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In series 'From Birth To Death,' AP reporters examine health care and racism


A large group of Americans is more likely than others to have complications and even die during childbirth, to struggle with asthma during childhood and high blood pressure during adulthood, and to develop Alzheimer's as elders. What do these Americans have in common? They're Black.

Researchers have known about these disparities for some time. But reporters with the Associated Press wanted to know how wide these disparities are and why they persist. So they spent a year examining all this and just delivered their work in a new five-part series called "From Birth To Death." I recently spoke with one of the series' main reporters, Kat Stafford.

You start the series talking about something that's gotten a fair amount of attention in recent years, which is the very high rate of death that Black women and babies experience in childbirth in the U.S. compared to white people in the U.S. and, frankly, compared to other parts of the world. But you go further. You say this is a pattern of health disparities that follows from birth to death. What made you take that expansive look?

KAT STAFFORD: So I did a lot of reporting for the AP amid the early months of the COVID-19 pandemic and really taking a deep look at the disparate toll that we saw on Black communities across the nation. And I felt like there's more to this. How do we get to this point where we saw these disparate outcomes? So that was kind of the genesis for this project where we really wanted to set out and show that the things that you encounter as a Black American, even before you take your first breath of life, can really set the stage for you to encounter and deal with these health inequities that impact Black Americans from birth, literally to their final moments of life.

MARTIN: And just even looking at maternal mortality, you point out that the differences exist regardless of income or education level for Black women. Why do you think it's so important to point that out?

STAFFORD: That is a crucial element of this project because this is true for the maternal mortality rates that we are seeing, but it's also true for many of these ailments that we reported on - that regardless of how much money you make, if you are a Black person in America, you have a higher chance of dying of these illnesses. And a lot of these deaths are preventable. If you are a Black woman, a Black person, you enter the medical system, you are likely to encounter a medical provider who might not listen to you. Your concerns aren't heard.

MARTIN: That was Angelica Lyons' experience in Alabama. When Stafford interviewed her for the series, Lyons told her that when she became pregnant in 2019, she started experiencing severe pain. But she says hospital staff did not take her seriously.


ANGELICA LYONS: I got in the bed. I felt this strong pain from, like, my vaginal area all the way up to my chest. I screamed. That was literally the beginning of literally them constantly leaving me in pain.

MARTIN: Black Americans report similar experiences when they become caregivers to aging parents with Alzheimer's. African Americans are 40% more likely to develop Alzheimer's than white Americans, according to federal data. But all along the way, family members say they struggle to get adequate information, treatment and support from medical providers.

STAFFORD: What we found was that a lot of Black caregivers, they encounter the same things. You have providers who aren't listening to them. Even getting a simple diagnosis is hard. So not only are Black people more likely to have Alzheimer's, they are also less likely to be receiving equitable care that they need to take care of this disease.

MARTIN: How do we know that this is a systemic issue? Because as you certainly know that we live in a time when there are a lot of people who are just really reluctant to - and even hostile - about the idea that there is something called systemic racism. So what convinces you that this is something about the systems that people live in and under?

STAFFORD: The fact that there are decades worth of research, statistics, all of these things that have laid out clearly the role that structural racism plays in inequities. We also made an intentional effort to highlight the voices of doctors, historians, folks that have really been rooted in this work, to really lay clear why these disparities exist today. And one thing that they all were very keen on pointing out was this cannot be explained by genetics alone. There is nothing genetically wrong with Black people. But what we are seeing are the effects of socioeconomic conditions, social determinants and all of these things that manifest because of this legacy of structural racism.

MARTIN: That legacy plays out in the city of Hartford, Conn. More than 21% of kids in East Hartford have asthma. That's compared with 13% statewide. Black children are disproportionately affected. Stafford spoke to a mom in Hartford named Catherine. Her 5-year-old son has asthma, and he suffered a frightening attack at a birthday party.


CATHERINE MANSON: So I literally had to pick him up. And he just kept saying, I can't breathe, I can't breathe. He's crying. And I'm just like, OK, just breathe. Just breathe. Sorry. That was scary.

MARTIN: Stafford also interviewed the former director of Hartford's health department, Mark Mitchell. He sought to raise awareness of how industrial development clustered near Black neighborhoods contributes to high asthma rates.


MARK MITCHELL: It's clear that there is systemic racism. I don't think that there is a racist on the steps of the Capitol saying, let's have all toxicants go to communities of color. But the rules and the processes that are in place tend to make that happen.

MARTIN: Would access to care fix this problem? I mean, if, for example, there were more health facilities in Black neighborhoods, would that address the problem? Or is it more than that also?

STAFFORD: Even if those places do exist, what a lot of advocates and experts have said is, that does not address the structural racism that might manifest in these institutions.

MARTIN: What do you think has been lost by the fact that the health of African Americans compares so poorly to that of other Americans, particularly white Americans? How would you kind of describe what the country has lost?

STAFFORD: When you think about all the people that we have lost across generations, we have lost people who we don't know what they could have become. And for me, I kept that throughout the course of the reporting. And I hope that is something that sticks with everyone. It's not just numbers we're losing here. These are real people.

MARTIN: That's Kat Stafford. She reported a series on the health disparities that African Americans experience from birth to death. Kat Stafford, thanks so much for talking to us.

STAFFORD: Thank you for having me.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.