Survival guide for women of color

ThePsychWhisperer, BSN, MSN, APRN, NP · Dec 10, 2018

Although what you said is not wrong, this IS a WOC problem. Education and social economic status have been included in these studies. An African American mother with an advanced college degree is still more likely to die or her infant die, than a white woman with an 8th grade education. The US has one of the highest maternal and infant mortality rate of developed countries and black women and babies are affected more than any other racial group.

If this is actually a WOC problem and not a socio-economic problem, then education level is really a moot point. But what is the core reason for the increased mortality of women and infants of color? I apologize up front, but in order for me to blame blatant racism in medicine and nursing for the higher mortality rate, I need to see evidence of a continued disparity in maternal care. The content of the original article posted is terrible, but the truth is that it was a process failure, and it could have happened to any woman of any ethnic or non-ethnic group; there is absolutely no way to prove that it happened just because she was black. Was it a wrongful death? Yes. Could it have been prevented? Absolutely. But again, there's no empirical evidence that it was only because she was a WOC. Where are the studies linking the mortality rates to substandard care? I know I'll probably get flamed for this, but I think we may need to stop yelling racism when there could very well be other underlying biological issues.

**LibraSunCNM, BSN, MSN, CNM** · Dec 10, 2018

If this is actually a WOC problem and not a socio-economic problem, then education level is really a moot point. But what is the core reason for the increased mortality of women and infants of color? I apologize up front, but in order for me to blame blatant racism in medicine and nursing for the higher mortality rate, I need to see evidence of a continued disparity in maternal care. The content of the original article posted is terrible, but the truth is that it was a process failure, and it could have happened to any woman of any ethnic or non-ethnic group; there is absolutely no way to prove that it happened just because she was black. Was it a wrongful death? Yes. Could it have been prevented? Absolutely. But again, there's no empirical evidence that it was only because she was a WOC. Where are the studies linking the mortality rates to substandard care? I know I'll probably get flamed for this, but I think we may need to stop yelling racism when there could very well be other underlying biological issues.

Did you read the NYT article we've mentioned? Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis - The New York Times

It lists emerging theories and studies being done to support what we're saying---that the experience of being a WOC in the U.S. causes enough psychological stress to affect the health of pregnancies and the microbiome itself. You may feel that it's just "yelling racism" and not be convinced but it seems pretty clear based on the evidence that's emerging that it's a valid theory.

Emergent, RN · Dec 10, 2018

I'm wondering if Hispanics are considered 'of color'? If so, are they considered shortchanged by the medical system?

Hispanics Have Highest Life Expectancy in U.S.

dinah77, ADN · Dec 10, 2018

First off, apologies for not responding to any of you sooner- for some reason I didn't get my regular email alerts of responses so I had no idea there was any activity on this thread

Second, I'm pretty shocked at many suggesting that there is no evidence for WOC being treated less adequately- Here is a link from the CDC showing that black women and WOC from other races die at a higher rate than white women

I'll respond later to other points

Pregnancy Mortality Surveillance System | Maternal and Infant Health | CDC

dinah77, ADN · Dec 10, 2018

I'm wondering if Hispanics are considered 'of color'? If so, are they considered shortchanged by the medical system?
Hispanics Have Highest Life Expectancy in U.S.

Well any woman who is not white dies at a much higher rate than white women in maternal care

Pregnancy Mortality Surveillance System | Maternal and Infant Health | CDC

dinah77, ADN · Dec 10, 2018

NICU guy

Maternal Mortality - ACOG

Pregnancy-Related Deaths | Pregnancy | Reproductive Health | CDC

It seriously took me about two minutes to find those

ThePsychWhisperer, BSN, MSN, APRN, NP · Dec 11, 2018

First off, apologies for not responding to any of you sooner- for some reason I didn't get my regular email alerts of responses so I had no idea there was any activity on this thread
Second, I'm pretty shocked at many suggesting that there is no evidence for WOC being treated less adequately- Here is a link from the CDC showing that black women and WOC from other races die at a higher rate than white women
I'll respond later to other points
Pregnancy Mortality Surveillance System | Maternal and Infant Health | CDC

We're not arguing whether or not WOC have a higher mortality rate. The point we're arguing is whether or not true disparities in health care between WOC and white non-Hispanics have any influence over maternal deaths. I read all the articles you provided with your most recent posts, and although they do address a quite large chasm between the races and maternal deaths, they do not address whether or not disparities in health care are considered a root cause. One thing I did notice however, is that among all the stated causes of maternal deaths in the US, cardiovascular diseases rates number one. In the US, up to 1/2 of African-Americans have some form of cardiovascular disease, as compared to only about a third of non-Hispanic whites.

