Maternal, Child, and Adolescent Health Inequities

Maternal, child and adolescent health inequities stem from implicit bias and systemic racism issues in the healthcare system. These inequities are connected to a host of environmental and societal issues represented in the accompanying sections of this feedback loop.

Climate change disproportionately affects Black pregnant women due to increased high temperature and air pollution exposures increasing the risk of premature and low-birth weight babies1. Additionally, organophosphorus pesticide exposure in utero is associated with decreased infant size, lower child cognition, and decreased lung function, disproportionately affecting Communities of Color, especially agricultural workers and their families2. COVID-19 also is exposing the deep health and racial inequities as Black and Latina pregnant mothers are more likely to be exposed to COVID-19 than their white counterparts, further exacerbating health disparities3. During the COVID-19 closures, there is decreased access to the Women, Infants and Children (WIC) program, school lunches and employment opportunities for low-income populations using government safety net programs, fully linking the connections of maternal, child and adolescent health disparities.



Black mothers have over a 3x higher risk of dying from pregnancy related complications than white mothers4.



Black infants die at over 2x higher rates than white infants before age one5

Black women are 50% more likely to give birth prematurely6.

Infants in the U.S. have 76% higher risk of mortality than other counterpart high-income nations7.

IMPLICIT BIAS
Numerous studies show that race is a determining factor in quality of care in the US healthcare system, even when controlling for socio-economic status8,9. Implicit bias can lead to less trust of the healthcare system for Communities of Color, poorer maternal, child and adolescent health, increased health and race disparities, and then eventually lead back to more implicit bias. For example, when other factors such as insurance, income, age, and comorbid conditions were accounted for, racial and ethnic minorities are still less likely to recieve adequate medication, and routine care. This bias results in adverse health outcomes and higher instances of death in these communities10.

DISRUPT THE LOOP
1. RESEARCH

2. SUPPORT

3. ACT
  • Federal Legislation- call your house of representative and support:
    • Urge to include in next COVID-19 relief legislation:
      • H.R. 4995, H.R. 4996 for maternal health + COVID-19
    • MOMMA’s Act (H.R. 1897, S.916), maternal mortality and morbidity prevention
    • Midwives for Maximizing Optimal Maternity Services Act of 2019 (H.R. 3849), special funding for racial and ethnic representation as midwives
SOURCES

1. Flavelle, Christopher. “Climate change tied to pregnancy risks, affecting black mothers most.” New York Times. 18 June, 2020. https://www.nytimes.com/2020/06/18/climate/climate-change-pregnancy-study.html

2. Stein, Lauren J., et al. "Early childhood adversity potentiates the adverse association between prenatal organophosphate pesticide exposure and child IQ: The CHAMACOS cohort." Neurotoxicology 56 (2016): 180-187.

3. Wu, Katherine J. “Study of coronavirus in pregnant women finds striking racial differences.” Boston News. https://www.boston.com/news/coronavirus/2020/07/11/study-of-coronavirus-in-pregnant-women-finds-striking-racial-differences


4. Center for Diseases Control and Prevention. “Pregnancy Mortality Surveillance System.” Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. 4 Feb., 2020. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm

5. Center for Diseases Control and Prevention. “Infant Mortality.” Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. 27 March, 2019. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

6. Center for Diseases Control and Prevention. “Preterm Birth.” Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. 21 Oct, 2019. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm

7. Novoa, Cristina, and Jamilla Taylor. "Exploring African Americans’ high maternal and infant death rates." Center for American Progress (2018). https://www.americanprogress.org/issues/early-childhood/reports/2018/02/01/445576/exploring-african-americans-high-maternal-infant-death-rates/

8. Singh, Gopal K., and Stella M. Yu. "Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010." American journal of public health 85.7 (1995): 957-964.


9. Hall, William J., et al. "Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review." American journal of public health 105.12 (2015): e60-e7


10. Nelson, Alan. "Unequal treatment: confronting racial and ethnic disparities in health care." Journal of the National Medical Association 94.8 (2002): 666.


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