• Description

Practitioners in maternal and child health (MCH) make it a priority to solve complex public health problems facing women, children, adolescents, and their families across the life course. The field of MCH has made significant advances in the past century, including the expansion of family planning methods and services, the eradication of once-common deadly diseases such as polio, and innovations in maternal and child health care that have significantly reduced the rates of maternal and infant deaths.

Despite these investments, the health of women and children in the United States lags far behind that of other countries. The U.S. has one of the highest infant mortality rates among developed nations. Furthermore, nearly one in every ten babies born in the U.S. each year are born prematurely, and those who survive face an increased risk of lifelong health challenges. More troubling is the fact that there are extreme and persistent racial inequities in MCH outcomes and, in particular, birth outcomes. Babies born to non-Hispanic African American women are twice as likely to die in their first year of life as compared to babies born to non-Hispanic white women. In some places, inequities continue to grow. In New York City, African American mothers are twelve times more likely to die in the year after childbirth than white mothers, according to the most recent data; a decade ago, their rate of death was seven times higher.

Most studies on birth outcomes that have accounted for differences in socioeconomic status among women continue to find racial inequities. Studies have also shown that African American women who abstain from risky behaviors during pregnancy (e.g., smoking, alcohol, or other drug use) still have higher rates of poor birth outcomes than non-Hispanic white women who engaged in some of those behaviors. Repeated exposure to structural, institutional, and interpersonal racism that many women of color experience throughout their lifetimes contribute to inequities in birth outcomes. Furthermore, the history of racial residential segregation, redlining, and systemic divestment in communities of color further compounds and concentrates disadvantage in specific geographic locations.