Failing African American Mothers and Babies

Amie Newman

September is Infant Mortality Awareness Month. It's a good time to explore a woefully under-addressed topic: the shocking disparity between the maternal and infant mortality rates of Blacks and Whites. 

Rachel at Our Bodies, Our Blog called my attention to a fascinating article on a woefully underreported topic, in Womens eNews this month – Black infant and maternal mortality in the United States. It’s a topic that, frankly, deserves much more attention from movements and communities across the spectrum – women’s health, feminism, reproductive rights, the medical establishment, mainstream media news, and alternative news sources all.

September is Infant Mortality Awareness Month. The truth is, however, as Kimberly Seals Allers writes in her article, Black Infant Mortality Points to Moms’ Crying Needs,

"…this country is miserably failing women of color, and black women in particular, in the process of birthing healthy babies."

When an obstetrician-gynecologist doesn’t know that African American women in the United States are nearly three times as likely to die during childbirth as white women are, or that the infant mortality rate in the black community is significantly higher than in other communities, there is a lot of work to be done. As Seals Allers (Womens eNews Editorial Director) writes:

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In the course of interviewing obstetrics-gynecologists I have found
many who aren’t aware that their black patients are at a greater risk
during pregnancy, regardless of their socioeconomic status.

African Americans have an infant mortality rate 2.3 times higher than that for non-Hispanic whites. But this isn’t new information. Why do these racial health disparities then still exist in the United States? And as we consider our current health care reform measures, how do we address these kinds of inequities?

Seals Allers quotes Dr. Camara Jones, research director on social determinants of health and equity at the National Center for Chronic Disease Prevention and Health Promotion:

"In this country, we have for a long time thought of our individual
behaviors as the main determinants of health," said Jones in a recent
speech at the University of Georgia. But encouraging individuals to
adopt healthier habits is not the key to ending health disparities.

"If we are interested in eliminating racial disparities in health,"
said Jones, "we need to examine the fundamental causes of those racial
disparities." That includes an awareness of the systems that make race
an important distinction and acknowledging the existence of racism in
practices and organizations."

And Rachel at OBOS notes that addressing these racial disparities is not only an issue of morality or social justice but it makes sense economically, 

"In addition to the moral or social justice argument for eliminating health disparities, a recent report
on the economic burden of these disparities makes a money-saving
argument for eliminating them, estimating that doing so “would have
reduced direct medical care expenditures by $229.4 billion,” money that
some suggest could be used to pay for health reform."

While we make our best efforts to shine a much needed light on the health of women in the developing world as worthy recipients of our attention, one must ask why the health of women in this country is not being given equally as deserving attention?

Carol Jenkins, writing on Rewire in response to Nicholas Kristoff’s and Sheryl WuDunn’s new book, Half the Sky, about the imperative of focusing on gender equity globally, calls African American women in the United States "invisibles", and an "endangered group right here in our backyard" precisely because of these staggering health inequities:

It is a group we need to keep in mind, because you won’t
see us very much in the media—home bred women of color don’t have the exotic appeal
of grand international rescue missions. But there are many of us who believe
that black women in America are now in full blown crisis, and require a
concerted effort of activists, philanthropists, big thinkers. Black women’s
voices are largely missing from our debate about health care, even as the
disparities in their care are the starkest. 

But where are the studies? The research on the multi-layered reasons for these staggering statistics? And why aren’t health care providers informed enough about these kinds of racial disparities to provide appropriate care?

In fact, infant mortality rates for black babies is rising in many states around the country. Sixteen states, of the 39 with a large enough population of black people to make the analysis reliable, "experienced rising black rates between the 1998-2000 and 2002-2004 period." Clearly, this gap persists and it’s not enough to continue to question. 

Seals Allers also raises these questions but adds that in the face of a serious lack of research and not nearly enough provider awareness, Black women – all women – need to advocate for themselves:

As a black woman, who can’t afford to wait for the government or
medical community to figure out how to save our babies, I have to
search for answers and solutions and ask black women all over the world
to do the same.

And as mothers and women of all races, whose lives are all
interconnected, we have to figure out how. It’s the least we can do.
Newborn lives are at stake.

