By Andrew Malekoff
In a report issued by Nassau
County’s Department of Health - Community
Health Assessment and Community Health Improvement Plan (2016-2018) – there
is no mention of maternal mortality or information on social and environmental
risk factors for women and infants of color. Consequently, no initiatives to
address maternal and infant mortality disparities are recommended, yet overall
Nassau County health data indicates that it ranks at the top of all counties in
New York State.
To address this “invisible
injustice,” maternal and child health advocates convened at Hofstra University
on March 23, 2018 for a Birth Equity
Breakfast organized by the Nassau County Perinatal Services Network.
Birth equity refers to the
assurance that all human beings have the best possible births, buttressed by
careful attention to racial and social disparities.
Keynoter Dr. Martine Hackett,
assistant professor at Hofstra University’s School of Health Professions and
Human Services, presented data from the NYS Department of Health that showed
the disparate outcomes for Black mothers and babies as compared with their
White counterparts.
Infant mortality refers to
the death of children before their first birthdays, which is a key indicator of
the overall health of a population. According to the United Nations
International Children’s Fund (UNICEF), Japan is the number one ranked country
for newborn survival, while the United States ranks only 22nd in the world.
Among the eye-opening data
that Dr. Hackett cited are the differences between the infant mortality rates
in contiguous communities in Nassau County. For example, in Roosevelt there
were 11.1 infant deaths per 1,000 births from 2012-2014, while neighboring
Merrick had zero deaths. Overall, in Nassau County the Black infant mortality
rate is more than four times that of the White infant mortality rate and even
higher than in New York City.
Dr. Joia Creer-Perry, President
of the National Birth Equity Collaborative, spoke about the perception of
Black mothers and the barriers to receiving holistic care by the health care
system. If a woman is living under great stress she will have trouble carrying
her baby to term. Premature birth to underweight babies is a leading cause of
infant mortality.
Social justice activist and
attorney Fred Brewington condemned the institutional racism prevalent in
healthcare that has resulted in infant mortality figures today that are no
different than they were almost a century ago.
Just weeks after the Birth
Equity Breakfast, Tasha Portley, a nurse living in Tyler, Texas, spoke at a
similar forum halfway across the U.S. In a report published in the April 16th
edition of the Tyler Morning Telegraph,
Portley stated that “Pregnant Black women often experience casually degrading
remarks from White people when they seek maternal health care.”
Portley shared the story of a
Black woman who had some difficulty acquiring a breast pump from a local social
services agency and, in the process, was the target of demeaning remarks by an
employee. Portley went on to say, “We are dying because we are Black and we are
living in a country where there is inherent racism. It is systemic. It is the
thread; it is the fiber of everything that exists.”
Dr. Hackett highlighted what
needs to happen in order to turn the corner on disparities in Nassau County.
Among her recommendations were to inform women after childbirth of warning
signs for hemorrhage, embolism or infection, especially when there are
preexisting conditions; to enhance service integration for women and infants;
and to treat women of color with dignity, respect and culturally relevant care.
Bringing birth inequities to
light is an important step forward. When this issue is not identified in Nassau
County health data, people don’t know about it and it cannot be addressed. The
breakfast concluded with the unveiling of the Birth Justice Warriors, an
initiative envisioned by Dr. Hackett, to train birth advocates with the hope of
ameliorating the birth inequities in Nassau County.
Published in the Long Island Weekly in May 2018
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