African American Faith Based Bereavement

Initiative

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Why do we care? Opening our eyes to our community’s pain?

1 Kings 8:52 NIVMay your eyes be open to your servant’s plea and to the plea of your people Israel, and may you

listen to them whenever they cry out to you.

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Crisis in the Crib

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A QuizWhich of the following is not true about African-American babies:

a. They are more than twice as likely to die during their first year of life than white babies

b. They are more than 2.5 times as likely to be born at a very low birth weight than white babies

c. They are more than twice as likely to be born at a low birth weight than white babies

d. They are more likely to die from congenital anomalies (birth defects) than white babies.

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The Answer

• They are more likely to die from congenital anomalies (birth defects) than white babies.

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A Quiz

• True or false. The reason more African-American babies are born early or die young is that there is a genetic problem that can be traced back to Africa.

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The Answer

• False

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A Quiz

• True or false. Other women of color in the United States experience pregnancy losses at the same rate as African American women.

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The Answer

• False

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A Quiz

• True or false. Rich and well-educated African-American women have birth outcomes that are like those of white women at their socio-economic level?

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The Answer

• False

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Population of women 15-44 years by race/ethnicity

US, 2006

All race categories exclude Hispanics. Source: US Census Bureau. Population estimates based on bridged race categories released by the National Center for Health Statistics. Retrieved December 8, 2009, from www.marchofdimes.com/peristats.

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Percentage of infant deaths by race/ethnicity

US, 2003-2005 Average

All race categories exclude Hispanics. Percentages will not total 100 percent since missing ethnicity data are not shown. Source: National Center for Health Statistics, period linked birth/infant death data. Retrieved December 8, 2009, from www.marchofdimes.com/peristats.

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Disparities in Infant Mortality

Data Source: Mathews and McDorman, 2010

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Why Are Babies Dying?

• Non-Hispanic black babies are much more likely than non-Hispanic white babies to die from: – Sudden Infant Death Syndrome (2.4 times more

likely)– African American babies are at higher risk due to:

• More likely to be put to sleep on their stomachs• More likely to sleep in bed with parents and other children• More likely to be put to sleep on couches and other unsafe

surfacesLi, et al, 2009; Shapiro-Mendoza, et al, 2009;Hauck, et al, 2008; Bruckner, 2008; Fu, et al, 2008; Lahr, et al, 2007; Ostfeld, et al, 2006; Shields, et al, 2005; Hauck, et al, 2003;Unger, et al, 2003; Hauck, et al, 2002; Pollack and Frohna, 2002.; Mathews and McDorman 2008

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What can you do

• In many communities, churches hold SIDS Sundays to promote information about safe sleep for babies.

• Free resources are available for your church to do a SIDS Sunday– Electronic files to have Safe Sleep information

fans printed– Suggestions for sermons

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Why Are Babies Dying?

• Non-Hispanic black babies are much more likely than non-Hispanic white babies to die from:

Maternal pregnancy complications (3.1 times more likely) Other birth complications (twice as likely)

Mathews and McDorman 2008

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Why Are Babies Dying?

• Non-Hispanic black babies are much more likely than non-Hispanic white babies to die from: – Preterm births and the associated low birth weights

(5 times more likely)

Mathews and McDorman 2010

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Preterm by raceUS, 2004-2006 Average

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved December 8, 2009, from www.marchofdimes.com/peristats.

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What contributes to these differences?

• Genetics does not seem to play a role• Poverty and the stresses associated with it• Mothers who were low birth weight

themselves are more likely to have babies who are low birth weight

• Interpersonal racial discrimination experienced by the mother

Collins, et.al. 2004; Collins and David, 2009; Matthews, and MacDorman, 2008; Lu and Halfon, 2003)

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Fetal Mortality Rates—2005Data Source: National Center for Health Statistics

Overall White Black AI/AN AP/PI Hispanic0

2

4

6

8

10

12

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We cannot help what we do not see.

• We need to open our eyes to these inequities so we can open our hearts to the families who experience these losses.

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Hauck, F., Moore, C., Herman, S., Donovan, M., Kalelkar, M., Christoffel, K., Hoffman, H. and Rowley, D., (2002). The Contribution of Prone Sleeping Position to the Racial Disparity in Sudden Infant Death Syndrome: The Chicago Infant Mortality Study. Pediatrics, 110(4):772-80.Lahr, M., Rosenberg, K., and Lapidus, J., (2006). Maternal-Infant Bedsharing: Risk Factors for Bedsharing in a Population-based Survey of New Mothers and Implications for SIDS Risk Reduction. Maternal Child Health Journal, 11(3):277-86. Epub 2006.Li, L., Zhang, Y., Zielke, R., Ping, Y. and Fowler, D., (2009). Observations on Increased Accidental Asphyxia Deaths in Infancy While Cosleeping in the State of Maryland. American Journal of Forensic Medical Pathology, 11(06).Matthews, T. and McDorman, M., (2008). Infant Mortality Statistics from the 2005 Period Birth/Death Linked Data Set. National Vital Statistics Reports, (57)2.Mathews, T. and McDorman, M., (2010, April 30) Infant mortality statistics from the 20056 period birth/death linked data set. National Vital Statistics Reports, 58(17).

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McDorman, M., Hoyert, D., Martin, J., Munson, M. and Hamilton, B., (2009). Fetal and Perinatal Mortality, United States. National Vital Statistics Reports, (57)8.Ostfeld, B., Perl, H., Esposito, L., Hempstead, K., Hinnen, R., Sandler, A., Pearson, P. and Hegyi, T., (2006). Sleep Environment, Positional, Lifestyle, and Demographic Characteristics Associated with Bed Sharing in Sudden Infant Death Syndrome Cases: a Population-based Study. Pediatrics, 118(5):2051-9.Pollack, H. and Frohna, J., (2002). Infant Sleep Placement after the Back to Sleep Campaign. Pediatrics, 109(4):608-14.Shapiro-Mendoza, C., Kimball, M., Tomashek, K., Anderson, R. and Blanding, S., (2009). US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 through 2004: are rates increasing? Pediatrics, 123(2):533-9.Shields, L., Hunsaker, D., Muldoon, S., Corey, T. and Spivack, B., (2005). Risk Factors Associated with Sudden Unexplained Infant Death: A Prospective Study of Infant Care Practices in Kentucky. Pediatrics, 116(1):e13-20.Unger, B., Kemp, J., Wilkins, D., Psara, R., Ledbetter, T., Graham, M., Case, M. and

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Thach, B., (2003). Racial Disparity and Modifiable Risk Factors among Infants Dying Suddenly and Unexpectedly. Pediatrics, 111(2):E127-31.Willinger, M., Ko, C. and Reddy, U., (2009). Racial Disparities in Stillbirth Risk across Gestation in the United States. American Journal of Obstetrics and Gynecology, 201(5):469.e1-8. Epub 2009 Sep 17.