The Department of Health and Human Services (HHS) did develop the Healthy People 2010 initiative to "provide a vision for achieving improved health for all Americans." The initiative contains two goals  – one of which is to eliminate disparities in health based on a variety of factors including race. But a midway review in 2005 acknowledged that, thus far, "While there
have been widespread improvements in rates for most of the populations
associated with the social and demographic characteristics included in
Goal 2, there is little evidence of systematic reductions in disparity." [emphasis mine]

The report also notes that, "It may
be more difficult or more costly to implement effective disease
prevention and health promotion programs for some populations. However,
unless greater reductions occur for the populations with the highest
rates, disparities will not be eliminated."

The key then is for all of us to agree that the lives of African American women and their babies are worth saving. It’s a question of prioritization. Yes, it is critical that African American women are aware of institionalized racism and racial health disparities so that they may advocate for themselves. But that is not enough, of course. Not nearly enough. 

In order to make real progress, we must see attention paid to this problem by President Obama, Congress, advocacy and grassroots organizations, the medical community, activists and the mainstream and alternative media.

Dr. Jones says it best, quoted in Kimberly Seals Allers’ article,

Racism is not some vague thought or practice, it operates through identifiable and addressable mechanisms, says Jones.

So let’s identify and address.

Commentary Economic Justice

The Gender Wage Gap Is Not Women’s Fault, and Here’s the Report That Proves It

Kathleen Geier

The fact is, in every occupation and at every level, women earn less than men doing exactly the same work.

A new report confirms what millions of women already know: that women’s choices are not to blame for the gender wage gap. Instead, researchers at the Economic Policy Institute (EPI), the progressive think tank that issued the report, say that women’s unequal pay is driven by “discrimination, social norms, and other factors beyond women’s control.”

This finding—that the gender pay gap is caused by structural factors rather than women’s occupational choices—is surprisingly controversial. Indeed, in my years as a journalist covering women’s economic issues, the subject that has been most frustrating for me to write about has been the gender gap. (Full disclosure: I’ve worked as a consultant for EPI, though not on this particular report.) No other economic topic I’ve covered has been more widely misunderstood, or has been so outrageously distorted by misrepresentations, half-truths, and lies.

That’s because, for decades, conservatives have energetically promoted the myth that the gender pay gap does not exist. They’ve done such a bang-up job of it that denying the reality of the gap, like denying the reality of global warming, has become an article of faith on the right. Conservative think tanks like the Independent Women’s Forum and the American Enterprise Institute and right-wing writers at outlets like the Wall Street Journal, Breitbart, and the Daily Caller have denounced the gender pay gap as “a lie,” “not the real story,” “a fairy tale,” “a statistical delusion,” and “the myth that won’t die.” Sadly, it is not only right-wing propagandists who are gender wage gap denialists. Far more moderate types like Slate’s Hanna Rosin and the Atlantic’s Derek Thompson have also claimed that the gender wage gap statistic is misleading and exaggerates disparities in earnings.

According to the most recent figures available from the Census Bureau, for every dollar a man makes, a woman makes only 79 cents, a statistic that has barely budged in a decade. And that’s just the gap for women overall; for most women of color, it’s considerably larger. Black women earn only 61 percent of what non-Hispanic white men make, and Latinas earn only 55 percent as much. In a recent survey, U.S. women identified the pay gap as their biggest workplace concern. Yet gender wage gap denialists of a variety of political stripes contend that gender gap statistic—which measures the difference in median annual earnings between men and women who work full-time, year-round—is inaccurate because it does not compare the pay of men and women doing the same work. They argue that when researchers control for traits like experience, type of work, education, and the like, the gender gap evaporates like breath on a window. In short, the denialists frame the gender pay gap as the product not of sexist discrimination, but of women’s freely made choices.

