’s child. It’s a statistic that should anger you to the bone.
But even more than that, you should know that although the United States lags behind overall in terms of infant mortality, the rates of infant mortality for babies born to white, educated women is actually on par with that of other nations. As The Nation points out, in a piece published in February called “What’s Killing America’s Black Infants?” the babies who are most likely to die in their first year of life are those born to “poorer, less-educated families, particularly those headed by unmarried or black women.”
So infant mortality is a huge, reprehensible problem in America, but black babies are the ones most affected and disproportionately so. The article in The Nation is an important, heartbreaking work of investigative reporting that should be required reading for all Americans, parents or not. Zoë Carpenter, the author, unpacks the major reasons why the infant mortality rate is so much higher for black babies. The conclusion she comes to is complex, but it boils down to this: Black babies are dying at higher rates than white babies because of racial discrimination — on economic, social, and psychological levels.
Carpenter explains that it’s a deep kind of racism that goes beyond the socioeconomic barriers that many people of color face. For example, even among highly educated black women, the rates of infant death are higher than their white counterparts of similar socioeconomic status. According to Carpenter, regardless of where they come from, what they have achieved, and what economic advantages they have garnered, black women are treated differently than white women, including in the arena of pregnancy and birth.
“A growing body of evidence points to racial discrimination, rather than race itself, as the dominant factor in explaining why so many black babies are dying,” Carpenter explains. Carpenter believes that institutional racism, which she refers to as “unequal treatment [that] has been baked into our social, economic, and political systems,” is to blame here, and its effects have been felt in black communities for decades.
Carpenter surmises that institutional racism may be affecting women and babies on a chronic level, affecting their response to stress, and overall health, especially during the childbearing years. “These various forms of discrimination, stacked up over a lifetime, can cause chronic stress, which in turn can damage the biological systems necessary for a healthy pregnancy and birth,” says Carpenter.
Around the time this article came out, the American Congress of Obstetricians and Gynecologists (ACOG) released a statement about racial discrimination in the maternity care industry. The gist of their statement is that racial discrimination in maternity care exists, it’s not okay, and healthcare professionals working with women of color need to be aware of their biases and the different kinds of obstacles black women and their babies face.
“Racial bias is an issue that affects our patients, either directly by subjecting them or their families to inequitable treatment, or indirectly by creating a stressful and unhealthy environment,” the statement reads, going on to say that “[i]t is critical that physicians are aware of this reality for patients of color regardless of the patient’s financial position.”
Statements like this are a good start, though they will mean very little unless there is follow-up, dialogue, and efforts made to work through the deeply rooted racism inherent in our health care system, our country, and ourselves. I am someone who keeps up with health care issues as they pertain to women and children, and although I knew about the different rates of infant mortality between black and white babies, it wasn’t until I read the article in The Nation that I fully understood how deep it really goes and how vital it is to address it immediately.
I don’t know what the solution is exactly, and I know it might take years to fully untangle it all and address it. As a white woman, I can’t speak to the personal experience of my black friends and what they need most as women, as people, and as a community so their babies remain healthy and are able to thrive. But by god, it’s about time we start talking about it, acknowledging how utterly unacceptable it is, and band together to fight the good fight for the moms and babies who deserve the simple promise of a good, healthy start in life.