Revolution #87, May 6, 2007
Deadly Inequality: Behind the Rise in Black Infant Mortality
Now 21 years old, Krystal Allen of Hollandale, Mississippi, was 17 when she had her first baby. When the baby was four months old, he developed breathing problems, and Krystal took him to the emergency room. The hospital gave him antibiotics and a vaporizer and sent them home, where they went to sleep. Krystal remembers, “When I woke up I thought he was sleeping, and I was getting ready for church. But he was dead.”
In Detroit, 26-year-old Sparkle Ruffin, a telephone company worker, had regular prenatal care, but her baby was born three and a half months before her due date, weighing only one pound. Sparkle remembers, “She passed when I was holding her.”
Cheryl Fields lives in the Alice Griffith housing projects in San Francisco’s Bayview-Hunters Point neighborhood. She suffered from preeclampsia, an illness that affects pregnant women. She was so sick at the end of her sixth month that doctors had to deliver the twins with a C-section, even though they were too small to survive. Cheryl remembers, “My son lived two hours. My daughter lived an hour.”
Each of these women went through their own pain and sorrow as they lost their babies so soon after birth. But these are not isolated stories—they are part of a horrendous pattern of the high number of Black infants that die early compared to the number for white infants.
According to the most recent national statistics, in 2003 the Black infant mortality was 13.6 per 1,000 births—almost 2.5 times higher than the rate of 5.7 for whites. The overall rate for infants of all nationalities was 6.9. (U.S. government statistics, online at childstats.gov/ americaschildren/hea7.asp)
The “infant mortality rate” is the number of babies who die before their first birthday for every 1,000 live births. So the Black-white disparity in the infant mortality rates in the U.S. means that 13 to 14 Black babies out of every 1,000 do not even make it through their first year, as compared to between 5 and 6 white babies out of every 1,000 that die before age 1.
The Black infant mortality rate is not only outrageously high, comparable to the rates in some poor Third World countries, but that rate is climbing, especially in the South but in other parts of the U.S. as well.
The Rising Infant Death Rate in Mississippi
In Mississippi and nearby states with large Black populations, the rate of infant death has been rising sharply in recent years after a period of improvement. The mortality rate among infants of all nationalities rose from 9.7 in 2004 to 11.4 in 2005. The rise reveals the deadly effects of the cuts in government funds on the lives of the poor.
In 2005 and 2006, for example, the number of non-elderly people covered by Medicaid, and of kids under children’s health insurance programs in Mississippi dropped by 54,000. The southern regional director of the Children’s Defense Fund told the New York Times in a recent article, “When you see drops in the welfare rolls, when you see drops in Medicaid and children’s insurance, you see a recipe for disaster.” (“In Turnabout, Infant Deaths Climb in South,” April 22, 2007)
While the rise in the overall infant mortality rate is alarming, the rise in the death rate among Black babies is truly devastating. Infant deaths among Blacks in Mississippi rose from 14.2 per thousand in 2004—already much higher than the national rate—to 17 per thousand births in 2005.
There were also smaller increases in Black infant mortality rates in Alabama, North Carolina, and Tennessee in 2005, and in Louisiana and South Carolina in 2004.
There are some who try to blame Black women themselves for the rising number of deaths among their infants. The NY Times article mentioned above, for example, quotes an obstetrician at a private clinic in Clarksdale, Mississippi, who says, “I don’t think there’s a lack of providers or facilities. Some women just don’t have the get up and go.” An article in the Detroit News (“Health Gap Threatens Detroit Babies,” 12/19/04) blamed “behaviors” in some women, like “not taking the initiative to get public assistance” or “eating poorly.”
This is the same kind of argument that has been used to put down Black people and justify their enslavement and other forms of oppression throughout their history in America. It’s an attempt to put the blame on Black people themselves for their terrible conditions of life. In reality, what the rise in infant mortality rates shows is that these conditions are not the fault of the people themselves but arise from the way society is organized and run.
In a letter to the editor in the New York Times (April 26), H. Jack Geiger, M.D., a founding member and national coordinator of the Medical Committee for Human Rights, noted that when he and his colleagues started a community health center in the Mississippi Delta in the 1960s, the estimated Black infant mortality rate in the area was close to 60 per 1,000 live births. Dr. Geiger points out, “The causes were abysmal poverty, wide unemployment, crumbling shacks, outright malnutrition, contaminated water and lack of transportation.” When these conditions were addressed, and desperately needed health care was provided, the infant mortality rate dropped sharply.
