INFANT MORTALITY BLACK WOMEN

                When it comes to infant mortality we often assume that the cause heavily lies with medical reasoning’s. Extensive ethnographic research shows that there are multiple factors that cause infant mortality. This essay aims to discuss the reasons of why African American women face higher rates of infant mortality compared to other races. Using the ethnographic book, Stress and Resilience: The Social Context of Reproduction in Central Harlem authors Leith Mullings and Alaka Wali, I draw my conclusion that in order to provide better reproductive health for black women we must debunk how factors like policies, racial oppression, and culture cause immense amounts of stress. The author does a great job digging deeper into the issue and making notice of the causes for the disproportion beyond the typical medical explanations. They show that the rising rate of mortality among black women cannot be understood without looking at all aspects of life. I found this ethnographic work to be extremely interesting. I feel like the disparity of infant mortality among African American women is rarely talked about. Reading all the interviews conducted and statistical reports made me relate this to my community to see how much this issue relates here compared to Harlem. I was shock and a little startled when I realized how similar the personal stories in the book related to women of color I know who experienced the devastating loss of their child. I too believe that new public health approaches are needed to reduce infant mortality and improve reproductive care.

 

                Health statistics report that African American women disproportionally face pregnancy mortality rates higher than any other racial group. In the ethnographic book, Stress and Resilience: The Social Context of Reproduction in Central Harlem authors Leith Mullings and Alaka Wali examine how economic/ political factors, environmental injustice, and social contexts affect the reproductive health of African American women. They cover the personal journey of black women living in Harlem and how they face a barrier to accessing proper reproductive health inducing chronic strain and pain leading to accounts of mortality. They conduct their research by interviewing participants, accompanying participants to doctor appointments, and observing the community in which they live in. The author argues three main points. First, the disparity of infant mortality should not be looked at as genetically determined. Second, disparities should be prevented in populations not individually. Lastly, we need to understand how social and biological factors work together to cause stress.

 

                The disparity of infant mortality among African American women is a global health issue because it possesses serious health concerns for women of color not only in Harlem, but all over the world. Mullings argues that public health approaches must cater to the whole population rather than on an individual level. Harlem is a predominately African American community .Compared to other cities in New York, Harlem is associated with higher infant mortality rates (Mullings 12). In the book ethnographers look at the environment in which people live in that contributes to stress.  The ethnographers conducted interviews with the participants asking them about their neighborhood. Most participants complained about receiving poor services. Things like water, intercom, and heat being out of order. In the interviews participants describe having to fight with their landlords and public housing officials to get repairs done. Living in Harlem is described as important to some because it allows them to live comfortably among other blacks free of racial insensitivity. Black women often sacrifice living in poor housing conditions to live in a black community. Others are confined in Harlem simply because they cannot afford living outside of the city. Housing is a critical aspect of life. It provides the foundation for family, safety and support.

 

I Harlem, inadequate access to proper housing conditions, community safety, and police protection put heavy stress on community members. The women living in Harlem also talk about the lack of care they receive in their community in general. The women in the research worried heavily on their safety. They reported sidewalks being cracked dangerous to women in wheelchairs. Another epidemic that women worried about was the abuse of crack cocaine. Often finding empty vials of crack left on the sidewalks, the women shared their concern with the police but were frustrated with their response. They felt like they were discriminated because of the racial stereotypes of blacks. A member of the community explained that she believed police attitude was that drug activity was “normal” in the community and didn’t take them serious (Mullings 36). When troubles erupted the women were hesitant in calling the police. Community members believed that the police made more minor arrests on the young men than actual criminals (Mullings 35). The ethnographer shares the story of a woman named Ruth who a day after being present in a drive by shooting broke her water and had to repeatedly keep calling the ambulance which arrived more than an hour later. Ruth felt like the ambulance wasn’t taking her emergency as serious because of her neighborhood history. Ruth ended up losing one of her twins and expressed that she forever has a hole in her heart. Her story exemplifies how the poor police coverage in Harlem and the perception of racial judgment by ambulatory staff may have contributed to a death of an infant. 

 

                African American women living in Harlem believed social and biological factors to be a high cause of stress. The author provides a framework of the women’s lives in order to understand why black women undergo large amounts of stress. In 1990 in Harlem, 69 percent of households with children under 18 were headed by a woman (Mullings 113). Having a single black female household limits the amount of income and forces black women to play both gender roles. They have a weaker support system and increase feelings of regret and shame. Black women in Harlem also related racial oppression to high levels of stress. Mullings covers the outcry of anger from community members about the way the social media reinforces the negative stereotypes of blacks living in Harlem. The New York Times article, Another America it stated that people of Harlem were “dependent on public assistance, involved with illegal drug activities, and hopeless (44). Viewing the people of Harlem in this manner can affect the way they are treated/ receive healthcare. It further marginalizes them from other areas in New York causing more stress and feelings of alienation which affects pregnancy.

