InfantMortality Disparities among African Americans
InfantMortality Disparities among African Americans
AfricanAmericans otherwise known as Black Americans are American citizenswith African ancestry. They form the largest racial minority in theAmerican society. Majority of them moved to the United States in theslavery era mainly from west and central African, there are AfricanAmericans from other parts of Africa. It is estimated that AfricanAmericans constitutes more that 13 percent of the total Americanpopulation. Although there are numerous health issues affecting theAfrican American population, the high levels of infant mortalitycompared to the general population in the United States is one of themost important concerns. African Americans are struggling with drugabuse, obesity and diabetes among other serious health problems(Darlene, Rosalyn & Elsa, 2009). While they are genuine healthconcerns, the prevalence and seriousness of the health problems isnot as wide compared to infant mortality. Different studies haveindicated that the infant mortality rate in the United States isrelatively higher compared to other developed countries. Moreover,some less developed countries with less sophisticated health caresystems and technologies have a lower infant mortality rates comparedto the United States. For example, the infant mortality in the UnitedStates is higher than countries such as Japan, England, Greece,Canada, Italy and Cuba among others. The overall rates of infantmorality in the United States are above 25 percent higher compared tothe statistics in the European Union. Although the numbers of deathsper 1000 births have reduced from over 250 deaths in the mid 20thcentury to about six deaths, the mortality rate is relatively high.The statistics are alarming when the rate among African Americans isconsidered (Osel, 2008).
Studieson infant mortality rates in the United States indicate that AfricanAmerican infants’ mortality rates are more than twice the rate inthe general population. Although there has been huge decline ininfant mortality rates over the last two to three decades, thedisparities among different racial and ethnic groups has beenpersistent. For example, in the mid 1980s, statistics indicated thatthe number of deaths per 1000 births was about 18 deaths among theblack Americans. This was relatively high compared to the figures ofabout nine deaths per 1000 births among other racial groups in theUnited States. Despite the decrease in the number of deaths per 1000deaths due to improvement in maternal, prenatal and child heath care,the disparity has been persistent (Osel, 2008).
Thereare several studies that have been carried out to identify the maincause of the huge racial disparity in infant mortality rates. Thishas been done through identification of the infant mortality riskfactors across the population. There are several race specificfactors that have since been identified. The risk analysis indicatedthat infant mortality risk among black infant was twice that of whiteinfants. There are three factors that can be considered to be themain cause of the disparity. Statistics from the health recordsindicates that compared to white infants, black infants are morelikely to have low birth weight. Statistics indicated that blackinfants were three times more likely to have a birth weight of lessthan one and half kilograms compared to white infants. Additionally,they were twice more likely to weight between one and half and twoand half kilograms (MacDorman & Mathews, 2009). Medicalpractitioners have established that the birth weight is one of themost important determinants of the likelihood of survival. The lowbirth weight among the African American infants is the major factorcontributing to the high mortality rates. However, it is moreimportant to look at the factors that cause the low birth weightamong African American infant. They include demographic, cultural,medical, and behavioral factors. It is also important to note thatalthough the birth weight related factors are important, there areother important factors that contribute to high mortality rate amongAfrican American infants. Studies indicate that when African Americanand white infants with the same birth weight are considered, themortality rate is higher among African American infants compared tothe white infants (Mustillo et al, 2004).
Evidencebased practices indicate that African American infants have highermortality rates not because they are genetically inferior. Somestatistics have indicated that African Americans infants could havehigher survival rates compared to other races, especially if bornimmature. Despite these, the disparity in mortality rates isalarming. Over the last few years, the infant mortality rates amongAfrican Americans babies has been reported to be hovering about 14deaths per 1000 births. This is significantly high compared to thenational average of below six deaths per 1000 life births. The infantmortality rates among the Asian American infants is below 4 deathsper 1000 births while white Americans have recorded mortality ratesbelow six deaths per 1000 births. Despite being a minority race inthe United States, which has faced similar racial discrimination withthe blacks in the recent past, the infant mortality rates amongHispanics Americans is below six deaths per 1000 deaths (Spong et al2011).
