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Strategies to Activate Community Leadership in Research Practice and Increase Equity in Maternal Health Outcomes

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Community Leadership in Research

Culture and Its Impact on Health and Healthcare

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Culture in Healthcare

Power &amp; Progress Amidst Post-Pandemic Pandemonium: Prioritizing Black birthing Families

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Power, Progress & Priority

Advancing Equity in Maternal Health by Amplifying Community Voice. American Hospital Association

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Amplifying Community Voice

Increasing Equity in Maternal Health Outcomes. Institutional Justice &amp; Inclusion Committee

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Increasing Equity in Maternal Health

Embracing Equity: Activating Community Leadership in Research Practice to Enhance Black Maternal Health

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Embracing Equity in Community

A Systems Approach to Supporting Maternal Health Outcomes

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Supporting Maternal Health Outcomes

Advancing Power &amp; Precedent of Black Maternal Health &amp; Breastfeeding

Black Maternal Health & Breastfeeding

Cumulative Cost of COVID-19 on Communities of Color

COVID-19 on Communities of Color

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<h3>Lack of support from employers and the healthcare system leaves many Black mothers dependent on formula&nbsp;</h3>Since February, the country has experienced a shortage in infant formula prompted by the FDA shut down a Michigan plant due to a recall of three brands of powdered formula. Families across the country have struggled to find formula in their local stores as the federal government desperately tries to import stock from overseas. And while some have questioned why these struggling mothers just don’t breastfeed their babies, they are overlooking many of the structural barriers that make it more difficult for many mothers of color to do so.It’s true that breastfeeding has tremendous benefits for mothers and babies. As the CDC notes, it’s the best source of nutrition because mother’s milk changes to meet a baby’s nutritional needs as they grow. It also allows mothers to share antibodies with their babies that protect them from various illnesses. Breastfeeding can also help reduce a mother’s risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure. But Black mothers are still less likely to breastfeed their babies than any other racial group.The Infant Formula Crisis Could Hit Black Families Hardest The CDC reports that just over 75 percent of Black infants are ever breastfed compared with 85 percent of whites. As the months go on, the numbers go down significantly. According to the CDC, 20 percent of Black women breastfeed exclusively through the first six months, compared to 29 percent of white women. And when a mother doesn’t breastfeed, her milk supply quickly begins to decrease, leaving her to depend on formula.Much of this disparity is due to a lack of support from employers and the country’s healthcare system, which overwhelmingly pushes Black mothers to formula. According to data, most Black mothers return to work just eight weeks after they give birth, which is earlier than other racial groups. And when they return, they’re less likely to receive the support they need from their employers, including break time and a private space to nurse.Racism in healthcare system causes additional challenges for mothers of color. For example, in states such as Texas, Mississippi, Alabama and Georgia that have not decided to expand Medicaid, access to lactation consulting and breast pumps are not available. And hospitals in neighborhoods with a higher concentration of Black people are 15 percent less likely to provide lactation support to new mothers and instead pushes them towards formula feeding.As Andrea Freeman, author of the book “Skimmed: Breastfeeding, Race and Injustice points out, the system that has made so many Black mothers dependent on infant formula is now leaving them stranded in a time of crisis. “Nobody’s taking responsibility for the fact that they’ve steered families of color toward formula for so many years and made people rely on it and taken away choice. And then when it falls apart, there’s not really any recognition or accountability.”

