By Ramya Dronamraju
Black infant mortality rates are dangerously high in the Kalamazoo Country area. These Black infant mortality rates are correlated to the poverty in the Kalamazoo county area. 85% of Black women live in poverty in Kalamazoo. Factors affecting these rates include poverty and access to resources that are needed to raise a baby. Those living in difficult financial situations may not have access to important resources- materially and with regards to health care. This could potentially worsen the health of mothers and the babies in their care. This paper explores the access to resources mothers may or may not have in Kalamazoo while in situations of poverty and the disconnect in communication between professionals, community members and mothers.
High rates of infant mortality is a problem present all over the world. In Kalamazoo, particularly, rates of Black infant mortality show little to no signs of decrease; in Kalamazoo, 19% of Michigan’s children are poor compared to a national average of 18%. As well as, In Kalamazoo County, 16% of children are poor. (Wendt, 2010) 85% of black women giving birth in Kalamazoo County live in poverty compared to only 30% for white women.(MCMicheal) In addition these statistics, Black babies are four times more likely to die than white babies in Kalamazoo. Socioeconomic status seems to be directly linked to health outcomes of mothers, not only in Kalamazoo, but all over the world. (Pamuk Fuchs, Lutz) There are a lot of contributing factors to this tragedy, including the environment in which these babies are raised. Within this environment in which babies are raised, problems a such as co-sleeping, or malnutrition or delivering low birthweight babies are evident and are increasing mortality rates. Although it is easy to claim that these problems are easily solvable, the implications of each problem are vastly convoluted. Generally speaking, poverty and housing problems create an unsafe living environment for infants putting them at risk for numerous health problems. In addition to these concerns, a lack of resources and the poor availability and accessibility to the resources in Kalamazoo causes concern and poses as an obstacle in eliminating Black infant mortality.
The fact that there are such high rates of poverty in Kalamazoo, it becomes difficult for mothers in poor financial situations to acquire the proper resources. Unfortunately, living in this situation causes problems with accessibility with regards to the basic necessities needed to take care of a baby safely. Some of these resources are simple yet essential things such as a crib. If a baby is put to sleep on the couch or in the bed with a parent, these infants are at risk of being suffocated by their parents or even rolling off of the bed or couch. This risk is a major component in the growing Black infant Mortality issue in Kalamazoo. A professional attempted to empathize by stating “It sucks being poor, I’m just going to say it… you get asked different questions that people with money don’t get asked and then you’re supposed to tell them all this stuff and once you tell them maybe CPS gets involved…so it all gets turned around in a negative way.” Discrimination is one of the bigger problems associated with living in poverty and the assumptions that accompany such a living situation. There is a lack of understanding with professionals and other community members in different financial states, and raising a child in this environment becomes increasingly difficult. Living situations and familial situations are also affected dramatically when a family has a poor financial situation. “Coming from unstable family lives is part of it. Lower socioeconomic status. Inadequate transportation. Not having a safe place to be pregnant and to turn into adults…” The emphasis should be placed on the sense of not being safe. There are a lot of factors that come with living in poverty, but if you don’t feel safe in your own home with your family, this could affect a mother’s mental stability and the care that an infant will get is directly related to the home life which they are raised in. For example, one community member shared her tragic story when she told us “My uncle had started raping his daughter, which was eight. He, that’s when he started raping me at the age of eight…I ran. And I ran and I ran and I didn’t stop till I got home. And I was crying when I got home but all my mother said to me—cuz he’s supposed to oh, oh, oh, pay me for babysitting but I’m not babysitting—he’s fucking me. Okay. So, I run all the way home, my mom, I’m crying, I got right in my room—a onebedroom apartment, may I remind you—come out the room, she calls me out the room, she said she looked—“Did he give you the money?”—I’m crying. Not once did she say what’s wrong with me, this and that.” This toxic home life and the abuse and trauma that may come with an unhealthy familial situation can cause a lot depression and anxiety “If you have a mom who is depressed during pregnancy… she has stressors and when she has the baby usually she is depressed still and making that connection after she has the baby is so important.” With extra stress and depression during pregnancy, it is likely that this will affect not only the baby’s health, but the mother’s health as well.
