Introduction
Finding structural racism and disparities in physical ability is essential to ensure access to health care for all. To achieve equity in health, everyone must have an equal opportunity to reach their full physical potential. Racial equity in health care means that no one is prevented from reaching their full physical potential because of race. Our group’s work highlights the problem of racism in healthcare, namely the difference in maternal and infant mortality across communities in the United States.
Racism in Healthcare: Maternal and Infant Mortality in the United States
Health disparities between white and non-white communities are due to long-standing, deep-seated racism that has led to unfair systems, policies, and practices that reinforce barriers to opportunity. Racism hinders health, wealth, security, opportunity, employment, education, and a clean and healthy environment. The maternal mortality rate among black non-Hispanic women was 3.55 times higher than that of white non-Hispanic women (MacDorman et al., 2021). In addition, racial/ethnic and socioeconomic differences largely influence postneonatal infant mortality, with an average difference of 2.5–3 times (Singh & Yu, 2019). Thus, eradicating racism in the health care system will primarily affect the increase in the birth rate and the decrease in mortality. In this regard, the article’s purpose is to compare the mortality rate of infants and mothers depending on race/ethnicity.
Evidence Summary
Article 1
Reference
MacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and ethnic disparities in maternal mortality in the United States using Enhanced Vital Records, 2016‒2017. American Journal of Public Health, 111(9), 1673–1681.
Purpose, Hypothesis, Study Question(s)
The study proposes to re-examine the racial and ethnic disparities in maternal mortality in the US to identify the leading causes of maternal death by race and ethnicity and the specific causes of death that contributed most to racial and ethnic disparities.
Variables: Independent(I) and Dependent(D)
I – Race and ethnicity
D – Maternal mortality
Study Design
Quantitative
Sample Size & Selection
Analysis of mortality data by state bodies of vital statistics for 2016-2017.
Data Collection Methods
Analysis of data
Major Finding(s)
Among confirmed maternal deaths, the maternal mortality rate for non-Hispanic black women was 3.55 times higher than for non-Hispanic white women in 2016–2017.
Article 2
Reference
Singh, G. K., & Yu, S. M. (2019). Infant mortality in the United States, 1915-2017: Large social inequalities have persisted for over a century. International Journal of Maternal and Child Health and AIDS (IJMA), 8(1), 19–31.
Purpose, Hypothesis, Study Question(s)
This article aims to document the extent of social inequality by estimating the educational gradient in infant mortality for the entire population and for major racial/ethnic groups in the United States.
Variables: Independent(I) and Dependent(D)
I – Inequality of different age groups
D – Infant mortality
Study Design
Quantitative
Sample Size & Selection
Log-linear regression and inequality indices.
Data Collection Methods
Data from the National Vital Statistics System and the National Linked Birth/Infant Death (1915-2017).
Major Finding(s)
Social disparities in infant mortality rates in the US persist and remain visible, with disadvantaged racial/ethnic and socioeconomic groups and geographic areas experiencing a significantly increased risk of mortality despite a downward trend in mortality over time.
Article Comparison
Both quantitative studies in the table above used the same primary data source presented in the National Vital Statistics System. MacDorman et al. (2021) studied maternal mortality, focusing primarily on adult females; in addition, the researchers considered a more recent situation, having studied data only for 2016–2017. The study confirms the differences in mortality rates in racial and ethnic groups, but it is difficult to say that this is a consequence of racism. In addition, the article focuses on the difference between black and white Hispanic women, which also calls into question the researchers’ overall conclusion. Nevertheless, the data collected, the results obtained, and their justification fully correspond to the study’s goal.
Singh & Yu (2019) studied infant mortality based on the same sources, so nationally linked Birth/Infant Death data were also considered for completeness. In addition, besides the fact that Singh & Yu considered the causes associated with infant mortality, such. Like geography and social and economic positions, they also studied how the situation changed with time, from 1915–2017. Given the article’s purpose, it is impossible not to emphasize the reliability and depth of the material under study. However, the causes that affect the infant mortality rate do not seem to be sufficient to compare with the last century. It is necessary to take into account the significant changes that have taken place in society.
The selected articles have an essential place in the discussion raised by our group regarding racism in health care and its impact on maternal and newborn mortality. The maternal and infant mortality rate in the United States is much higher than in the same large and rich countries, and the colored population is at a low level. That, in turn, increases the risk of adverse maternal and child health outcomes. Black women are more likely to have certain risk factors at birth that contribute to infant mortality and can have long-term consequences for children’s physical and cognitive health.
Conclusion
Reducing racial and ethnic disparities in severe maternal morbidity and mortality requires an integrated approach to quality improvement across the continuum of care. In addition, changing the population’s standard of living, which also depends on the right policies, will significantly help fight against maternal and infant mortality. As seen from the analyzed articles, discrimination against different racial and ethnic groups persists, reinforced by the social and economic situation. The eradication of racism, not only in health care but in society as a whole, largely depends on the decisions and actions of the government.
