Will Health Care Reform Help the Racial Legacy of Health Disparities? Or Will Race Matters Get In The Way?

With people of color representing 50 percent of the uninsured in America, the new Affordable Health Care Act stands to represent the biggest social movement to impact our communities since civil rights.

But will it solve the health disparity issues that continue to plagues African Americans?

Recently, I attended the Families USA conference in Washington, D.C., where among other distinguished speakers, the 44th President of the United States, Barack Obama, spoke live addressing the conference attendees.

The president eloquently spoke of the benefits of the act, which has already dismantled that pesky "pre-existing condition" clause, which forced millions of Americans to be uninsurable by deep-pocketed insurance companies and caused thousands of others to die because of it. He was candid about the flaws in the law and reiterated his willingness to make changes in some areas.

As a self-employed mother of two who has struggled with my own health insurance issues, I listened intently to the debate that preceded the current law. And the still unfolding drama since it became law---and I just couldn't figure out why there was so much vehement dialogue against health care reform.

Was it really debatable that our system needed a major overhaul?

Having lived in London, England, and having experienced their medical care for myself and my children, I couldn't really understand what was the real problem with a universal health care system. Or with creating more options and lower costs. Not the political excuses and grandstanding, but the real issues. Especially since most of the most vocal objectors have some of the best health coverage this country has to offer. Lucky them.

The answer came to me at the conference in a dynamic panel discussion led by an extremely passionate woman--Gail Christopher, vice president for health at the W.K. Kellogg Foundation. (Full disclosure: The Black Maternal Health Project is funded by the Kellogg Foundation)

After sharing her personal story of arriving at a hospital to deliver a baby only to be left in the corner because someone just assumed she was a black woman on Medicaid, she said something so simple, yet true: "Where you stand is often based on where you sit."

It took all my strength not to jump out of my seat with an uncharacteristic, "You said it, sister!!"

I clapped instead.

But where most detractors "sit" is at the table of the haves with little concern for the have-nots and a lot of selective amnesia.

They've forgotten that this country got its haves by raping, killing and stealing from the people of color they found when they got here. They forget that their history of racism and segregation, left blacks concentrated in communities with severe health risks and without access to any remedies. They choose to ignore the cumulative impact of this racial legacy and the scores of women and vulnerable children it disproportionately impacts.

They forget about environmental racism, doctor deserts, food deserts and other gaping holes that have created and maintained a systemic inequity in access to health care.

An inequity and legacy that plays out every day in high maternal mortality and infant mortality rates and poor birth outcomes in black women across all socioeconomic levels, among others.

And multiple studies have already proven that people of color receive inferior care regardless of their insurance status or socioeconomic status. (I was happy to learn that the health care law has over 75 provisions to address equity issues, including more community based health care services.)

This is an important step in the right direction.

And so, unfortunately, like so many other issues in this country, it really comes down to race. Racial tensions in this country are getting worse, not better.

Everybody knows the true wealth of a nation is the health of its people. Yet, in this country any concept of a publicly supported health care system has a stigma of helping poor people. And by poor, they think lazy. So what if your children suffer? This stigma needs to be removed.

Politicians have pulled off a near-Reagan like maneuver duping Americans into believing who really benefits from the new health care act.

Every one benefits.

But the same patriotic, Federalist Papers-reading countrymen who "want their country back" should take a fast forward real look at the country they hold so dear. By 2042 it is estimated that one in four people will be a person of color. You can take the health care reform issue to the Supreme Court if you'd like, masking your political agenda in a baseless legal challenge. But we're all in this together, with our futures inextricably linked. And we are a constituency not to be ignored.

Because unfortunately for you, my memory is not like your memory.

Saving Ourselves: We Need Our Village Back

I was walking in Harlem one day and I heard and saw a young African American boy, about 10 years old, being scolded by his father. Like most kids, it seemed like his father was telling him to do something he didn't want to do. The exchange escalated to the point where the father was yelling at his son and it became more intense. The rest of the conversation–-voices elevated, high intensity, passersby watching-–went something like this:

Young Black Boy: "I wish I could kill myself." (Repeat, repeat, repeat.)

Father: "Oh yeah, what good would that do?"

Young Black Boy: "At least I could be in heaven and I wouldn't have to be around you."

I stop in my tracks.

I couldn't move. The father continued to yell at the boy, while the mother stood by quietly holding onto a baby stroller.

Now I know emotional blackmail when I hear it and I could see this boy's pain in his face and in his body language. It was one of those moments when my mommy instinct told me to run over there, hug that boy and tell him millions of moms are rooting for him and his success.

I would add that this life here on earth can be beautiful and peaceful and full of possibilities. "And that, even when it isn't, you don't ever give up."

