'Incredible' racial disparities in maternal and infant health persist in Delaware
Tuesday's annual Delaware Healthy Mother and Infant Consortium summit in Wilmington focused on the disparity between maternal and infant health outcomes for white and black women in Delaware.
“Do black babies in the state of Delaware matter as much as white babies?” asked Dr. Arthur James, OBGYN and Ohio State University professor, at the conference. “While everybody generally will suggest yes, I think your results don’t support that response.”
Delaware has the 14th highest statewide infant mortality rate in the country, according to 2017 CDC data.
"Do black babies in the state of Delaware matter as much as white babies?" - Dr. Arthur James
The infant mortality rate for white Delawareans averaged 4.5 deaths per 1,000 births between 2013 and 2017, according to the state Division of Public Health. The rate for black Delawareans was more than 12 deaths per 1,000 births.
The highest infant mortality rate in Delaware is for black women in the City of Wilmington, whose babies die at a rate of 16.3 per 1,000 live births. That’s nearly three times the national average for all races of 5.8 deaths per 1,000 live births.
“The racial disparity in birth outcomes is the largest, the most significant maternal-child health problem we face in this country,” said James. “Generally we say, 'black babies die at two to three times the rate of white babies,' and we move on. We have to change that narrative.”
Dr. Cecil Gordon is a longtime OBGYN based in Wilmington. He says there is no one cause for the disparity in health outcomes between black and white mothers.
“Underlying medical conditions are always an issue,” said Gordon. “Social parameters are always an issue. Access to healthcare is another issue. And the list goes on and on. To be perfectly honest though, I think there are some other factors that we don’t completely understand.”
"Why don't you talk to the people in the community and see what happens?" - Michelle Drew
Michelle Drew, DNP, is a midwife at Christiana Care and part of the national Black Mamas Matter Alliance. She says social determinants of maternal and infant health include housing, income, neighborhood safety, air quality, environmental stress, food insecurity, educational attainment, unemployment and access to comprehensive, culturally competant health services.
She adds that racism, rather than race, is a primary factor. Other experts at the summit pointed to bias in the medical system.
Drew advised the state to look more to community organizations for solutions.
“You have hundreds, thousands of community-based organizations with people who have first-hand, lived experiences of what it’s like and what these communities need,” said Drew. “Instead of expending lots of energy and lots of money designing these programs you’re going to carry out and five years later fail, why don’t you talk to the people in the community and see what happens?”
"We need to find a way to ... hear everybody's voices, and really have those hard and true conversations on racism and how that affects outcomes." - Dr. David Paul
Delaware Healthy Mother and Infant Consortium leaders agree that more community engagement is needed.
“I think what we heard today is that we need more community voices,” said Dr. David Paul, chair of the Consortium.
“Despite our great efforts— we’ve reduced infant mortality twenty-plus percent in Delaware— we still have incredible racial disparities,” Paul added. “We need to find a way to solve that problem, hear everybody’s voices and really have those hard and true conversations on racism and how that affects outcomes.”
Paul notes the state is looking to gather more data this year on social determinants of health in Delaware through the Healthy Women Healthy Babies program.