Surging Infant Mortality Rates in African-American Women: Is Racism to Blame?

As February comes to a close, so does the official observation of Black History Month. But, just as the ending of a month does not signify a sudden disregard for black history or culture, the long-standing effects of racism do not simply go away as the result of an end to government-sponsored slavery and segregation. Instead, racism now roams like a silent predator, able to strike without being identified as the obvious culprit. In fact, research has emerged exposing racial discrimination as a probable offender to a jarring phenomenon: alarmingly high infant mortality rates among African-American women.

In the United States, the infant mortality rate for African-American women is about twice that of white women. This is especially significant as the infant mortality rate is widely used by public health officials as an important indicator of overall population health and healthcare quality. So why the disparity?

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Mother with twins. Image Credit: Seattle Municipal Archives via Flikr

Are these  women simply not receiving  the necessary prenatal care? During his time serving as Surgeon General (1977-1981), Dr. Julius B. Richmond ordered in his 1979 yearly report for there to be a public health push for increased access to prenatal care. Yet even after the public health intervention, African-American women were still experiencing poor birth outcomes – even worse than those of white women who had not received any prenatal care at all during their pregnancy.

Many also attributed the disparities to differences in socioeconomic status and sociodemographic factors. However, infant mortality rates among college-educated African-American women of high socioeconomic status were still as disproportionately high when compared to infant mortality rates of their white counterparts. Additionally, they were still more likely to have children of a lower birth weight than white women who did not even have a high school degree and were of a much lower socioeconomic status.

Is it something specific to the genetic makeup of African-American women? Some sort of “preterm birth gene?” Wrong again. Neonatologists James Collins and Richard David documented  that African-born women have similar infant mortality rates to U.S.-born white women. However, after they immigrate to the United States, studies show that their infant mortality rates grow closer to those of African-American women. Moreover, this increase can be seen in as little time as one generation.

Dr. Arline Geronimus, a professor at the University of Michigan, offers her explanation to the phenomenon as the “weathering hypothesis.”  Her study concludes that “racial inequalities in health exist across a range of biological systems among adults and are not explained by racial differences in poverty.” Essentially, something other than the effects of having a low socioeconomic status is responsible for these health disparities between African-American women and white women. The difference? African-Americans are exposed daily to chronic stress associated with racial discrimination. This stress wears down their biological systems more quickly than in other groups.

Here’s how it works: when we are exposed to stress, our body releases a “stress management” hormone known as cortisol.  Its job is to sustain blood glucose (sugar) levels that may be depleted by nervous and muscular systems. This is necessary for short-term stress management, but it is important that cortisol levels go back to normal after the stressor has dissipated. At sustained higher levels, cortisol can cause weakened immune system, impaired cognition, and yes, even premature labor.

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Stressed. Image Credit: Sodanie Chea via Flikr

Researchers believe  that a lifetime of chronic stress can actually disrupt and change biological processes within the body, such as the metabolic and endocrine systems, and have an impact on the next generation. Therefore, an African-American woman who fears daily that she may be mistreated based on the color of her skin would absolutely show signs of elevated stress levels that could have disastrous effects on the body’s systems. So while race may only present itself on the surface of our skin, the effects of racism permeate much deeper.

Natalie Eldredge is an undergraduate student studying Public Health at the University of Georgia. In addition to studying public health, Natalie is an intern for the Southeastern Wind Coalition, a nonprofit organization that supports wind energy development in the southeast. In her free time, you can find Natalie at Taco Stand or watching documentaries with her roommates. Connect with her on Facebook or via email at natalie.eldredge@uga.edu.