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The bias behind higher death rates for Black pregnant women, and how to tackle it


Black women are nearly three times more likely than white women to die of pregnancy-related causes in the U.S. Two Miami doctors discuss the causes of this disparity and how to address them.

Regardless of education level or income, federal datashows that Black women are more likely to die from pregnancy-related complications than white, Asian or Latina women.

To mark Black Maternal Health Week, which took place last week, WLRN explored on the latest episode of the South Florida Roundup why that disparity remains and how to tackle this matter.

Local specialists Dr. Dudley Brown Jr. and Dr. Lysa Auguste blamed biases in the nation's health care system and a lack of representation among medical staff.

Recent data showed maternal mortality has reached one of the worst rates in the country's history, a number that is higher than in other developed countries. And a disproportionate number of mothers who are dying are Black — they are nearly three times more likely than white women to die of pregnancy-related causes.

Auguste, a resident OB-GYN at Miami's Jackson Memorial Hospital, said that now that we know socioeconomic status does not make a difference in these stats for Black women, we have to look at what else could be causing these numbers.

“We recognize that a lot of it is systemic and institutionalized racism, and bias that's being come into play. … A lot of us are walking around with a bias that affects our patients and we don't even see it,” she said.

Brown, the president of Brown Institute for Health and Wellness and the vice chief of staff at Jupiter Medical Center, said that implicit bias affects every field, including health care.

“Specifically within health care, what we've done for years is assume that we live and work in a vacuum and that outside factors don't affect the care that we give,” he said. “And it affects the way we care for patients. It affects the way we come up with a diagnosis.”

To combat bias in health care, providers are aiming to increase diversity in the workplace.

“A lot of what we recognize now is that Black women feel more comfortable when they have providers who look like them and they feel more comfortable. And it's been shown that Black women do better with providers who look like them,” Auguste said.

She said that Jackson Memorial has started what it calls "health equity rounds." Every six weeks, providers take a patient presentation and look at not only the medical care they provided, but also the social aspects of their care.

They look at what went wrong, what implicit biases were at play and how they could have done better in providing patients equitable care.

Brown said that what is being done at Jackson Memorial must be done by society and health care leaders. Conversations about what the data represents and the reality minorities experience in health care need to be had in the open, he said.

“My Black colleagues and I have been having these conversations amongst ourselves for years, and now we're having these conversations in the open,” he said.

“And we need to get buy-in from everyone … the same thing that we talk about in academics, we need to do in health care in terms of diversity, equity and inclusion training.”

Both doctors agree that it’s necessary to have more providers that are representative of the community in which they serve, and to bring awareness to the subject and the data.

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