Neonatal Mortality: The Quiet Crisis of the African-American Community


In my years working in healthcare, I have been blessed to see patients celebrate happy moments, but I have also witnessed times of profound grief. The loss of a baby is one such example that deals a devastating blow to our families, healthcare providers, communities and nation as a whole.

Most newborns grow and thrive, but in the United States, almost six out of every 1,000 babies die during their first year, according to the Centers for Disease Control and Prevention. Many of these deaths occur in the neonatal phase of development — the critical period

from birth to 28 days of life in which babies are more vulnerable to disease, infection and other complications. No mother, family or community in our country should have to endure the pain of losing a child. It’s all the more shocking to learn that African-American mothers lose a child before their firstmonth of life at more than twice the rate of white women— the highest rate of any racial group, according to the CDC.In some states, the equity gaps are even wider.

These figures should sound the alarm for all Americans, especially African-Americans, policy makers, healthcare providers and community leaders. This cannot be our quiet crisis any longer.

There are real lives at stake. It will take all of us, working together, to ensure African-American babies born in America have every opportunity to thrive. Here are five steps we can take to

get there:

Access— Increasing access to quality, timely and affordable healthcare is critical to our mission. African-American mothers who lost an infant were 2.3 times more likely than White mothers to not begin prenatal care until the third trimester, or not receive prenatal care at all, according to the Department of Health and Human Services.

Culturally Competent Care— The factors that influence neonatal health are myriad and complex, but we must continue our efforts to build a culture of health in the Black community— one that competently serves the unique needs of mothers on their pregnancy journey and ensures they are at her healthiest even before they conceive. This work requires healthcare providers enhance our outreach to communities of color to forge bridges of understanding among medical professionals and the patients they serve— relationships we know

lead to better health outcomes across the board.

Early Intervention— Caring for healthy Black babies begins before conception and continues throughout a mother’s prenatal and postpartum experience. Early care interventions are critical if we are to address and prevent neonatal and infant mortality, because they allow us to address conditions that could lead to poor birth outcomes.

Hypertension— a disease that disproportionately affects African-Americans and can cause serious birth complications —is one such disease that can be managed through a mother’s ongoing relationship with her healthcare provider.

Self-Empowerment— Importantly, African-American mothers must take full ownership of their healthcare experience. That means taking advantages of every opportunity to access proactive preconception, prenatal and postpartum care, and feeling empowered to ask questions. Understanding what’s normal, when to be concerned and when to call a doctor is the No. 1 thing African-American women can do to ensure their babies are born and stay healthy.

Healthy Communities— More cities and neighborhoods are waking up to the notion that where you live has a significant impact on your health. Addressing environmental and social factors of health— such as nutrition, stress, substance abuse and domestic safety— will do more than improve the lives of mothers and babies. Its impacts will be felt throughout the community. Healthy Neighborhoods Detroit, an Ascension Michigan program, provides a powerful example of a community building its capacity to address holistic health needs. By integrating healthcare, education, grocery access and affordable housing in some of the city’s most blighted areas, the effort is creating nerve centers where all residents can access the services they need.

The health of our youngest citizens is the yardstick by which we measure the prosperity of our country and communities. Fortunately, we have made great gains in reducing high rates of neonatal mortality. But there is still more work to do to address equity gaps for African-Americans. It will take a comprehensive,coordinated effort to eliminate this quiet crisis. By working together, we have reasons to hope for a future in which African-American babies survive, thrive and lead our communities into the future.

Patricia A. Maryland, Dr.PH, is the

President of Healthcare Operations

and Chief Operating Officer for Ascension

Health, the healthcare delivery subsidiary

of Ascension, the nation’s largest

non-profit and largest Catholic health