The recent, tragic death of Torie Bowie – a celebrated Olympic athlete – once again got me thinking about the crisis of Black maternal mortality and morbidity in our country. Why is it that Black women – from everyday folks to famous athletes – are disproportionately experiencing fatal and near-fatal complications from pregnancy and childbirth? What can we do to turn the tide, especially given the alarming trend of increasing maternal mortality?
It's abundantly clear that entrenched injustice within our society and inequitable social determinants of health play large roles in the maternal mortality disparity, but is it the whole story? I recently read Linda Villarosa’s excellent book, "Under the Skin," and she points out that not only are Black women three to four times more likely to die from pregnancy or childbirth, but that the Black-white disparity is more pronounced as it relates to education levels. In other words, a higher-income, highly educated Black woman is statistically more likely to die in childbirth than a lower-income white woman without a college degree. So, even as we work to expand access to education and improve economic mobility in our communities, efforts that are critical to advancing equity – something that Advocate Health is committed to – may just not be enough.
To solve for this dilemma, we need all the real information we can get, which is why we're working with partners to gather data on health equity and maternal mental health as part of the Premier Perinatal Improvement Collaborative. Public health scholar Arline Geronimus, for instance, found in her research that racial discrimination of all kinds takes a toll on the body over time and can negatively affect health outcomes, including pregnancy outcomes. She coined this effect "weathering." Therefore, we must take action to dismantle systemic inequities in all parts of our society.
It's clear that we haven't yet taken all the steps we need to as a broader society, to do what it takes to protect and support Black women, especially those on the journey of parenthood. Health systems have a major role to play in closing gaps in access and supporting families through pregnancy and parenthood, and I'm proud of the work of Advocate Health, Atrium Health, Advocate Health Care and Aurora Health Care.
Atrium Health and community partners have developed a first-of-its-kind mobile medicine unit focused on women's health care in communities that have historically lacked access to resources and created two community clinics in Charlotte for pregnant women and new parents. And with the support of our board chair Tom Nelson, his wife Anna Nelson and their generous $10 million contribution through the C.D. Spangler Foundation, we're bringing community doulas and in-home care to more patients and expanding access to care in a wide range of ways. When community philanthropists partner with health systems and business, that's when real change can happen.
Our organization's work in Milwaukee is another testament to our efforts. Aurora Sinai – which operates a Level III neonatal intensive care unit in the city – is doing phenomenal work providing specialized care to Black women who are at higher risk than white women of pregnancy-related complications, as well as directly connecting patients in need with resources for food and formula. We continue to strive toward improving maternal health outcomes and, last year, successfully narrowed the racial gap in cesarean section delivery rates by more than 10 percent at our Midwest hospitals, with Sinai eliminating the gap entirely.
Let's make this an all-hands-on-deck moment when it comes to Black maternal health, recommitting ourselves to helping every parent and family thrive by tackling systemic inequity and injustice.
Eugene A. Woods is CEO at Charlotte, N.C.-based Advocate Health.