What if — within communities of color — we could build a regionally or nationally accredited midwife training program designed to work with mom’s who potentially could have a problem pregnancy— or fit the data set for having a pre-term birth?
The midwives could be supervised from a central organization or a hospital within the county or through the county health department. There could even be a requirement that every third year midwives would have a re-examination and additional instruction in state-of-the-art obstetrics and new techniques in matters which influenced their work.
The needs of black communities— as it relates to health — are often ignored as part of the public discourse. We can move people from sickness to wellness and use health as an extension of social justice. Facing the discrepancy in BIMR is part of this.
Having the midwife training programs in communities with close proximity to hospitals offer the possibility of additional staff support from medical providers. Is it possible that we could have a regional or statewide effort to create the training of midwives—within communities? With an infant mortality rate for black infants that is double than for other races, we have to do something. The reality is that thousands Black infants will die this year and next year. The infants cannot help themselves. The adults have to act. It is, therefore, my belief that reform is urgently needed. The status quo is a failure. The metrics fully present the story.
The exceedingly high death rate of Black infants—as compared to other races — must claim the attention of physicians, philanthropists, religious leaders, county health officers and other community-based stakeholders. We will continue to identify the causes and factors responsible for the destruction of black infant lives—leading to deaths before a first birthday— and face them.
In our belief, ‘better parents are needed to have better children.’ I am, by definition, expanding the traditional definition of ‘parent’ away from father, mother or grandparent to include members of the community who can— and should —take a demonstrable interest in the lives of black infants.
I believe there must be a general awakening to this public health crisis and each of us accept responsibility to help black infants get to their first birthday. From that point, let us then look to firmly establish systems that give black infants chance to make the most of their lives.
Do we need a reformation? I say, ‘yes!’
A study of life expectancy in the antebellum Mississippi indicates that a 20-year-old Negro slave could on average expect to live for 17.5 more years. But in Mississippi, as in all slave states, the difference between black-and-white life expectancy changed considerably when infants were included in the statistics. Among white infants the mortality was distressingly high; among slaves it was fantastic. By the Civil War, the white and Negro populations were almost equal, but slave infants died at a rate of 2:1. In Mississippi, one analysis numbered 2772 Negro infant deaths in one year compared to 1315 for whites.
Everywhere in the south the Negro infant mortality rate was more than double that of whites. In one particularly disturbing account from Georgia, nine slave women were interviewed who together and had 12 miscarriages and 55 live births. 29 of the children were dead before one year.
Black infant mortality rate (BIMR) is a public health crisis in the United States. It is a burden that we either are unable or unwilling to see. We must look at the problem through a different lens.
In chapter 97 of a book called The Art of Thinking Clearly by Rolf Dobelli, the author introduces a compelling paradigm. It is called “The fallacy of the single cause.”
He illustrates the paradigm through a story from Tolstoy: Does the apple fall from the tree because the fruit is ripe or because of gravity or because the wind shakes the tree or because the ground is calling the apple to the earth. So, is there just one reason the apple falls, or is there a blending of reasons.
I assert we must study (BIMR) applying a comparable frame. Are the BIMR metrics so disturbing because of preterm births, lack of consistent prenatal care, lack of health insurance, environmental toxins in the air and water, low birth weight babies, smoking or something else— or, perhaps, is it a blending of some (or all) of these. There is no ‘single cause.’
The goal of our series (The_Gap) is to ‘UN-SILO’ the contributing factors influencing BIMR. We want to determine how these problems are connected instead of how they are separate. Our series will explore these inter- locking narratives. If you haven’t taken a moment to watch the sizzle reel, please take a look.
Does It Truly Matter?
Forces inimical to the lives of black children have been unleashed on our communities. Simply stated, we’re in a mess. And what do we know about ‘messes’? The same level of aberrant thinking that gets you into a mess is neither deep enough or broad enough to get you out.
Film and television represent the most dominant and influential art form and communications methods of the last 100 years. Much of what we see and think and feel is influenced by visual storytelling.
The_Gap will be a documentary series. Upon completion, the story will be available across multiple digital channels— and, if we are fortunate, on public television. Dr. William Callaghan, senior scientist at the National Center for Health Promotion, cited during a Congressional hearing that over 500,000 babies are born premature each year in the United States. Additionally, preterm birth is an important risk for infant mortality and more than 33% of infant deaths can be attributed to preterm birth.
“Preterm birth and infant mortality are particularly critical issues in the African American community,” advises Dr. Callaghan. “African American women are one and half times more likely to deliver a preterm infant compared to white women.” Callaghan continued, “And the infant mortality rate for black infants is more than twice that of white infants.”
“African-Americans in the medical community must take a strong, persuasive leadership role to create awareness and education on this national crisis. Film is a powerful way to tool and I’m pleased to be part of this influential campaign,” said Ladrian P. Brown, MD.
We must face this public health crisis with purpose, resolve and commitment.