A groundbreaking new analysis of two million births indicates that rich Black women and their babies are twice as likely to die in the year after childbirth compared to their white counterparts.
According to The New York Times, nearly all the infants born to two million first-time moms between 2007 and 2016 in California, the state with the highest annual birth rate, are included in the study, released last month by the National Bureau of Economic Research.
The babies born to the wealthiest Black women, or those in the top 10% of earners, tended to have higher risk factors than those delivered to more affluent white women. Black babies also had more risks than those born to the poorest white mothers — an indication that Black mothers and their newborns suffer harm before childbirth, regardless of socioeconomic background.
“It suggests that the well-documented Black-white gap in infant and maternal health that’s been discussed a lot in recent years is not just explained by differences in economic circumstances,” said economist Maya Rossin-Slater, an author of the study, according to The Times. “It suggests it’s much more structural.”
Research has consistently shown that Black mothers and babies have the worst childbirth outcomes in America. Pregnancy-related deaths among Black women are three times more probable than among white women, and Black newborns are three times likelier to die than whites.
The Kellogg Foundation and others have produced similar findings, noting that despite ongoing improvements in medical treatment, there are still significant racial disparities in maternal and newborn health in the United States.
For example, the foundation said, since the Supreme Court overturned Roe v. Wade, greater impediments to abortion for people of color may make the already significant gaps in maternal and newborn health even more pronounced.
Still, this “landmark” study is noteworthy since it is the first to demonstrate how Black families, regardless of their financial condition, are disproportionately impacted by the dangers of childbirth, according to The Times.
An economist who studies racial disparities in health care agreed with the study’s importance. “This is a landmark paper,” said Atheendar Venkataramani of the University of Pennsylvania, “and what it makes really stark is how we are leaving one group of people way behind.” Venkataramani was not involved in the research.
According to the study, babies born to the 20% of households with the highest incomes are the least healthy. They are more likely to experience preterm delivery and low birth weight — two significant precursors to early-life medical issues — because their mothers are more likely to be older and have twins, sometimes due to fertility treatments.
“As a Black infant, you’re starting off with worse health,” said University of Michigan health economist Sarah Miller, according to The Times, “even those born into these wealthy families.”
Miller, Stanford professors Rossin-Slater and Petra Persson; Columbia’s Kate Kennedy-Moulton, NYU’s Laura Wherry, and Gloria Aldana of the U.S. Census Bureau authored the study.
Rich and poor women were equally likely to have high-risk pregnancies, but poor women were three times more likely to pass away, even in the same facilities. The authors noted that wealthy women’s pregnancies are not just the riskiest but also the most protected.
This study implies that the American medical system can save the lives of many infants with early health problems, but the means to do so may be out of reach for low-income families.
In every health measure the researchers looked at, including whether babies were born early or underweight, whether mothers had birth-related health issues like eclampsia or sepsis, and whether the babies and mothers died, Black mothers and babies fared worse than those who were Hispanic, Asian, or white.
“It’s not race, it’s racism,” said economist Tiffany L. Green from the University of Wisconsin-Madison, The Times reported. “The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”
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