Also, after looking at the following Harvard article, it suggests hypertension as a probable cause for this cardiovascular disease, a condition that, due to a genetic component, African-Americans are more likely to have than non-Hispanic whites. When you look at all the conditions on the CDC website as contributing factors to maternal deaths from 2011-2014, hypertension could be considered as an underlying (but admittedly not definitive) cause for cardiovascular disease, cardiomyopathy, hemorrhage, cerebrovascular accidents, and is a sure cause of hypertensive disorders of pregnancy. Add these all together, and these conditions contribute to a whopping 51.2% of all maternal deaths. This is why I was curious as to whether or not these maternal deaths were truly being caused by intentional or unintentional disparities in health care, or if there may be something more insidious at work.

Race and ethnicity: Clues to your heart disease risk? - Harvard Health

dinah77, ADN · Dec 11, 2018

We're not arguing whether or not WOC have a higher mortality rate. The point we're arguing is whether or not true disparities in health care between WOC and white non-Hispanics have any influence over maternal deaths. I read all the articles you provided with your most recent posts, and although they do address a quite large chasm between the races and maternal deaths, they do not address whether or not disparities in health care are considered a root cause. One thing I did notice however, is that among all the stated causes of maternal deaths in the US, cardiovascular diseases rates number one. In the US, up to 1/2 of African-Americans have some form of cardiovascular disease, as compared to only about a third of non-Hispanic whites.
Also, after looking at the following Harvard article, it suggests hypertension as a probable cause for this cardiovascular disease, a condition that, due to a genetic component, African-Americans are more likely to have than non-Hispanic whites. When you look at all the conditions on the CDC website as contributing factors to maternal deaths from 2011-2014, hypertension could be considered as an underlying (but admittedly not definitive) cause for cardiovascular disease, cardiomyopathy, hemorrhage, cerebrovascular accidents, and is a sure cause of hypertensive disorders of pregnancy. Add these all together, and these conditions contribute to a whopping 51.2% of all maternal deaths. This is why I was curious as to whether or not these maternal deaths were truly being caused by intentional or unintentional disparities in health care, or if there may be something more insidious at work.
Race and ethnicity: Clues to your heart disease risk? - Harvard Health

Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care

WOC generally do not receive the same treatment as white women in a timely manner. Period. I'd call that a pretty big disparity

Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care

ThePsychWhisperer, BSN, MSN, APRN, NP · Dec 11, 2018

Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care
WOC generally do not receive the same treatment as white women in a timely manner. Period. I'd call that a pretty big disparity
Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care

That was an interesting read, and a compelling argument to do more research on the topic. It helps convince others when your postings contain evidence relevant to the argument.

**LibraSunCNM, BSN, MSN, CNM** · Dec 20, 2018

Just read this today: https://www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/. Talks about a lot of what we're discussing here---they call the idea "weathering"---that racism puts stress on the body chronically and causes health disparities.

Emergent, RN · Dec 21, 2018

Several studies point to the fact that nutrition is a huge factor. Black Americans in general eat a less healthy diet than Whites. Perhaps it's because the culture arose in The South where the diet is high in soda pop and deep fried foods? Poor whites from the South are not the healthiest people either.

Also studies point out the fact that Black folk have a higher percentage living in inner cities with fewer nutritional choices. Urban decay, crime, and fewer Trader Joe's and even regular supermarkets.

For all Americans, the deterioration of nutrition is really a national crisis. The food industry is ruining the health of the nation. In my opinion, to help poor Americans, the first step is to limit the foods available on food stamps to healthy ones. Bring mandatory cooking classes into the schools teaching nutrition and cooking combined. Start a national campaign about fit for life exercise and nutrition.

dinah77, ADN · Dec 21, 2018

Yes, that is exactly what I'm talking about!!!! In one of my public health classes for my MPH we learned a lot about constant stress people of color undergo due to racism and especially poverty and how many of them end up with heart problems despite having no other risk factors

Just read this today: https://www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/. Talks about a lot of what we're discussing here---they call the idea "weathering"---that racism puts stress on the body chronically and causes health disparities.