For Black Mothers, Breastfeeding Isn't Always An Option

The COVID-19 pandemic has drastically changed lives in ways that will forever shape human history. Few previous pandemics have unleashed the level of devastation in disease and death as the coronavirus pandemic has.Declared a global public health emergency in March 2020, the total number of COVID-19 positive cases in the United States skyrocketed to over 4 million by late Summer 2020 and continued to climb to now more than 29 million infected and more than 500,000 deaths as of March 2021, the one year anniversary of the COVID-19 pandemic. African American/Black, Latino and Indigenous people experienced disproportionately higher rates of disease, death and negative social impacts.The Program for Multicultural Health, a division of the Community Health Services Department at Michigan Medicine, analyzed available information and data to understand the impact of COVID-19 on communities of color.Reports show Native Hawaiians/Pacific Islanders were most likely to have contracted COVID-19, while Black/African American people were most likely to have died from the virus, according to data retrieved from the COVID Tracking Project at Boston University.As of March 2021, more than 73,000 Black lives were lost to COVID-19 in the U.S.In Michigan, the cumulative COVID-19 case rate has been 40% higher for Black Michiganders than white residents and the death rate for Black residents has been more than three times the rate in white residents. Given the inequitable disease distribution of the disease, equitable distribution of the COVID19 vaccine is critical. The percent of vaccinated people who are Black has more than tripled between the first three weeks and the last week of vaccination (0.5% to 3.8%), but the proportion of vaccinated adults 16 and older who are Black is far lower than the proportion of Black residents (14%) in Michigan.For this analysis, social-ecological framework was used to understand the racial health gap as it considers multi-level systemic factors (i.e., individual, institutional and socio-historical) as impactful on the quality of life of individuals. Experts attribute the racial gap in coronavirus death, for example, to several societal factors including: the over-representation of Black workers in essential jobs, mass incarceration, residential segregation, wealth inequality, and a host of other structural inequities that have long affected Black, Indigneous and Latino communities. A recent study found, for example, that Black people were six times more likely to be turned away from COVID testing once they arrived at the hospital.Like the problem, viable societal solutions must be multifactorial to best ameliorate inequitable and negative impacts of COVID-19. Because pandemics rarely affect all people in society in a uniform way, it is essential to address the ways in which major social institutions such as health systems entrench and perpetuate broader societal power hierarchies, resulting in differential and inequitable health outcomes.Experts suggest an intersectional approach that analyzes "within group differences" by measuring the interaction between and across specific demographic data (race, sex, age, location, etc.) to expose hidden inequities.Solutions should reflect a systems approach that recognize healthcare and other societal institutions as products of broader societal systems. What must also be acknowledged is that sociocultural and historical contexts shape health inequities. Individuals do have a responsibility to engage in behaviors that enhance their own health, but individual responsibilities must be understood in the context of opportunities that exist within communities in which many people of color live."Vaccine reluctancy", influenced by past and current experience with discrimination, is especially important considering the higher COVID-19 infection and death rates in communities of color. However, we must also recognize that structural barriers, such as lack of transportation and lack of proximity to vaccination sites, decide access to the vaccine as well.In sum, our team recommends six concrete multi-level systems strategies:1. Develop translational interventions through community engaged research and practice.Research practices must center the community in creating interventions that reinforce trust and positive engagement to produce optimum health outcomes among marginalized communities.&nbsp;Community-university partnered research such as the recent Ypsilanti COVID-19 Study led by a collaboration between Eastern Michigan University Family Empowerment Program, the Washtenaw County Racial Equity Office and the Center for Equitable Family &amp; Community Well-Being within the U-M School of Social Work, demonstrate equitable research practice and impactful outcomes by engaging community in all steps of the research process.2. Incorporate experiential and measurable anti-racism training, education and other measures for providers.Training must be incorporated into medical school curriculum and mandated health provider training with deliverables that demonstrate first, effective treatment of bias and discriminatory practices and second, improved reports that people of color are receiving respectful, trusted and equitable healthcare.3. Support grassroots community and non-profit organizations' efforts to elevate social and economic status for people of color.To amplify positive health impact, it is critical to identify and support community-focused, grassroots organizations and efforts that target the upstream causes of structural and systematic inequities which manifest themselves in downstream social and health disparities.4. Advocate for policy changes at all levels across multiple institutions that highlight and dismantle systemic inequities.Government institutions and communities need to work in partnership and use coordinated strategies to ensure laws, policies, and practices alter systemic inequities. &nbsp; &nbsp;5. Track and prioritize for COVID-19 infection and vaccination data and distribution.Because Black and Brown communities have been disproportionately affected by COVID-19, "improving the race and ethnicity data being collected for vaccinations is critical for ensuring equitable administration of the vaccine," says Joneigh Khaldun, the chief medical executive and chief deputy for health in Michigan. The Social Vulnerability Index, or SVI, helps prioritize high-risk individuals and communities by using U.S. Census Bureau data to identify certain 'vulnerability indicators' (e.g. economic or minority status).6. Promote individual introspective review and address personal biases and misconceptions. &nbsp;Self-education is an important first step in understanding roles and impact on achieving social justice. Individuals are also encouraged to think about their own social identity and racial group membership and recognize how it positions or has positioned them for access to structures of opportunity, power or resources. &nbsp; &nbsp;The Program for Multicultural Health at Michigan Medicine supports the educational needs of staff, faculty and the community by analyzing and discussing effective strategies for addressing the disproportionate impact of the pandemic on communities of color. To learn more, visit the <a data-mce-href="https://www.facebook.com/UMHSProgramForMulticulturalHealth" href="https://www.facebook.com/UMHSProgramForMulticulturalHealth">Program for Multicultural Health's Facebook page.</a>

Addressing the Cumulative Cost of COVID-19 for Communities of Color

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Community-Based Focus Group Development: Identifying Strategies to Address Critical Issues Underlying Racially Disparate Breastfeeding Outcomes

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For Black Mothers, Breastfeeding Isn't Always An Option

Addressing the Cumulative Cost of COVID-19 for Communitie...

Community-Based Focus Group Development: Identifying Stra...

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