 

                Looking at the gender role difference between white and black women will help us understand the reason behind the racial disparity. The Sojourner syndrome is also used to explain the intersection of gender and racial oppression. The Sojourner syndrome is based off her abolitionist speech And Ain’t I a woman? It conceptualizes the lifestyle of many African American women. The author talks about how black women in Harlem face problems with gender identity. Having to be primary economic providers, head of household, and community activist, black women carrying a significant amount of pressure and stress. In comparison to white women are as many of the people in Harlem view, are protected by their patriarchal system. White women maintain their female gender role with relaxed motherhood and womanhood (Mullings 170). Relating historical events like slavery and colonization will provide a more in depth explanation of why these two racial groups have significantly different health outcomes. Understanding the role that social and biological factors play can allow us create a better framework that more realistically caters to African American women to improve their reproductive health.

               

                The author did great job showing multiple perceptions on the issue of infant mortality disparity. The perception of black women in Harlem feeling that discrimination to social, economic, and political factors limits the amount of resource and health care they receive. He also shows the perception of the doctors, police officers, and housing officials used preconceived notions of Harlem to look at the cases individually. Not realizing the systematic way of institutionalized racism leading to the lifestyle of Harlem. Lastly, he shows the perception of the media referring to Harlem as “Another America” as if they are too far left to be included with the rest of America. The author makes light of the media’s take on the issue to show how the accuracy of the story rather than someone simply observing from the outside. Rather than covering a story in your words, the ethnographic study allows the black women and men’s voice in Harlem to be heard. Allowing the people of Harlem to tell their own story. The author’s purpose in this is to create common bridge between Harlem and the rest of not only New York but America. Understanding the lifestyle of people in Harlem will help others understand the structural problems to reduce individual blame. In addition to allowing public health officials to generate an approach that improves reproductive care for black women. Mullings research relates to Borovoy and Hines article, Managing the Unmangeable in which the authors discuss the story behind diagnosed Russian immigrants not receiving treatment for diabetes. They show both the perception of the doctors believing they are being lazy and telling the actual side of the immigrants and showing how it is a culture difference. Borovoy and Hines work is similar to Mullings because it shows us if we shed light on the different perceptions of the other group we will be able to understand and realize the actuality of the problem. This shows the importance of including different perceptions in ethnographic work to generate a solution.

 

                While Mullings was successful addressing the multiple factors contributing to infant mortality among black women in Harlem, she was failed to include possible public health intervention solutions. After reading all of the different stories in the book, I felt like there was a missing chapter. She focused entirely on showing the frustration in the women’s lives however, didn’t include how we can better progress. The women in the survey were not asked how they think the disparity can be reduced. Or critical areas they believed needed immediate change. Mullings towards the end lightly glosses over how her data can be used to give the people what they want. She stresses that hearing the voices of the women will allow us to make an intervention that benefits the people. She broadly states that the women want to, “take control of resources so they can care (170).” Mullings leaves out how the black women in Harlem believe we should go about increasing the access to the women. Her main focus was to make sure their voices were being heard but, their voice of what/ how they think interventions should take place is silenced. Silencing that information leaves it up to public health and other officials to create a framework they feel will benefit the people, rather than looking at the way the women believe they will benefit and work together to formulate a plan. Mullings research could have been stronger if she extended beyond documenting their personal stories and speaking to them about their opinions on change.

 

We see how the discrimination within the economic, political, and social structure of Harlem city women, contributes to poor reproductive health. In order to improve for better reproductive care we must work on creating a framework for public health interventions that relates to the lifestyle in which these women live in. Taking into account factors like environmental injustice, social and biological factors, and institutionalized racial oppression. Connecting those factors to chronic strain and stress will allow us to improve their care. The rates of infant mortality among black women not only in Harlem but all over the world, is disproportionally high making this a serious public health concern. Mullings research shows that in order to treat someone we have to understand all aspects of the culture they live in. Because infant mortality is confined solely with black women it is not a genetic issue therefore, biomedical intervention cannot be the only solution. Based on the data collected biomedical intervention is not the only answer to this issue. The intervention must include ways in which black women can be able to preserve their gender identity. The solution extends way beyond medical intervention, using ethnographic data we can create a framework that reduces the disparity of infant mortality among African American women.

 

 

Bibliography:

Borovoy, Amy Hine, Janet. (2008). Managing the Unmanageable: Elderly Jewish Emigres and Biomedical Culture of Diabetes Care. American Anthropological Association.

Mullings, Leith Wali, Alaka. (2001) Stress and Resilience: The Social Context of Reproduction in Central Harlem. University of New York, New York.