Sharpest Scalpel Opinion Piece:( continued)
States.”
The studies are indisputable. There is clearly a racial and socioeconomic gap that has been understood, at its most basic level, for over thirty years. Yet( at best) we continue to accept the situation as one that cannot be justifiably or practically addressed, or( at worst) as one we choose to willfully ignore. Either way, the human damage and the incalculable hurt caused by this phenomenon is incommensurable and, year after year after year, it’ s costing us the lives of young black women like Erica Garner.
There are states taking steps to address and eliminate implicit bias against black women. In California, Senate Bill( SB) 464, the California Dignity in Pregnancy and Childbirth Act, authored by then-Senator Holly Mitchell, took effect January 2020. It is designed to begin to address the harms caused by racism and improve racial disparities in birth outcomes by helping providers recognize their own biases and thereby develop a new perspective on the view of equitable healthcare.
This is a fundamental and vital first step in order to avoid the most tragic of consequences such as the one experienced by 39-year-old Kira Johnson, a beautiful, vibrant, and healthy young black woman who died on the operating table at a local hospital in Los Angeles because doctors refused to believe the post-childbirth pain she was experiencing. When her doctors finally took her into emergency surgery, ten hours after she first shared the agonizing pain she was in, they discovered a bladder that had been lacerated during her C-section resulting in three liters of blood discovered in her abdomen.
SB 464 is a small step, but the fact remains that the chronic stress of a life lived under the direct threat of racism, or the acute pressures of discrimination and bias can cause measurable wear and tear on the body, increasing the risk of hypertension, depression, diabetes, heart failure and prenatal difficulties. This is no longer just conjecture. Researchers have been investigating mechanisms that connect the emotional world of stress with the physiological world of disease for more than thirty years.
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It is designed to begin to address the harms caused by racism and improve racial disparities in birth outcomes by helping providers recognize their own biases and thereby develop a new perspective on the view of equitable healthcare.
Health is an environmental and social condition. It is just as much about where you are and who you are as it is about what you do and how you do it. A range of factors, known as social determinants of health, influence an individual’ s overall health and well-being. The locations where people live, work, go to school, and socialize, as well as the characteristics of those environments, are all important indicators of financial security, access to highquality healthcare, social and communal environment, and neighborhood and surrounding structures.
The solutions to such complex and chronic problems are never easy, particularly problems that have existed for generations. But they start by taking the first step. They start by dealing with the structurally rooted factors that have caused weathering in the first place. They start by removing the stresses inherent in society that stigmatizes blacks and causes disproportionate physiological deterioration in women of color. They start by placing that first Jenga piece back exactly where it came from.
Only then can we start building an inclusive society. In order to be truly considered equal, we must have a long overdue conversation about access to a quality education and good healthcare, about safe neighborhoods and livable housing conditions. Deliberate conversations of inclusion require civic engagement and local government partnership. Discussions begin with systematic and productive. We must remove self-imposed or social stigmas associated with our minority and disenfranchised communities and lift one another to a place of fairness and impartiality.
The road may be long, but the destination is well worth the journey. We could gain a lot more ground if we started walking towards each other, in pursuit of equity and the exact same liberties, and stopped creating barriers limiting access. The first step towards fashioning an appropriate solution is recognizing there is a problem and removing barriers from an inclusive society accessible to all. Dr. Geronimus recognized this over thirty years ago. It’ s time we did as well. SB 464 provides a starting point for addressing birth equity. However, accountability starts with individuals implementing change within their sphere of influence.
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CDU College of Medicine | PG. 18