Thehigh mortality rates among African American infants are not a newphenomenon. It can be traced back to the slavery era. During thesalivary era, the rate of death among African American infantstogether with the Native Americans was significantly high. However,while infant mortality rate among Native Americans has improvedsignificantly, the rate among the black Americans have not improvedrelative to the national average. Additionally, rate of survivalamong black infants born of foreign black mothers is higher comparedto the native born black mothers. In the case of foreign bornparents, infant mortality rates increases in the subsequentgenerations. This suggests that while there are some cultural factorsthat increase the risk of death among infants, there are some racistinduced factors, which play a major role. Majority of recent studieshave linked the high infant mortality rates to the stressors relatedto racism which have characterized the lives of blacks in theAmerican society. Although several other racial groups have sufferedsome form of racism and discrimination in the United States, theblacks have been worst affected. The effects of the slavery era andthe Jim Crown segregation laws are very evident in the black Americansociety. Although there is no formal discrimination against theblacks in the American society, the informal racial disparities inemployment, health care accessibility and income are very evident.These factors have a direct impact on impacts of the prenatal healthof the mother, infant health and consequently the infant mortalityrate (Mustillo et al, 2004).
Itis important to note that majority of African Americas have theircultural roots from Africa. Although the infant mortality rates inAfrica is relatively high, reaching 100 deaths per 1000 life birthsin some countries, it can be linked to the high mortality rate amongblack infants in the United States. As stated earlier, the highmortality rate in not as a result of inferior geneticcharacteristics, but cultural, social, economic and medical factors.The big variance between the African Americans infant mortality ratestatistics and the statistics in the African countries is partly dueto the superior medical care system in the United States. However,the African Americans and their counterparts in African have culturaland social settings similarities. Some of these social factors may bea major contributor to the disparities among blacks and other racesin the United States. For example, in the African society, there is ahigh level of prejudice against women, including pregnant women. Thisresults into poor maternal health which has a direct impact on theinfant health and survival. Other social and cultural factors such asthe high prevalence of male child and the role of men or fathers onthe mother and child’s health is also a contributor to the highmortality rates. These social and cultural factors have been observedin some African American societies in the United States. There alsocultural characteristics, lifestyles and habits among AfricanAmericans which contribute to high mortality rates but are not linkedto their African heritage (Fuse & Crenshaw, 2006). For example,the increased cases of teenage pregnancies, obesity, alcohol andother drugs abuse and diabetes among African Americans is animportant cause of poor maternal health and high mortality rates.Some of these factors explain why improved financial and economicconditions among African Americans society does not decrease theinfant mortality rates (Spong et al 2011).
Darlene,C., Rosalyn, T. & Elsa B. (2009). BlackWomen in America: An Historical Encyclopedia, PaperbackEdition, Indiana University Press.
Fuse,K & Crenshaw, E.M (2006). "Gender imbalance in infantmortality: A cross-national study of social structure and femaleinfanticide". SocialScience & Medicine62 (2): 360–374.
MacDorman,M. F. & Mathews, T. J. (2009). "The challenge of infantmortality: Have we reached a plateau?” Publichealth reports124 (5): 670–681.
Mustillo,S., Krieger, N., Gunderson, E. P., Sidney, S., McCreath, H., Kiefe,C. I. (2004). "Self-reported experiences of racialdiscrimination and Black-White differences in preterm andlow-birthweight deliveries: The CARDIA Study". Americanjournal of public health94 (12): 2125–2131.
Osel,J. D. (2008). "Being (Born) Black in America: PerceivedDiscrimination & African-American Infant Mortality". SSRNElectronic Journal.doi:10.2139/ssrn.2173553
Spong,C. Y., Iams, J., Goldenberg, R., Hauck, F., & Willinger, M.(2011.) "Disparities in Perinatal Medicine: Preterm Birth,Stillbirth, and Infant Mortality." Obstetrics& Gynecology. Volume 117, Issue 4, pp 948-955.