But, Dr. Geiger notes, “Those causes persist, now worsened by deep cuts in Medicaid and welfare.” And he adds, “The consequences of shredding the social safety net is more dead black (and white) babies. No health services can overcome the effects of social policies that devastate the lives of the poor… We should be enraged, and ashamed, that these preventable excess deaths continue, and increase, among us.”
A Problem Affecting Black People Generally
The outrageously high (and increasing) Black infant mortality rates in Mississippi and neighboring states reveal the ugly legacy of slavery and Jim Crow in the South. But this is also a problem that affects Black people throughout the U.S. Some examples:
• In Detroit, 17 out of every 1,000 Black infants die before they are 1 year old, according to state health statistics for 1998-2002. This is almost 3 times the rate for white infants born in Detroit. The rates are even higher in some other places in Michigan—like in Oakland County, where Black babies are four times more likely to die than whites before reaching their first birthday.
• In Massachusetts, Black babies die at a rate three times higher than white babies, according to a 2005 report from the state Department of Public Health. In 2003, the most recent year covered in the report, the mortality rate for Black infants was 12.7, compared to 4.1 for white infants. The Boston Globe noted in reporting on these statistics, “A tinderbox of poverty, racism, and chronic disease fuels the gap in infant mortality rates, a health measure long regarded as a bellwether of a nation’s commitment to social well-being, maternal health specialists said yesterday.” (“Disparity Persists in Black Infant Mortality,” 4/20/05)
• The Bayview-Hunters Point neighborhood in San Francisco was for decades a predominantly Black area, but now there are many Latino and Asian/Pacific Islander people living there also. This is the poorest area in the city—a third of the children younger than 5 here live below the official poverty line. San Francisco overall has one of the best infant mortality rates among large cities in the U.S. But the infant mortality rate in Bayview-Hunters Point, 11.8 per 1,000 births, is 2.5 times higher than for the rest of the city. And of the 66 babies less than a year old that died in this neighborhood between 1992 and 2001, 43—or 65 percent—were African American.
The high rate of infant mortality doesn’t just affect the poorest Black women and families—African American women who have steady jobs or are in the middle class also suffer from this problem. According to various researchers, professional/middle class Black women have two to three times higher risk of having babies with low birth weight—the top cause of early infant deaths—compared to white women. Babies with low birth weight are 17 times more likely to die than babies weighing at least 5.5 pounds at birth. And underweight babies, even if they survive, are more likely to develop heart problems, respiratory disease, and other serious health problems later in life.
What accounts for this disparity? A study published in 2004 in the American Journal of Public Health reported that women—of any class background—who experienced high levels of racial discrimination were almost five times more likely to deliver low birth weight babies than women who have not experienced racial discrimination.
According to an article in the San Francisco Chronicle (“Too Young to Die,” 10/3/04), some medical researchers looking into black-white differences in infant mortality are focusing on “the grinding stress—from factors like segregation and racism—that blacks may face over a lifetime.” The Chronicle noted that in a 2003 study, UCLA professor Michael Lu “suggested that research should look at the stress a mother experiences during her whole ‘life-course,’ beginning with her own development in the womb, or even stretching back to encompass the intergenerational effects of the stress her grandmother may have experienced. He cited studies showing that mothers who were themselves born at low birth weights are much more likely to give birth to low-birth-weight babies.”
All this points to the fact that the problem of the high rate of Black infant mortality is not fundamentally caused by individuals “acting irresponsibly,” but is tied in to the whole historical and present-day oppression weighing down on Black people as a whole.
The “Health Gap” and Systematic National Oppression
The Black-white difference in infant mortality rates is one aspect of the more general “health gap” between African Americans and whites in the U.S. To cite a few examples: Black people have a 25 percent higher cancer death rate than whites. Around 40 percent of African American men and women have some form of heart disease, compared to 30 percent of white men and 24 percent of white women. The rate of diabetes among Black people is twice as high as among white people. More than 54 percent of HIV/AIDS cases diagnosed in 2002 were among African Americans, who are 10 times more likely to die of AIDS than whites. (Health and Human Services statistics from 2005, omhrc.gov)
And this “health gap” in turn is part of the overall, systematic oppression of Black people in this country. The U.S. rulers boast of the “freedom and prosperity” in this country. But this is a system based on their “freedom” to brutally plunder, exploit, and suppress the people of the world—a system which couldn’t exist the way it is today without the barbaric exploitation of Black people under slavery, then after slavery through the plantation sharecropping system, the Jim Crow segregation that followed, down to the continuing oppression of Black people after legal segregation was largely overturned. And that national oppression is in many ways intensifying today—with the increase in Black infant mortality in Mississippi and other areas as one glaring and intolerable example.
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