Nauseating statistics: black infant mortality rates

Now that I’ve picked out some geographically and racially diverse locations for my game’s protagonist–a black male US citizen–to be born, today I did a little research on infant mortality rates to see if there was a substantial difference between white baby deaths and black baby deaths in the US.

I am not a mother and have no plans to ever become one, so this isn’t a topic that I know much about. I really did not know if this would even be a factor that would be statistically significant enough to bother including as a part of the game’s narrative.

I’m sure there are black mothers who just read the paragraph above who are either laughing or crying at my naiveté.

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Source: http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_08.pdf

So black infants are twice as likely to die within their first year than white infants. What in the hell?!

Ok, so this is a huge problem. How do we fix it? Short answer: we have no freaking idea.

Probably because it’s babies dying, and we have great big Love For Babies in our country, scientists have jumped on this problem. They jumped on it 50 years ago, apparently.

“[Negro Americans] must march from the cemeteries where our young and our newborns die three times sooner and our parents die seven years earlier. They must march from there to established health and welfare centers. – National Urban League Director Whitney Young, August 28, 1963

It is hard to believe that after half a century of social, scientific, and medical progress, these words by Whitney Young are as telling today as they were in 1963 when he spoke at the March on Washington for Jobs and Freedom. Today, as in the early 1960s, black infants are more than twice as likely as white infants to die within their first year of life.”

Source: http://www.urban.org/urban-wire/despite-fifty-years-improvements-infant-mortality-large-black-white-gap-remains-unchanged

So what have researchers been doing for fifty years? Trying to figure out the underlying cause of the problem. Is it genetic? Economic? Political? Social? Environmental? Some heinous combination of all of the above? We still are very, very unsure.

“Many factors are known to affect birth outcomes – these include the mother’s age, education, health status, and behavior during pregnancy. But study after study show that these factors fail to explain large differences by race.

Highly educated white women who wait until their 20s and 30s to have a child have much better birth outcomes than highly educated black women of the same age. In fact, black mothers with college and even advanced degrees have a higher infant mortality rate than white mothers who have not finished high school.

Nor do genetics explain the difference. The birth weights of babies born in the US to African-born mothers are similar to those of babies born to white American mothers – and both are significantly higher than those born to black American women.”

Source: http://www.urban.org/urban-wire/despite-fifty-years-improvements-infant-mortality-large-black-white-gap-remains-unchanged

If this all isn’t enough to make you feel queasy yet, keep reading. A recent study looked at twins to “attempt to untangle how genetic and prenatal environmental variation may make different contributions to infant health among white and black populations in the United States.” In the end, they didn’t really get very far, mostly because you can’t untangle genetics and environment from our current cultural idea of race. But in the study they made this Darwinian side observation that is absolutely appalling:

“Integrating the above empirical patterns (e.g., survival paradox) with social stratification perspectives, some authors raise the possibility that black babies’ smaller sizes may reflect a biological and/or genetic adaptation to adverse social and environmental circumstances (i.e., the “robustness hypothesis”) (Mangold & Powell-Griner, 1991; North & MacDonald, 1977). Given adverse conditions, a smaller size may be an advantage. With inadequate environmental resources, giving more energy to organ development, and less to overall body size, is likely to increase survival. In an evolutionary adaptive scenario, genetic mutation and natural selection over generations could have led black babies to have more “thrifty genotypes” that are better suited to environmental deprivation. In an individual-level gene-expression scenario, dispro- portionate exposure to prenatal environmental stressors among black fetuses could lead to a “thrifty adaptive response,” altering how genotypes for growth and development are expressed.”

Source: https://files.nyu.edu/dc66/public/race_infant_mortality_social_science_medicine.pdf

That’s right. Black babies could have a higher mortality rate because so many black people in our country have lived in deprivation for so many generations that their children evolved to adjust to the condition of not getting enough to sustain their tiny little lives. So that now, even when they do have enough, it doesn’t matter–the evolutionary damage has been done.

There is another theory that is gaining traction because it half-sidesteps the quagmire of genetic and socioeconomic factors, and is something that is relatively easy to track. It won’t make you feel any better.

The theory is that black women, regardless of socioeconomic status, are simply exposed to more psychosocial stress. Stress produces hormones that are believed to play an important role in triggering labor in pregnant women. And in black women, the elevated buildup of stress hormones may trigger early labor and other pregnancy problems.

“That’s the theory,” Parker Dominguez said, adding that studies that have controlled for poverty and other socioeconomic factors appear to back it up.

For poorer black women, elevated stress may come from dealing with poverty and unstable families. For middle-class women, from having to work harder to prove themselves at work and having to battle preconceived notions about their abilities. And across income levels, black women experience stress due to real or perceived racism. The theory goes that over time, elevated stress from all of these social factors has a “weathering” effect that takes a toll on black women’s bodies.”

Source: http://www.scpr.org/news/2014/03/03/42483/why-do-black-infants-die-so-much-more-often-than-w/

That’s….godawful. The effects of endemic racism in the US is not just psychologically, but physiologically wearing away at the health and well-being of our citizens and their children (in more ways than one).

Needless to say, these statistics will be in the game narrative. Players will have a 1.14% chance of not making it past their first year of life. And if they choose to have children, there will be a 1.14% chance the infant will die. It will actually be less clearcut than that; this site breaks the statistics out by state, and I’ll use those for each location.

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