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The EPI study’s co-author, economist Elise Gould, said in an interview with Rewire that she and her colleagues realized the need for the new report when an earlier paper generated controversy on social media. That study had uncovered an “unadjusted”—meaning that it did not control for differences in workplace and personal characteristics—$4 an hour gender wage gap among recent college graduates. Gould said she found this pay disparity “astounding”: “You’re looking at two groups of people, men and women, with virtually the same amount of experience, and yet their wages are so different.” But critics on Twitter, she said, claimed that the wage gap simply reflected the fact that women were choosing lower-paid jobs. “So we wanted to take out this one idea of occupational choice and look at that,” Gould said.

Gould and her co-author Jessica Schieder highlight two important findings in their EPI report. One is that, even within occupations, and even after controlling for observable factors such as education and work experience, the gender wage gap remains stubbornly persistent. As Gould told me, “If you take a man and a woman sitting side by side in a cubicle, doing the same exact job with the same amount of experience and the same amount of education, on average, the man is still going to be paid more than the woman.”

The EPI report cites the work of Harvard economist Claudia Goldin, who looked at the relative weight in the overall wage gap of gender-based pay differences within occupations versus those between occupations. She found that while gender pay disparities between different occupations explain 32 percent of the gap, pay differences within the same occupation account for far more—68 percent, or more than twice as much. In other words, even if we saw equal numbers of men and women in every profession, two-thirds of the gender wage gap would still remain.

And yes, female-dominated professions pay less, but the reasons why are difficult to untangle. It’s a chicken-and-egg phenomenon, the EPI report explains, raising the question: Are women disproportionately nudged into low-status, low-wage occupations, or do these occupations pay low wages simply because it is women who are doing the work?

Historically, “women’s work” has always paid poorly. As scholars such as Paula England have shown, occupations that involve care work, for example, are associated with a wage penalty, even after controlling for other factors. But it’s not only care work that is systematically devalued. So, too, is work in other fields where women workers are a majority—even professions that were not initially dominated by women. The EPI study notes that when more women became park rangers, for example, overall pay in that occupation declined. Conversely, as computer programming became increasingly male-dominated, wages in that sector began to soar.

The second major point that Gould and Schieder emphasize is that a woman’s occupational choice does not occur in a vacuum. It is powerfully shaped by forces like discrimination and social norms. “By the time a woman earns her first dollar, her occupational choice is the culmination of years of education, guidance by mentors, parental expectations, hiring practices, and widespread norms and expectations about work/family balance,” Gould told Rewire. One study cited by Gould and Schieder found that in states where traditional attitudes about gender are more prevalent, girls tend to score higher in reading and lower in math, relative to boys. It’s one of many findings demonstrating that cultural attitudes wield a potent influence on women’s achievement. (Unfortunately, the EPI study does not address racism, xenophobia, or other types of bias that, like sexism, shape individuals’ work choices.)

Parental expectations also play a key role in shaping women’s occupational choices. Research reflected in the EPI study shows that parents are more likely to expect their sons to enter male-dominated science, technology, engineering, and math (often called STEM) fields, as opposed to their daughters. This expectation holds even when their daughters score just as well in math.

Another factor is the culture in male-dominated industries, which can be a huge turn-off to women, especially women of color. In one study of women working in science and technology, Latinas and Black women reported that they were often mistaken for janitors—something that none of the white women in the study had experienced. Another found that 52 percent of highly qualified women working in science and technology ended up leaving those fields, driven out by “hostile work environments and extreme job pressures.”

Among those pressures are excessively long hours, which make it difficult to balance careers with unpaid care work, for which women are disproportionately responsible. Goldin’s research, Gould said, shows that “in jobs that have more temporal flexibility instead of inflexibility and long hours, you do see a smaller gender wage gap.” Women pharmacists, for example, enjoy relatively high pay and a narrow wage gap, which Goldin has linked to flexible work schedules and a professional culture that enables work/life balance. By contrast, the gender pay gap is widest in highest-paying fields such as finance, which disproportionately reward those able to work brutally long hours and be on call 24/7.

Fortunately, remedies for the gender wage gap are at hand. Gould said that strong enforcement of anti-discrimination laws, greater wage transparency (which can be achieved through unions and collective bargaining), and more flexible workplace policies would all help to alleviate gender-based pay inequities. Additional solutions include raising the minimum wage, which would significantly boost the pay of the millions of women disproportionately concentrated in the low-wage sector, and enacting paid family leave, a policy that would be a boon for women struggling to combine work and family. All of these issues are looming increasingly large in our national politics.

