Addressing Black Infant Mortality Through Harnessing the Power of Community

In Hamilton County, Ohio, the infant mortality rate is above the national average and the Black infant mortality rate is more than 3 times the white infant mortality rate. These racial disparities in infant mortality cannot be explained through other socio-economic characteristics like education, income, housing, or medical insurance. Research has shown that racism, not race itself, is the driving force behind the high disparity in infant mortality rates in Hamilton County and the nation as well. The World Health Organization (WHO) and the Institute of Medicine have long cited institutional/structural racism and cultural racism as a key factor in health disparity. A paradigm shift needed to occur to address the consequences of racism within the lives of Black women, namely disempowerment and agency. The Commission on Social Determinants of Health (CSDH) model was which engaged Black women and positioned them as an asset, to share in the process of strategizing, creating, and implementing a plan. Queens Village was founded to implement the CSDH model and address the upstream determinants of infant mortality through cultivating a sense of community.

Using Collective Impact to Develop a Community-Led Initiative for Improving Black Infant Mortality

The United States has one of the highest infant mortality rates among developed countries. When stratified by race, disparities are more evident: Black infant mortality rates are 2.5 times higher than non-Hispanic white infants. Structural, systemic racism is a contributing cause for these racial disparities. Multisector collaborations focused on a common agenda, often referred to as collective impact, have been used for infant mortality reduction interventions. In addition, community-based participatory approaches have been applied to incorporate those with lived experience related to adverse pregnancy outcomes. This article critically describes the transition of an infant mortality collective impact initiative from being led by a multisector organizational group to being community led over a 5-year period, 2015–2020. A 34-member community leaders group was developed and determined four priorities and corresponding strategies for the initiative. Findings show that community participatory approaches are a way to address racial equity for public health initiatives.

Do Racial Stereotypes Contribute to Medical Misdiagnosis of Child Abuse?

Despite growing recognition that misdiagnoses of child abuse can lead to wrongful convictions, little empirical work has examined how the medical community may contribute to these errors. Previous research has documented the existence and content of stereotypes that associate race with child abuse. The current study examines whether emergency medical professionals rely on this stereotype to fill in gaps in ambiguous cases involving Black children, thereby increasing the potential for misdiagnoses of child abuse. Specifically, we tested whether the race-abuse stereotype led participants to attend to more abuse-related details than infection-related details when an infant patient was Black versus White. We also tested whether this heuristic decision-making would be affected by contextual case facts; specifically, we examined whether race bias would be exacerbated or mitigated by a family’s involvement with child protective services (CPS). Results showed that participants did exhibit some biased information processing in response to the experimental manipulations. Even so, the race-abuse stereotype and heuristic decision-making did not cause participants to diagnose a Black infant patient with abuse more often than a White infant patient, regardless of his family’s involvement with CPS. These findings help illuminate how race may lead to different outcomes in cases of potential child abuse, while also demonstrating potential pathways through which racial disparities in misdiagnosis of abuse and subsequent wrongful convictions can be prevented.

Radical Mothering as a Pathway to Liberation

I weave several threads in this essay, including the history of obstetrics and traditional Black midwifery, the devastating statistics of Black infant and maternal mortality rates, the experiences of eastern Congolese mama activists, the written and lived testimonies of Black North American mama activists, and my personal narratives to illustrate that the practice of mothering is fundamental to creating co-liberatory revolutionary movements and societies. This essay shows how mama activists, in particular Black mama activists, are taking great risks to their lives in the face of white patriarchal structures and in the midst of the ‘afterlife of slavery’ in order to honour the fallen and create a more just future. It also questions scholar-activists as to how they, whose scholarship is built off of the work of these mama activists, redistribute the life and death risk that mama activists shoulder to create the just world scholar-activists claim to desire.