There is a large discrepancy between community members, health care providers and mothers who have lost their babies with regards to knowledge about resources available to them in the Kalamazoo area. When discussing the resources pregnant women have in Kalamazoo, a professional stated that “There are a lot of resources in Kalamazoo for pregnant women. I mean, compared to the greater population… I don’t want to imply that this is a hopeless situation. There are a number of programs in place in the community to help women get the stuff they need for the babies, to provide education for them. I honestly could make countless referrals during the pregnancy and it’s still not working.” The professional puts the focus on the fact that these mothers are not doing their part to take care of themselves although there are a plethora of resources. This blame on the mothers is further spread into the community which is exemplified when a female community member indicated that “There’s a lot of resources, but no one is taking them. [Parents} just don’t take the initiative to come to it. Because I know, working thorough head start, we do a lot. We do a lot for the parents, and they still don’t come out and do what they need to do. Like when the kids need to go to the dentist and doctor, we even take them to the doctor.” and a male community member addressed the crib accessibility issue when he said “always that option [to put your baby to sleep in a crib], when people say they can’t buy cribs, I say that’s a lie. There’s a lot of resources here. There’s a lot of places helping women with kids, but not a lot of single dads going to these places. But if you keep calling and stay consistent. If you want to change you got to do it yourself. You can go to events and read everything, but if you don’t apply it, it’s not important.” However, from the YWCA a woman who had lost her child stated that “They [hospital workers] just send you out the hospital and, [agreement from the group] and send you on your way—it’s nothing. Only, only help you got is the Y and the sexual assault program…And that’s why us African Americans go other places cuz’ there’s nothing out here for us. In Kalamazoo, Michigan we don’t have nothing. For us young black mothers who lost kids, we don’t have nothing. They don’t help you get over that. I mean, they, they, they don’t. It, it’s seems like they just don’t care.” From these differing perspectives, it is evident that the types of resources that are being discussed by both the social workers and the community members are not easily accessible to Black mothers in Kalamazoo or that there is a lack of communications between each of these groups.
Health resources seem to be easily accessible to women in Kalamazoo, but are underutilized, especially by those living in poverty. Women who live in poverty have two times higher risk of delivering low birth-weight babies and this leaves infants at risk for premature death. (McMicheal) During a presentation hosted by the YWCA on Black Infant Mortality, it was even made evident that 83% of Black mothers will not show up to a post-delivery appointment. (5/14/15) So one of the biggest concerns is why mothers are not utilizing health resources when it is so easily accessible to them. What is not taken into account is the lack of accessibility that women may have to transportation, or the short amount of time women may have while balancing their children and a job. As well there needs to be a sense of understanding and a nurturing environment at the doctor’s office, which may not necessarily be present, deterring women from returning to the doctor’s office if they do not feel like they are in a safe environment. This is also evident because officials report that poverty and racism cause a woman to feel like a “lower-class citizen” and may not want to return to an office where they don’t feel that they are being treated with adequate respect. (McMicheal) Women living in poverty would also have increased stressors such as depression but the focus is more on the health outcomes as opposed to emotional support. According to a study done on the availability of health resources on the health of a population with regards to infant mortality, the contribution of health resources to the health of the population as a whole is really rather small in comparison to the role of socioeconomic resources. (Kim, Moody,1992) One of the main resources available to women in Kalamazoo is the YWCA, which is the “oldest” and the “largest” women’s organization in the world which is dedicated to helping women who are have dealt with domestic abuse, sexual abuse who are homeless and is even used for help with career counselling and job training in some instances. (YWCA, Kalamazoo) As a resource, the YWCA provides females with what they need in order to take care of themselves and their babies.
It would be extremely difficult to claim that there’s one solution or that there is an easy way to fix the situation at hand, but there are several steps that the community can take in order to overcome the obstacles associated with Black Infant Mortality . Professionals have been brainstorming ideas by using other states and hospitals as examples. This was the case for one professional who said : “I know there’s a birth center and clinic in Washington D.C. in the inner part of town that has really good luck just by providing patients care that is respectful, compassionate and that makes the patients feel welcome and makes it feel like it’s in a place that they want to be … So if patients are getting that level of special treatment and respect and compassion, where they feel like they are being listened to and they want to come back. And it’s not just put this on your tongue step on that scale, everything looks fine, see you next time.” As an initial step, this would be beneficial to helping women who don’t feel respected in the doctor’s office and to have women come back to the doctor’s office. “It always makes me think of a young man one time that said “write me the check, and that will change my life. Forget about sending these people in telling them to figure out how to do it, write me a check so my life is changed.” It’s like… we are spending all this money trying to do this, what can we do different?” One solution would be bridging that gap between mothers and professionals who have access to resources that mothers may need to know about. In this instance, communication is essential and would help to bridge the gap for those who have resources and those who need resources. Housing situations must also be improved, with regards to emotional care and family care.