But in order to advance these policies, it’s vital to debunk the right’s shameless, decades-long disinformation campaign about the gender gap. The fact is, in every occupation and at every level, women earn less than men doing exactly the same work. The right alleges that the official gender pay gap figure exaggerates the role of discrimination. But even statistics that adjust for occupation and other factors can, in the words of the EPI study, “radically understate the potential for gender discrimination to suppress women’s earnings.”

Contrary to conservatives’ claims, women did not choose to be paid consistently less than men for work that is every bit as valuable to society. But with the right set of policies, we can reverse the tide and bring about some measure of economic justice to the hard-working women of the United States.

News Politics

Congresswoman Pushes Intersectionality at Democratic National Convention

Christine Grimaldi

Rep. Bonnie Watson Coleman (D-NJ) charges that reproductive health-care restrictions have a disproportionate impact on the poor, the urban, the rural, and people of color.

The members of Congress who flocked to the Democratic National Convention in Philadelphia this week included a vocal advocate for the intersection of racial and reproductive justice: Rep. Bonnie Watson Coleman (D-NJ).

Watson Coleman’s longstanding work in these areas “represented the intersection of who I am,” she said during a discussion in Philadelphia sponsored by the Center for Reproductive Rights and Cosmopolitan. Reproductive health-care restrictions, she stressed, have a disproportionate effect on the poor, the urban, the rural, and people of color.

“These decisions impact these communities even more so [than others],” she told Rewire in an interview. “We don’t have the alternatives that middle-class, suburban, white women have. And we’d rather they have them.”

Watson Coleman has brought that context to her work in Congress. In less than two years on Capitol Hill, she co-founded the Congressional Caucus on Black Women and Girls and serves on the so-called Select Investigative Panel on Infant Lives, a GOP-led, $1.2 million investigation that she and her fellow Democrats have called an anti-choice “witch hunt.”

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Coleman said she’s largely found support and encouragement among her fellow lawmakers during her first term as a woman of color and outspoken advocate for reproductive rights.

“What I’ve gotten from my Republican colleagues who are so adamantly against a woman’s right to choose—I don’t think it has anything to do with my being a woman or an African American, it has to do with the issue,” she said.

House Republicans have increasingly pushed anti-choice policies in advance of the ongoing August recess and November’s presidential election. The House this month passed the Conscience Protection Act, which would give health-care providers a private right of action to seek civil damages in court, should they face supposed coercion to provide abortion care or discrimination stemming from their refusal to assist in such care.

Speaker Paul Ryan (R-WI) lauded passage of the bill and the House’s thus-far unsuccessful effort to prove that Planned Parenthood profited from fetal tissue donations—allegations based on widely discredited videos published by the Center for Medical Progress, an anti-choice front group that has worked closely with GOP legislators to attack funding for Planned Parenthood.

On the other side of the aisle, Watson Coleman joined 118 other House Democrats to co-sponsor the Equal Access to Abortion Coverage in Health Insurance Act (HR 2972). Known as the EACH Woman Act, the legislation would overturn the Hyde Amendment and ensure that every woman has access to insurance coverage of abortion care.

The Hyde Amendment’s restriction of federal funding for abortion care represents a particularly significant barrier for people with low incomes and people of color.

The Democratic Party platform, for the first time, calls for repealing the Hyde Amendment, though the process for undoing a yearly federal appropriations rider remains unclear.

For Watson Coleman, the path forward on getting rid of the Hyde Amendment is clear on at least one point: The next president can’t go it alone.

“The president will have to have a willing Congress,” she said. She called on the electorate to “recognize that this is not a personality contest” and “remove some of those people who have just been obstructionists without having the proper evidence.”

In the meantime, what does a “willing Congress” look like for legislation with anti-choice roadblocks? A majority voting bloc helps, Watson Coleman said. But that’s not everything.

“There are lots of bills that Republicans will vote for if their leadership would simply bring them up,” she said.