I wanted to run over to his mother with hugs as well and an understanding and empathetic look that would send the message, "I know, sister, it ain't easy" and then maybe share some of my own struggles in childrearing.

I knew none of these options was allowed.

Back in the day, it was a given in most black neighborhoods that everybody on the block or apartment building was responsible for the wellbeing of each child. Every neighbor could tell you off or tell your parents what you were up to (and their concern was welcome) and a few select neighbors may have had punishment or spanking privileges. Your child was everybody's child. Your wellbeing was everybody's well-being.

But, on that day, I knew that our "village" mentality has long disappeared and that I needed to mind my own business, stop standing on the corner acting as if I was lost (when I was really engaged in the drama) and keep it moving to my car.

I drove off very sad that day. I was sad to hear that beautiful young boy declare that he thought death could be better than his life. I was sad to know that at a time when we need other mothers, aunties, grandmothers and sometimes well-meaning strangers more than ever before to help us raise powerful and productive black children that we have rid ourselves of these traditions. To our own detriment, I believe.

At the time when we need full community support to improve our individual health as black women and to have healthier babies, we have instead resorted to isolationism and leave-me-alone-ism, followed by do-nothing-ism. It's a dangerous combination.

But on that day, I was even more upset with myself. I felt I should have said something, done something anything, despite the consequences. I even dreamed about it--my negligence haunting me in my sleep.

I wonder, if we can start showing African-American mothers that we care, understand and support each other, can we bring “the village” back? If we add community responsibility to the basic tenets of personal responsibility then would you take a stand for me to have a healthy lifestyle? If we rewrite the rules for what actually defines “my own business,” and say every African-American child is connected and if yours fails, mine fails so therefore, by some very fundamental rules of logic and humanity, it is indeed very much “my business,” can we bring it back?

Can we????

We Need Our Village Back

For some time now, I've been lamenting the demise of our "village."

When our parents grew up the whole neighborhood helped raise them (and probably had spanking privileges). And when I grew up you could best believe that any neighbor would quickly tell my mother or father if I was ever seen someplace I wasn't supposed to be. There was an "we're all in this together" mentality and a thinking that my child is my responsibility and your child is my responsibility because at the end of the day, we are all in this community together and one success is our collective success and one failure is our collective failure and affects us all.

Somewhere along the way, we lost this village mentality. The changing economic climate has dictated that we move away from relatives or that we move often because of job opportunities. As a result, we never really grow roots in our communities anymore. We don't have our extended family of aunties, uncles and grandparents nearby anymore.

This week Women's eNews hosted a screening of Tonya Lewis Lee's powerful documentary on reducing infant mortality and improving maternal health, in celebration of the second year of The Black Maternal Health Project. It was a full house. The film, Crisis in the Crib--Saving Our Nation's Babies (view the trailer here) speaks directly to preconception health, mobilizing young people as peer educators in the movement and putting a face and voice to the infant mortality issue. The conversation afterward with Tonya and our fabulous guests was even more empowering.

We couldn't understand while infant mortality remains a taboo topic in our country's agenda. Even when you remove African American statistics from the equation, the United States still had an embarrassing ranking as far as infant mortality is concerned. We couldn't understand why maternal health is absent from the current debate about healthcare reform. And we certainly couldn't understand why very little is being done to save our most vulnerable population. There was so much that didn't make sense.

But here's what was crystal clear. We can't wait for the government to solve this crisis. Yes, we have to push for laws. But we also have to advocate in our communities to remove some of the social barriers to our health issues. We need to advocate for safe places to exercise, removing toxins from our communities, having fresh fruit and vegetables available in our communities and more.

It was clear that we need our village of womenfolk. And then some.

In Crisis in the Crib, the 'Healthy Baby Begins With You' Campaign,  takes on a peer education model. It uses college students to go into their own communities and also speak to high school students about preconception health. It goes back to that "village" mentality.

That night of the screening we deployed our own village, a room full of women of all races with personal and professional interests in embracing mothers and producing healthy babies. We thought of ways we could let our own network know about the OMH campaign, spread more awareness about the problem, or help be a part of the solution.

We saw the powerful ripple effect that could be sparked just from those in the room doing one thing. For that evening, we brought our village back. And it felt oh so good.

What can you do to help bring our village back to our babies? What more can we be doing? I'd love to hear from you. Please post a comment here.

Kudos to New Moms. Taking Care of Baby Is Not Like Riding a Bike.

A few weeks ago I happily agreed to watch my girlfriend's one year old son for about two days so she could take a work trip.

"I got this", I thought. Auntie Kim is on it! After all, it was only four years ago that I had a one year old. I figured getting back into the baby mode would be like riding a bike. It was more like getting hit by a bus!

