Q: As an African-American mother, I know my children will be at risk for many bad health problems. What can I do to prevent them?
A: Dr. Martin Luther King Jr. said in 1967, “Of all the good things in life the Negro has approximately one half those of whites, of the bad he has twice that of whites. Thus, half of all Negroes live in substandard housing and Negroes have half the income of whites. When we turn to the negative experiences of life, the Negro has a double share. The infant mortality rate is double that of whites …”
In 1967, African-Americans were almost 2 1/2 times more likely to die in the first year than white infants. While both races have seen improvements in infant mortality, there’s still a huge difference in rates: blacks, 13.31, and whites, 5.63, per 1,000 births in 2007.
Public health experts speak of this as only one example of the shameful health disparities between whites and people of color in the United States. Though Hispanics share infant mortality rates (IMRs) similar to those of whites, they fall behind in other important ways, as shown in New Mexico statistics: for example, they die of diabetes twice as often as whites, are four times as likely to give birth as teenagers, and are almost twice as likely to contract chlamydia, a sexually transmitted infection, as whites.
Like Hispanics, Native Americans have IMRs similar to whites, but Native Americans suffer from very high rates of obesity, diabetes, alcohol-related illness, homicide and accidental injury (among others; see www.health.state.nm.us/plans/2011%20Racial%20and%20Ethnic%20Health%20Disparities%20Report%20Card.pdf for details).
Because many of the reasons for these differences are unknown, it isn’t possible to recommend ways to fully protect your African-American children, just as we have only some theories as to why all American children are at such higher risk of many diseases during their childhood than Japanese or Swedish children, for example.
A small fraction of African-American children suffer from sickle cell disease. All New Mexico newborns are tested for sickle cell disease; early diagnosis helps to improve the outcome of this serious disorder. Make sure you know the test results. But the majority of African-American child deaths are due to disorders that afflict other groups, though at lower frequency.
Starting with pregnancy, be sure to get good prenatal care. Don’t smoke: smoking during pregnancy is associated with lower birth weight and prematurity, both of which contribute mightily to infant mortality. Get your influenza and tetanus-diphtheria-pertussis vaccines during your pregnancy to protect your newborn and yourself, and start your infant out right with good medical care.
Be certain that your infant sleeps on his or her back; studies show that black infants are more likely than whites to be put to sleep face down, and are more likely to die of sudden infant death syndrome. Make sure that your child gets a good education and is given self-advocacy skills to resist peer pressure. I would suggest the same to all racial and ethnic groups.
Those words are easy to write; much more difficult is recommending how and where to live. Public health statisticians know that some environments are hazardous to health and well-being. In a fascinating 2005 paper, Harvard researchers led by Christopher Murray found that the gap between life expectancies of Asian-Americans and white Americans and black inner city residents was greater than the gap between Icelanders (at the top of the world scale for length of life) and Bangladeshis. Black Americans who lived in Middle America lived three years longer than those living at risk in an urban setting.
Bernalillo County is one of 16 places nationwide where The Joint Center for Political and Economic Studies has a team working to reduce the disparities in “land-use, environmental, and social policies that the disproportionate environmental burdens placed on Bernalillo County’s minority, low-income, and vulnerable communities and lessen the poor health outcomes experienced by members of our communities as a consequence of stress from environmental and social conditions.”
This Place Matters Team indicates that where you live makes a difference in your health, among many other things. (See www.jointcenter.org/hpi/pages/place-matters-teams.)
King said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.” Perhaps as we mark the 83rd anniversary of King’s birth, we can resolve to strive to decrease this inhumanity while we ensure the better health of all New Mexicans.
Lance Chilton, M.D., is a pediatrician at the Young Children’s Health Center in Albuquerque, associated with the University of New Mexico. He is happy to take questions at 272-9242 or lancekathy@gmail.com.
