By Gina E. Wood,
Deputy Director of the Joint Center’s Health Policy Institute
April 24, 2008  
 
The United States overall infant mortality rate is high in comparison with other major industrialized nations.  According to the Centers for Disease Control and Prevention (CDC), in 2002 the U.S. infant death rate ranked 28th against selected countries, placing us considerably behind Western European and Scandinavian nations as well as Japan, Canada, Israel, Greece, New Zealand and Cuba.  More alarming still is the huge disparity between infant death rates for blacks and whites in this country.  Nationwide, infant death rates are 2.5 times as high for African American babies than for white babies.  This black/white disparity in infant death rates has either held steady or widened since 1980.   

To investigate these disturbing trends, in 2005 the Joint Center’s Health Policy Institute (HPI) established an Infant Mortality Commission entitled the “Courage to Love.”  Rather than view the growing disparity between African American and white infant deaths rates as solely a medical problem, the Commission focused on examining the social determinants – economic, environmental, behavioral and community conditions – that serve as root causes.   

 As part of the Commission’s work, research by Dr. Fleda Mask Jackson of Emory University has uncovered significant linkages between the stress of gendered racism, anger, and anxiety.  Anger and anxiety are causal factors for hypertension, diabetes and obesity – ALL of which are risks for poor birth outcomes.  Dr. Jackson’s study of African American women in Atlanta also indicated specific manifestations of depression resulting from racial, cultural and gender experiences of discrimination.  Moreover, pregnant African American women in this study also expressed fears about the racism that would be directed at their children.  The fact that inequality is a causal factor in high rates of Black infant mortality in this country – even among highly educated Black women – needs to be handled as a civil rights issue of paramount importance.          

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