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.

Joan Rivers' "Blackie O" Comment Is An Insult to All Black Women and Mothers

I was really saddened and quite frankly, upset, to hear Joan Rivers share recently on national radio that her pet name for the First Lady is "Blackie O." Now, I often find Ms. Rivers hilarious as she pans celebrities on the red carpet and when trying to move her face despite way too many plastic surgeries. But this one, just wasn't funny.

Why not Chelly O? Or Mrs. O since her last name already starts with the letter? But to take it to race was just unnecessary, and highlights a few key points that have been bothering me of late.

For one, there is an unsettling undercurrent of disrespect toward our first family that always comes back to race that has never been experienced before. For eight years we had a president who couldn't find his way to a coherent sentence with a flashlight and a map, but the insults never equated his stupidity with race. I would have preferred if Ms. Rivers talked about Mrs. Obama's outfits.

And for the uninformed the world "blackie" has an extremely negative and racist connotation. It was used to denigrate, dehumanize and liken people of African descent to monkeys. Monkeys. Blackies. Get it? Still not funny, right?

I didn't think so either.

I'm happy to chalk it up to Joan's ignorance. I can only imagine what all that pulling and tugging has done to her brain capacity. But I think it continues a pervasive negative tone of disrespect for African Americans, and specifically black women. Here we have a Princeton University and Harvard Law School educated woman, who has worked at top law firms, selflessly served her community, a committed mother, and is serving as First Lady of the most powerful country in the world with more grace, poise, and dare I say fashion flair, than the White House has seen in decades, and even SHE gets thrown racial epithets?

What hope is there for me and my daughter? And the millions of the other black mothers raising their daughters and sons to be their best and serve their communities? Is that what we can expect, that even in the face of extraordinary accomplishments, to still be viewed as "blackies?"

This is not a laughing matter. In fact, it gives me goose bumps, and not the good ones. It's just another example of the kind of stresses black mothers face, and it upsets me that Michelle Obama's mother is feeling it, even as she sleeps in the White House.

Oh and memo to Joan Rivers: I know you are trying to keep your career afloat, sign new reality show deals and hold on to your relevance and youth, but America is trying to move past its racist history. We have much at stake in addressing this type of thinking and the many ways it plays out in our health and in our lives. And by referencing it, and then acting surprised that African Americans would be offended by it, you are showing yourself to be the one thing you strive so hard not to be: Old.

Am I Doing Good Enough As a Single Mom?

Sometimes, I really think I have this single mom thing under control. Not perfect. But nicely managed. I feel confident that my children are adjusting and that our routines matter. But the other week a troubling thing happened.

While eating a very lovely dinner of roast chicken (stuffed with rosemary,sage and thyme) and macaroni and cheese, my children and I found a wishbone. They decided to make a wish.

Of all the things that could be running through a child's mind to wish for, my 6-year old son whispered this, "I wish my parents would get back together."

I was somewhat shocked and a little sad.

My husband left July 2006 and since then I've worked tirelessly to keep a stable home environment for them. I left my demanding and lucrative career to work for myself and be more present for them. I am there at nearly every drop off and pick up, every school performance and book fair, we have family dinners every night, fun weekend activities and I have worked every day to maintain a good co-parenting relationship with the "wasband" for the good of the children. I tell them that we are still a family, just a different kind of family and I make sure they include their Dad in their nightly prayers. But I've also tried to make it abundantly clear to them that their father and I are happier apart and this is how things will be.

So, where have I gone wrong? Should I take it personally that my children are still holding on to a dream that will never (and I do mean never) happen? Or is this what children do for years and years after divorce? Will they ever get it and be okay?

My parents have been married 51 years and I feel blessed that I don't know what my children are experiencing. But that also leaves me clueless as to what is "normal" for this situation and what is not. You can only read but so many books.

As mothers, we want to make our children are emotionally well-rounded, stable and sure in their sense of self. As black mothers, we know the latter is most important because the world will try to tell them who they are. It is our job to make sure they know the truth. And much of that, in my opinion, begins at home, with a strong family. Regardless of what your "family" looks like.

