Causality is a cornerstone of modern medicine. Its essence is that cause and effect are distinct, but knowing one does not imply knowledge of the other. Physicians have been trained to make inferences about the cause from associations with effect. But when it comes to understanding the causes of maternal mortality in black women, complex biological and sociological underpinnings don’t lend themselves to simplistic “cause and effect” formulations.
This is not to say we need to abandon medical training—it’s to say that there needs to be room for patients’ cultural and environmental experiences.
“Much of the current research on MMM focuses on the medical cause of death—such as cardiovascular conditions, hypertension, hemorrhages, and thromboembolism—but not the larger environmental context. Thus, little research exists examining the root causes of the racial disparities in maternal health in the United States,” says Samia Noursi, Ph.D., ORWH’s Associate Director for Science Policy, Planning, and Analysis. “Understanding the variations in experiences across socioecological domains between White and minority women in the United States is important in developing more effective policies and programs to reduce racial disparities in MMM and, ultimately, save mothers.” [Source: NIH]
When it comes to race-based causes of high rates of black maternal mortality, there is a strong tendency to attribute these outcomes to biology rather than environmental or sociological factors, despite little research or focus on the environmental or cultural context that impacts a black mother’s pregnancy outcomes. We need to change this, and it’s time to prioritize understanding our patients’ culture, values, and beliefs and how they impact black maternal outcomes.
Since the pandemic, we have faced an alarming rise in maternal deaths in the U.S. Many factors contribute to these disparities, and a unified or holistic solution has yet to be.
In 2020, Black women were most disproportionately affected with a mortality rate of 55.3 deaths per 100,000 live births, compared to 19.1 deaths per 100,000 live births, and 18.2 deaths per 100,000 live births for White and Hispanic women, respectively. (Source: CDC)
Together, we can make sure the conversation is not one-sided. We can help people realize that the disparities exist by starting conversations with health organizations and others with something profound to say. And we can use technology to enable patients and medical professionals to understand each other better to work as partnered teams toward better care.
Partner with us. Our Health Culture Index is a global tool designed to understand the patient value system – collecting patient stories and translating them into meaningful and measurable analytics. Please message us to learn more.
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