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Katlyn Carter
In preparing to write a paper requiring use of one identity category and two distinct
markers of maternal-child health, I thought about what numbers have been most surprising to me
thus far in my journey into cultural competency. First, and foremost, I have been surprised and
horrified to look at the data surrounding the data involving black infant mortality, specifically in
the article written by Fleda Mask Jackson (2007) titled Race, Stress, and Social Support:
Addressing the Crisis in Black Infant Mortality. Choosing to look further into whats going on
When choosing the two markers of maternal-child health, I found myself curious about
how the stress that Ms. Jackson (2007) describes is effecting African American infants
birthweights. In thinking about birthweights, I began wondering how breastfeeding was going in
In my review of McKinney, et al. (2016) article titled Racial and Ethnic Differences in
Breastfeeding, I wasnt surprised at what I found. Data was collected from 3 different locations
in the USA: Baltimore, Maryland, Washington D.C., and Lake County, Illinois. This specific
study looked at the breastfeeding outcomes in white, black, Spanish, and English speaking
Hispanic women of low socio-economic status. The data (from 2012) found the initiation rates
of breastfeeding in black women were 66.4% compared to 83% in white women (McKinney, et
al. 2016). The black women in this study had the lowest rates of intention to breastfeed and the
lowest rates of initiation. McKinney, et al.s study explained the rates by increased poverty,
reduced educational attainment, and low marital status. I feel it is important to add the highly
BREASTFEEDING AND LOW BIRTHWEIGHTS 3
varying rates of introduction of infant formula to black mothers (76%) compared to that of white
David, Handler, Wall, and Andes titled Very Low Birthweight in African American Infants: The
performed a study including 104 African American women who delivered very low birthweight
infants (less than 1500 grams or 3.31 lbs.) preterm and 208 African American who delivered
non-low birthweight infants (greater than 2500 grams or 5.51 lbs.) in Chicago, Illinois (Collins,
et al., 2004). They concluded that, The lifetime accumulated experiences of racial
discrimination by African American women constitute an independent risk factor for preterm
delivery (Collins, et al., 2004). African American babies can be very low birthweight because
they are born prematurely which can be influenced by stress. Infant birthweight is a main
determining factor of infant mortality risk (Collins, et al., 2004). Something else I found very
interesting was that in the US, foreign-born black women have considerably lower preterm birth
One of our class readings titled Reducing Health Disparities by the American College of
Nurse Midwives, discusses the disparities in infant mortalities between privileged and deprived
communities. The American College of Nurse Midwives go on to say, For African American
women, the lifetime of and generational exposure to institutional and interpersonal racism have
been shown to affect pregnancy outcomes such as birth weight, as well as other health conditions
(2007). There is a low birthweight gap that ranges from 13.4% in African American infants to
We have a long way to go in closing the massive gap in outcome among communities
and improving the health of women and their families. I believe we have organizations in place
who are working in the right direction. In the preface to Ms. Jacksons 2007 article, Ralph B.
Everett talks about the work of the Courage to Love: Infant Mortality Commission (part of the
larger effort by the Joint Center Health Policy Institute), whose mission is to ignite a Fair
Health movement that gives people of color the inalienable right to equal opportunity for
healthy lives. The American College of Midwives whole-heartedly endorses efforts to improve
the health of women and most especially of those women at greatest risk for poor health
outcomes (2007). These groups and their missions (and many others!) give me hope that we
References
American College of Nurse Midwives. (2007) Issue Brief: Reducing Health Disparities. Silver
Collins, J. W., David, R. J., Handler, A., Wall, S., & Andes, S. (2004). Very Low Birthweight in
Jackson, F. M. (2007). Race, stress, and social support: Addressing the crisis in black infant
mortality.
McKinney, C. O., Hahn-Holbrook, J., Chase-Lansdale, P. L., Ramey, S. L., Krohn, J., Reed-
McKinnon, B., Yang, S., Kramer, M. S., Bushnik, T., Sheppard, A. J., & Kaufman, J. S. (2016).
Comparison of blackwhite disparities in preterm birth between Canada and the United
http://doi.org/10.1503/cmaj.150464