Apparently four years is more than enough time to fall off your mommy game. It's amazing how quickly we can forget the work, the juggling (literally), the organization, the patience, the lack of sleep and all the "stuff" that baby's actually require. Because every phase of childhood brings its own stresses, I had nearly forgotten about this phase.

I didn't even mention that my girlfriend still breastfeeds him (Whoo Hoo!), so putting him to bed was going to require some serious creativity and a lot of patience. I haven't rocked and walked and sang that much in years!

Truth be told, on one of the days, I had a little help. My girlfriend from London was in town--and though childless, she is a highly capable Auntie to even my own kids. As two highly educated, savvy women we set out to run errands and take care of some business with my two kids and the baby in tow.

This was my moment to shine. I felt like I was back in the zone. I dutifully packed the diaper bag, refilling his water cup, adding snacks and checking for diapers and wipes. Meanwhile, my girlfriend got my children out the door and into the car. Everybody was belted, buckled and ready to go.

We pulled out the driveway proudly, slapping high fives at our teamwork!

We were halfway to our destination before I realized I left the superbly packed diaper bag in the house!

So there we were out for a long day with a one year old, with no diapers, no snacks, no nothing! Oy!

Watching (and laughing at) my own mommy blunders reminded me how tough parenting can be in the early years. Now I remember why we rejoice at the end of our diaper days, the end of our dependence on wipes, butt creams, changing pads and more baby gear than one human being can manage. I am very happy to be past those years.

On the other hand, there's a specialness of those early years that can never be duplicated. I miss the amazing bond and comfort I enjoyed while breastfeeding--I could totally understand why that little man did not want to go to sleep without it.

But when he did finally doze off, and I watched him sleeping peacefully, I was reminded of the calm that only a baby can bring over you. The joy of motherhood. I saw my own son, little Michael, just four years ago, when I used to stare in wonderment as he slept. I saw this baby as a future strong black man, and myself as part of his "village" that will help mold and shape him. (His mom is certainly part of the village that raises my children).

I saw everything that is beautiful about motherhood.

Hope.

Promise.

And endless possibilities.

Michael and Mama's Milk: A Lesson in Breastfeeding

Recently, a conversation around our dinner table began a little something like this:

Michael, my 5-year old: Mommy, did I used to drink milk from your breasts?

Me: Yes, you did

Son: Why?

Me: Well, it makes you healthier and smarter. Mama's milk is why you're so smart.

Son: Is that why I'm the only one in my class who can read?

Me: Yes

Son: And why I can ride a two wheeler and why I can tie my shoes by myself?

Me: Yes and yes.

By now I hope you get a sense of how my brainwashing works. Yes, I know my comments may not be completely scientifically proven facts. But he's my child to brainwash. Go get your own kid to tell your truths!

As far as I'm concerned, we have a multi generational effort on our hands when it comes to breastfeeding support in the black community and I'm starting early.

I'm hoping that this young black male who will hopefully have his own wife and children one day will remember my enthusiasm and even my exaggerated benefits of breastfeeding and someday wholeheartedly support his wife if she chooses to breastfeed.

For now, I talk to my son and daughter about how much I enjoyed the breastfeeding experience (which is the gospel truth!) even after I was still trying to wean my daughter at 14 months and then my son cut teeth at 4 months. Ouch!

Sometimes when my children don't eat properly I threaten to put them back on the breast so I can make sure they get their proper nutrition. LOL! I tell my nine year I will have to come to her lunchroom, whip it out and feed her. You should see the look on their faces. It is so funny!

But the low breastfeeding rates in the Black community are no joke. For over 30 years, African American women have had the lowest breastfeeding rates. The numbers have greatly increased in recent years, black moms still trail all other ethnicities. And when it comes to the gold standard of infant nutrition--six months of exclusive breastfeeding, among African Americans the rate is only 20% compared to 40% among whites. And as much as I respect a mothers' right to choose what feeding method works best for her lifestyle, I think there are some strong cultural forces at play that often cloud the issue. I also think that with so many dire statistics on the infant mortality rates among African American babies, we have a deeper responsibility to give our babies every possible advantage for a healthier start in life.

That's why I'm so honored to be an advisory board member of the Bravado Breastfeeding Information Council, which is dedicated to getting a full and diverse sampling of breastfeeding views for their research of the emerging trends, obstacles and challenges faced by nursing women at home, in the office, and other aspects of her life.

I'm asking all women of color to please take this brief survey  to add our perspectives to the research on breastfeeding attitudes and behaviors. You will be entered to win one of five $100 Target or Sephora Gift Cards. Whoo hooo!!

As you know my life's work involves making sure women of color are included in any and all research on the motherhood experience. Well, here is an important opportunity. Please share your voice.