Infant Mortality and Inequality

Larry Adelman is co-director of California Newsreel  and the creator and executive producer of Unnatural Causes: Is Inequality Making Us Sick? and RACE-The Power of an Illusion.  “When the Bough Breaks”, the episode from Unnatural Causes exploring African American infant mortality, can be screened on-line for free during the month at www.newsreel.org.

I still remember when first researching our documentary series Unnatural Causes: Is Inequality Making Us Sick?  being steered to the work of two neonatologists from Chicago, Drs. James Collins and Richard David.

It’s well-known that African Americans have infant mortality rates more than twice as high as white Americans.  Collins and David wanted to know why.  According to the CDC, complications due to low-birth weight are the leading cause of African American infant deaths. In one study, Collins and David compared the birth weights of newborns of three different groups:  white Americans, African Americans and African immigrants born in the U.S.

They discovered that while African American babies are born, on average, about half a pound smaller than white Americans, babies born here to African immigrants are about the same weight as white American babies.

In a subsequent study, Collins and David found that just one generation later, the daughters of those very same African immigrants were giving birth to lower birth-weight babies.

What changed in a generation? Not genes; genes don’t change in a generation. But kids born to African immigrants grow up here as African Americans, their bodies subject for decades to the cumulative stressors of racism experienced by other African Americans (many studies show that large racial gaps in birth outcomes remain even after controlling for pre-natal care, education, nutrition and other factors).

Our earlier documentary series, RACE – The Power of an Illusion , tried to help viewers negotiate a two-step:  the idea of ‘race’ as innate biological difference between population groups makes little scientific sense, yet race as lived experience is very real – and can even have biological consequences.

And among the most enraging as well as heart-rending of those consequences is high infant mortality.  Why enraging?  Because it doesn’t have to be this way.

Nancy Krieger and colleagues found that in the aftermath of the Civil Rights movement and the War on Poverty both racial and class infant mortality gaps narrowed between 1966 and 1980. But progress ceased as the Reagan presidency initiated a 30-year binge of rollbacks of social programs, tax cuts for the rich and corporate deregulation which helped spawn unprecedented growth in inequality.

Health tracks wealth as well as race. On average, the wealthier you are, the healthier. And our growing inequality is taking a toll on white American babies as well.  I just took a look at the infant mortality tables at CIA’s World Fact Book. By my calculation, if white Americans were a separate nation, their infant mortality rate of 5.6 / 1000 would rank them about 33rd in the world (even lower if small entities like Guernsey and Andorra are included).

There are many exciting initiatives tackling infant mortality one city, one county at a time. They are each important. But if we want to make a lasting difference, if we want to give all our children the opportunity for a healthy start, shouldn’t we also be reversing those policies which have increasingly channeled the nation’s wealth, power and resources into the hands of what FDR used to call the plutocrats and the financial elite?

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