I thought, well hoped, that my efforts would make my children feel normal. Complete. That they would accept their new reality and be ok with it. I thought that they were happy and settled in their new life but as it turns out, they are still yearning for their old one. And I'm concerned.

Am I doing something wrong? Or are they exactly where they are meant to be?

Battling the Bulge from Birth

This is the time of year when everyone is thinking about eating lots of good food with family. Then in a few weeks, we will all make new and not-to-be kept resolutions about losing the weight gained by eating those same meals and many others throughout the past year.

But to really battle the bulge, not just for ourselves but for our children, we have to start early, avoid empty promises and face the facts.

Now, for the most part we black women love our curves and really have no use for the latest crash diets. The way we walk, talk, and dress says "I am bold and beautiful, love it or leave it!" But at as fabulous as we think we are, obesity is still a prominent issue in the black community.

I have heard every excuse from "My family is big- boned" to "queen- sized" and my favorite "That just means there's more of me to love!" And, while these statements and mantras seem to scream I am confident and love my body, we need to address why statistics show that six out of every ten African American women are overweight and four out of every ten is morbidly obese. There is a huge difference between having a little belly or being a little hippy and packing on 30 to 100 extra pounds or more. 50 percent of African-American women are obese compared to only 40 percent of Mexican-American women and only 30 percent of White women.

While we already know that the high rates of obesity in our community is linked to the prevalence of diseases such as heart disease, diabetes, high blood pressure, stroke, arthritis and cancer. We don't see too many people addressing prevention strategies for all of these diseases that start at birth. If we really want to curb the obesity epidemic in our community we have to start well before childhood. We can start as soon as the baby is born.

Breast-feeding helps us lose the weight we gained during pregnancy and has many other health benefits for us too.

Breastfeeding is proven to reduce your baby's chance of being obese. The breastfeeding-obesity link is now recognized by key government agencies and professional groups, Including the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. Experts at the CDC in Atlanta estimate that 15 percent to 20 percent of obesity could be prevented through breastfeeding. Here are some of the reasons why:

• Breastfed infants may be better at self-regulating their intake. Mothers cannot see how much milk their child is drinking, so they must rely on their infant's behavior, not an empty bottle, to signal when their infant is full. Thus, breastfed babies might be better able to eat only as much as they need.
  
  
• Breastfed infants are more likely than formula-fed infants to try and accept new foods. Acceptance of new foods is important because a healthy diet should include a wide variety of foods, especially fruits and vegetables. Because breast milk contains flavors from foods eaten by mothers, breastfed infants are exposed to a variety of tastes early in life. In contrast, artificial baby milk (formula) always tastes the same.
  
  
• Breastfeeding has different effects than formula feeding on infant's metabolism and hormones such as insulin, which tells the body to store fat. Formula-fed infants tend to be fatter than breastfed infants at 12 months of age.
  
  
• For us to make a real impact on obesity in our community, we have to start at birth. It's really that simple. Resolving to breastfeed more and support any breastfeeding mother you know, is a real resolution for change.

Want Happy Holidays? Avoid the Holiday Spending Hangover

It always strikes me how the holidays are supposed to be so merry, but they seem to always end up being so stressful. Moms and dads want to create the "perfect" Christmas, everyone is trying out out-do the other and the whole thing turns into a mess. A lot of the holiday stress is around money, or the lack thereof. And the holidays are often the time when many families take on more credit card debt, blow their budget and avoid paying bills just to find money to buy presents. And in these tough times, overspending can be more dangerous than ever before. It has been estimated that one out of every three African American families is at the risk of falling out of the middle class due to job loss, overspending, unexpected financial crises or other issues.

Even though our spending power exceeds $920 billion the average net wealth of black families is merely $15,000. In fact, Black people disproportionately represent a major portion of Americans in debt:

• Right out the gate more Black college grads are left with more debt than white students, and the average American takes about 10 years just to pay off their student loans.

