Social Determinants of health
September is Infant Mortality Awareness month and on Saturday, September 24, 2016, Mamas on Bedrest & Beyond and her supporters will walk from Seton Medical Center in Austin to The Dell Seton Medical School at the University of Texas to raise awareness of Black Infant Mortality. Why are we walking?
From 2000 to 2013, The National Vital Statistics Report shows the infant mortality rate (IMR) declined nationally, yet there remains a persistent 2—3 fold disparity in IMR of black infants compared to their white and hispanic counterparts. Texas follows this trend with an IMR of 5.8 overall in 2013. But looking at specific data from the Texas Department of Health and Human Services for 2013, while the overall IMR was 5.8 deaths per 1000 births, the IMR of black infants statewide was 11.9 deaths per 1000 births. The picture gets even gloomier if we look at Travis County. In 2012 (the last year for which data has been compiled) the IMR for black infants was 13.6 deaths per 1000 births, 2.85 times the death rate of white infants. In 2013, the disparity ratio for IMR of black infants to all infants in Texas was 3.02, or black infants are 3.02 times more likely to die before their first birthday than infants of other races here in Travis County.
Austin/Travis County is the state capital and one of the wealthiest counties in the state. Yet since 2000 Austin/Travis County has failed in its attempts to improve birth outcomes and survival rates for black infants to match those of infants of other races. The IMR for 2013 actually represents an increase in IMR from previous data.
The Call to Action
We believe that an IMR of 6.0 deaths per 1000 or less is attainable for black infants in Travis County, just as it has been attained for infants of other races. Here are 6 steps we could initiate to make this possible:
- Strongly encourage the Texas Legislature to take the Medicaid Expansion funds allotted for the state by the Affordable Care Act. This alone would insure another 1.3 million Texans, many of them women and infants, and give more access to comprehensive prenatal care, post natal and pediatric care.
- Work to increase the number of black health care providers (physicians, nurses, midwives, lactation consultants, childbirth educators and community health workers) in Austin/Travis County.
- Include members of the black community in the conversation about Place Based health initiatives and new treatments (like 17P for the prevention of preterm labor) so that they can make informed decisions about their health care, help educate members of the community and increase utilization.
- An aggressive community outreach campaign which includes community gatherings for conversations, presentations at churches and other community venues and even door to door health information and health education efforts by members of the community.
- Educate and elevate. Black citizens in Travis County are not looking for a handout, but a hand up. When information is presented in a clear and understandable way, people are more receptive, more apt to listen and more likely to act.
- Support initiatives that will help restore the infrastructure in the black community such as improved schools, jobs, affordable housing, safe and affordable childcare, additional security, public transportation and grocery stores.
What are you doing to raise awareness about Black Infant Mortality? Share your thoughts and events in our comments section below.
For more information about our walk or to get involved, e-mail us at firstname.lastname@example.org
The National Vital Statistics Report, Volume 64, Number 9. August 6, 2015
The Office of Minority Health and Health Equity, Infant Mortality for the State of Texas and Travis County
As Black Breastfeeding Week wraps up, I am pleased to share with you an infographic that I helped to develop. Hope it helps you have get the vital information you may need to breastfeed!!!
Black Breastfeeding Week is August 25-31, 2016. Many may be asking, if August is Breastfeeding Awareness Month and August 1-6 was World Breastfeeding Week, why is there a need for a Black Breastfeeding Week???
According to organizers Kimberly Seals Allers, Kiddada Green and Anayah Sangodele-Ayoka,
“Black Breastfeeding Week was created because for over 40 years there has been a gaping racial disparity in breastfeeding rates. The most recent CDC data show that 75% of white women have ever breastfed versus 58.9% of black women. The fact that racial disparity in initiation and an even bigger one for duration has lingered for so long is reason enough to take 7 days to focus on the issue.”
And the organizers cite 5 specific reasons a Black Breastfeeding week is essential:
- The High Black Infant Mortality Rate
- High Rates of Diet Related Disease in African Americans
- Lack of diversity in the lactation field
- Unique cultural barriers among black women
- Desert-like conditions in our communities
If you ask any black breastfeeding expert what are the top barriers to breastfeeding for black women, they will reply:
- The historical role of black women as “wet nurses” to white (slave owner’s) children
- The perception by many black people that breastfeeding is “dirty” or “nasty” (the result of #1)
- The aggressive campaign by formula companies who capitalized on the notion that “poorer women” breastfeed and modern women of means used formula.
- Hospitals that serve primarily black patients have been shown not to offer the same level of support and education for breastfeeding initiation to black women
- Few professional black lactation consultants
- The lack of support from family members for breastfeeding
It has to be recognized that breastfeeding has very different implications for black women than for white women and lactation consultants trying to counsel black women to breastfeed must be aware of the cultural history of breastfeeding for black women. They need to be aware of the fact that many black women have no breastfeeding role models as their mothers, grandmothers, sisters and aunts may not have breastfed their babies. Without the family tradition of breastfeeding, and the history of the “mammy” wet nurse, many black women lack breastfeeding support and encouragement from their families and are not eager to breastfeed themselves. Many black women work at jobs where they may not be able to take time to nurse or pump, nor do they have a private place to nurse or pump at work. For these reasons in particular and many others, it is imperative that more black women become trained as lactation consultants. Certification to become an Internationally Board Certified Lactation Consultant (IBCLC), the top credential for lactation consultants, is such a rigorous and expensive endeavor, and many black women who want to become certified state they cannot afford to undertake the process.
So while there are many challenges that face black women who choose to breastfeed and Sellers, Greene and Sangodele-Ayoka-like many other black women who are well versed in the benefits of breastfeeding for back women-have taken it upon themselves to create an organization that promotes breastfeeding and where they can provide information, education, support and resources for black women who want to breastfeed.
In counseling black women to breastfeed, highlighting the benefits of breastfeeding is a potent motivator. Breastfed babies are:
- Less likely to have allergies and asthma
- Less likely to have upper respiratory and ear infections
- Less likely to have weight problems as adults
- Less likely to develop Type 2 Diabetes
- Able to self soothe/are less fussy
- Have less stomach upset (and less incidence of Necrotizing Enterocolitis)
- May have increased intelligence
- Less likely to die from Sudden Infant Death Syndrome (SIDS)
And breastfeeding greatly benefits Mamas, Too!
- Mamas who breastfeed tend to return to their pre-pregnancy weight sooner
- Mamas who breastfeed experience decreased incidences of breast and ovarian cancers
- Mamas who breastfeed experience decreased incidences of Type 2 diabetes
Before being brought to this country as slaves, black women successfully breastfed their babies. Unfortunately, the legacy of slavery and many current socioeconomic and cultural barriers have made breastfeeding a difficult process for many mamas. It is imperative that these barriers be eliminated and that the education, support and resources be made available so that black mamas and their babies can reap the many life enhancing benefits of breastfeeding.
My Breastfed babies then…..