Why Is The African-American Infant Mortality Rate So High?
Rita Beam was a young nurse working in the mother-baby unit at Denver's Rose Medical Center three decades ago when she noticed a disturbing disparity, which would forever define her career.
An unusually high number of African-American babies were being born premature, underweight or both, and not surviving.
“I asked myself, ‘Why haven’t I read about this?’ You didn’t hear about it. No one was paying attention,” she said.
Beam noticed something else. These high-risk babies were being born to black women regardless of how much money they made, or their level of education. Beam started digging into the healthy baby gap, and she’s been dedicated to solving the mystery ever since.
Over the last two decades, research has confirmed that African-American babies die at two or three times the rate of other infants. But still, no one knows why.
The latest Colorado numbers from the Centers for Disease Control show that in 2007, the black infant mortality rate was 13.5 out of every 1000 live births, compared to 5.2 for whites and 7 for Hispanics.
Colorado’s numbers closely follow the national statistics, which are not good even for white babies. The United States ranks 29th worldwide in infant mortality despite its vaunted health care system.
The striking racial difference has so alarmed the Centers for Disease Control that neonatal specialists there have made the issue a number one priority.
“We need to solve this problem,” said the CDC’s Director of Maternal and Infant Health Dr. Bill Callaghan. “You know when you wake up at night and your head starts to zoom? That’s what I think about.”
It’s not the usual suspects of tobacco and alcohol. Colorado black women smoke and drink less in pregnancy than their counterparts. Colorado black pregnant women do report more stress and more infections.
“People have proposed the answer lies in differences in African-American biology. They’ve proposed differences in culture between blacks and whites in America, and they’ve proposed the stress of what it’s like to be black in America. But at the end of the day, we don’t have a satisfactory answer as to why this is happening,” said Callaghan.
Dr. James Collins, a neonatologist at Northwestern University just outside of Chicago, has studied the disparity for 15 years.
“When Africans first come to the United States, they have the same infant mortality rate as whites. But the next generation has the same rate of premature babies as American blacks,” Collins said.
He has concluded: “The difference is the racism blacks experience in this country.”
“This means being treated differently when you’re getting a cab, when you’re in an elevator, by strangers, and even colleagues at work,” even if you are educated and higher income, he said.
Collins theorizes that a lifetime of this stress can decrease the immune system and trigger pre-term labor.
Collins’ advice includes undoing racism, improving health care for black women before pregnancy, and getting black fathers more involved.
Candice and Randy Reese are a classic middle-class, suburban couple in Brighton. She’s a principal at the elementary school she once attended in Denver, and he’s a project manager for a utility company.
When they learned their first child was coming, they were ecstatic. They had met at a family barbecue, married, and within two years, Candice was pregnant.
“Candice did everything she was supposed to do. She took her prenatal vitamins, she ate right and we made every doctor’s appointment,” Randy said.
But the pregnancy did not go well. Candice went into labor three months early, and gave birth to a 1.11-pound baby girl.
She lived for eight days. The Reeses were grief-stricken. Making it worse, they didn’t understand why their baby had been born so early.
Sitting close together on the family room couch recently, they recalled their first-born.
“We named her Nevaeh,” said Candice. Nevaeh is “heaven” spelled backwards. Her middle name was LaJoy. “Randy came up with that. Heavenly Joy. I can’t imagine a more beautiful name!”
“She was so small, she looked just like a little doll. She had your beautiful skin color,” Randy said to Candice.
She smiled. Looking at his face, she said, “She had your nose.”
These days, the Reese family room is alive with the sound of their two little girls. Eight-year-old Erica, who was adopted, and seven-year-old Alicia, born after Nevaeh, are singing a song about spiders.
“If my sister was alive she would be nine. She was so tiny! But she’s my big sister,” said Alicia. Their middle names are Nevaeh LaJoy, “...so that Nevaeh is still part of them,” Randy said. “Never to forget.”
When Nevaeh died, the Reeses did not know that there were many other African-American families experiencing the same loss. But since then, they have learned more.
Randy believes that Collins’ work is on the right track. “Being treated differently because of race is obviously an issue in my mind. Candice wasn’t a single mom who couldn’t afford health care. We’re African-American professionals living in the ‘burbs! But stress from intolerance is definitely an issue. When you’re African-American you constantly have to justify your position.”
But Candice is not so sure. “I grew up in Montbello surrounded by people who look like me. I’d still like to see more research. There’s a reason this is happening.”
Beam has continued her drive to solve the problem by helping to form Aurora Healthier Beginnings, which provides help before and after birth. The Nurse-Family Partnership of Colorado provides similar services statewide.
Advice for would-be mothers:
- Plan the pregnancy, get healthy, take vitamins, quit smoking and drinking.
- Get pre-natal care
Source: Tri-County Health Department nurse Rita Beam
Three top causes of infant death:
- Birth defects
- Premature birth/low birth weight
- Sudden Infant Death Syndrome (sudden death of undetermined cause)