In Los Angeles County, black babies are more than three times more likely than white babies to die in the first year of life.
It's a shocking statistic, but racial disparities in infant mortality rates have persisted for decades. Los Angeles County has a new plan to close the gap.
On Friday, the county announced an action plan to reduce that disparity by 30 percent in the next five years by averting the chronic stress that contributes to poor birth outcomes.
The majority of infants are dying after being born prematurely and too small. Poverty, education, prenatal behavior, and access to health care can be part of the problem – but none of those factors explain the persistent gap.
"Of course, poverty does make a difference, but what's amazing is that when you look at rich black women and poor white women, poor white women do better," said Deborah Allen, deputy director of the county health department said during her presentation at the High Desert Regional Health Center in Lancaster. "Race trumps income, race trumps poverty."
A growing body of research points to chronic stress as the culprit. Over time, elevated stress from racism takes a toll on black women's bodies.
What's the plan?
The county's plan seeks to, as Allen puts it, "interfere in the translation of social experiences into physical stress in the mother's body." Allen says policymakers have to shift from seeing this as a personal failing to a social issue, and address the underlying social problems in a holistic way.
"So it really flips the mindset from, 'we only worry about babies when the woman’s already pregnant,' to 'we worry about the woman because we care about her and we care about the babies that she may have,'" she said.
For now, it's a basic framework, that includes strategies such as:
- Providing implicit bias training to all 100,000 Los Angeles County employees as way of combatting racism within the county.
- Reducing the stress faced by African American women due to economic hardship, by exploring ways to get black pregnant women to the top of the list for public housing.
- Call on doctors to always ask women if they plan to get pregnant at every visit and to provide information about the risks and prenatal care supports.
Dozens of health workers and community organizers attended the event.
During a public comment period, many called on public health officials to put increased funding behind programs already up and running in the county and to make sure black community members are involved in outreach efforts.
"I'm hopeful," said Jill Elam, program manger for the Black Infant Health. Many initiatives, like the Black Infant Health program, which has been in the Antelope Valley for 15 years, have long utilized similar methods.
"The plan is a good plan. It's in alignment with what Black Infant Health is currently doing," she said. "Now let's put feet to it. No more work groups. Action."