Racism in health care
Staggering death rate for pregnant Black women
By
Monica Moorehead
"Racism ... needs to be studied if we want to understand
health differences between Blacks and whites." This simple but
profound statement was made by Dr. Richard David, associate
professor at the College of Medicine at the University of
Illinois, two years ago at a conference organized by the
Northern New Jersey Maternal Child Health Consortium.
The words ring just as true today.
They appeared in a front-page article in the Aug. 8 New York
Times titled, "Black Mothers' Mortality Rate Under Scrutiny."
The article focused attention on a study released this past
spring by the Centers for Disease Control in Atlanta.
The study was a compilation of statistics exposing the fact
that Black women in the U.S. are nearly four times more likely
to die during childbirth than white women. The numbers include
both poor, working-poor and middle-class Black women.
The statistics speak for themselves.
From 1987 until 1996, one out of every 5,102 Black women
died in childbirth. The number for white women was one out of
every 18,868.
This disturbing disparity has remained relatively constant
over the past four decades. This particular gap ranks among the
highest in U.S. public health. And it comes at a time when the
overall infant mortality rate has decreased.
The factors that make pregnant Black women at high-risk
include hypertension, diabetes and obesity--which are closely
associated with malnutrition and poor diet.
The lack of adequate pre-natal care is tied to the increased
levels of poverty due to President Clinton's eradication of
welfare.
Drug and alcohol abuse, as well as exposure to environmental
toxins and violence, are important factors as well.
All of these conditions have made Black women more prone to
high levels of stress on the job and in their daily lives as
they struggle to survive in a racist and sexist society.
`Off the scale'
Even the U.S. surgeon general, Dr. David Satcher--who is
Black--has spoken out on this issue. He stated that "the
disparity is important... If we were comparing Black women in
this country with women in Tanzania, we would be talking about
how great we are doing. We are not.
"In this country, we have a certain standard of expectation
about the risk of women in pregnancy, and Black women are off
the scale right now."
No other city has felt this crisis more profoundly than
Washington, D.C.
D.C. is truly a tale of two cities. One part of the city is
home to the administrative branch of U.S. imperialism, while
the other part is home to a deeply impoverished and colonized
African American community.
At D.C. General Hospital, the city's largest public health
facility, three quarters of pregnant Black women are classified
as high risk. It is no wonder that the mortality rate of Black
mothers there is the highest in the entire country.
The mortality rate of Black mothers cannot be separated from
the mortality rate of Black infants.
Black infants are two-and-a-half times more likely to die
before the age of 1 than white infants. The CDC estimates that
by the year 2000, the rate will climb to three times as high.
In the poorer neighborhoods, the rates are even more
astronomical.
The Black infant mortality rate in the U.S. is the highest
among the most industrialized countries, and is even higher
than some developing ones.
For example, the ratio of infant mortality in Washington is
twice that of socialist Havana, Cuba. Seventy-nine countries
have a/ lower infant mortality rate than Harlem, according to
Harper's Index.
Health care: Who can afford it?
Cutbacks in health care, especially in the poorer
neighborhoods, have had a devastating impact.
There has been a general policy of closing down hospitals in
the inner cities. In Chicago alone, 10 hospitals have been shut
down recently--all in Black and Latino neighborhoods.
In the remaining hospitals, access to care has been severely
reduced. In Cook County Hospital, with a clientele that is 90
percent people of color, the waiting period for an appointment
can be upwards of six months.
Local private hospitals use a policy called "patient
dumping" whereby huge numbers of patients who come through
their doors without health insurance are transferred to Cook
County--no matter how severe the health problem may be.
Another study, released this spring, concluded that the
Special Supplemental Nutrition Program for Women, Infants and
Children (WIC) and Medicaid helped to reduce infant deaths.
Dr. Karen P. Carver from Penn State stated, "WIC and
Medicaid have helped poor women reduce infant mortality on two
levels. First, WIC and Medicaid participants have lower infant
death rates associated with pregnancy and delivery.
"Second, WIC participation by mothers is beneficial for
infants at risk of death due primarily to environmental or
external causes, including infectious and contagious diseases
and accidents."
The vast majority of women participating in the WIC program
are African American, young and very poor. While the WIC
program has remained intact for the moment, millions of single,
poor women and their children lost their Medicaid coverage when
they were eliminated from the welfare rolls.
The U.S. health care system is a vital institution riddled
with racism. The only concern of this profit-driven industry is
to rake in billions of dollars. Health care under capitalism is
creating a genocidal crisis for millions of people.
Only a social revolution can assure that health care can be
a right for all and not just a privilege for those who can
afford it.
This article is copyright under a Creative Commons License.
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