• Over 90% of African-American families earning between $10,000 and $24,999 are in credit card debt.

• 26% of Americans said that they do not pay all of their bills on time. Among African-Americans, this number is 51%.

This year, I'm imploring all families to be mindful of their budget. Avoid taking on undue stress by digging yourself deeper into debt, and strongly consider going back to basics and remembering the true spirit of the holidays. Family. Togetherness. As moms we play a critical role in setting the tone for the holidays and we also bear the brunt of cleaning up any financial messes we create. As part of my personal gift to you, I also found these great tips that I wanted to share with all women and heads of households, so that you can have a merry holiday without the holiday hangover. That never feels good.

1. Minimize all gifting and expenditures to your immediate family (You and your Kids, and husband/significant other)

2. Make a list of your income and all of your expenses.

3. After you have a very clear picture of where your money has to go you can see where you have room to wiggle room! Give yourself a very specific credit card budget and don't go beyond that.

4. Instead of buying 3 or 4 expensive gifts buy more inexpensive gifts.

5. Start early and use layaway programs for your must-have items.

6. Make this holiday season about family bonding. Check your local papers and websites for free events that will be great for you and your family.

Let's make smart decisions to close out this year that won't leave us stressed out next year.

Formula Fed? Not For My Baby: One Mom's Story

According to my Random House dictionary, definition No. 6 for the word "formula" is a mixture of milk and other ingredients for feeding a baby. I can deal with the milk; it's the other ingredients that concern me. The word "formula" immediately makes me think of mad scientists hovering over test tubes in a laboratory. It also makes me think of experimenting and trial and error. Why "formulate" something to feed your baby when God has equipped most women's bodies to produce milk after they give birth. Breast milk has exactly the right amount of fat, sugar, water, and protein that a baby needs.

I once heard that humans are the only mammals that intentionally feed their young something other than their own milk. That, among many other factors, helped me decide not to give my baby formula. When breastfeeding is an option, I think Black mothers owe it to themselves and their babies to breastfeed for as long as possible. Other than women with illnesses that prevent them from breastfeeding, new moms should at least make an attempt to give their babies the considerable health advantages that breast milk has been proven to provide.

Extended breastfeeding has been credited with protecting babies from various illnesses. It is said to increase a child's intelligence and it may also help to prevent obesity. Breastfeeding may offer protection from SIDS (Sudden Infant Death Syndrome). Some research has even linked the failure to breastfeed to intestinal issues experienced later in life. Breastfeeding exclusively for the first six months seems to offer babies significant health protection.

Moms benefit just as much from extended breastfeeding as their babies do. Breastfeeding moms are often free of a menstrual cycle for a longer period of time after giving birth. Breast, uterine, ovarian, and endometrial cancer risks are lower in women that practice extended breastfeeding. Diabetes is a disease that is prominent in the Black community. According to some studies, breastfeeding may lower insulin needs in diabetic women (http://breastfeeding.about.com/od/problemssolutions/a/diabetes.htm). Weight loss is another incentive for extended breastfeeding. In my case, about three months into breastfeeding I weighed less than I weighed prior to my pregnancy.

Along with the health benefits, extended breastfeeding provides an opportunity to bond with your baby in a way that no one else can. I can't put into words the joy I felt cradling my baby knowing that I was created by God to be able to nourish her. Mothers and babies are physically connected for 40 weeks during the baby's development. For breastfeeding mothers and babies extended nursing is a continued physical, emotional, and spiritual link.


Tangela Walker-Craft is the creator of Go Pillow! a patented, multipurpose childcare item that allows moms hands-free breastfeeding with comfort and president of Simply Necessary Inc. After nursing her own daughter for two years, Walker-Craft, realized that there was not a product on the market that allowed mothers to have nursing privacy and cradling comfort when others were present. Existing nursing pillows were too bulky and cumbersome for travel and cover-ups on the market required too much manipulation. The GoPillow! satisfies the needs of both breast feeding and bottle feeding mothers and caregivers. Learn more at http://www.simplynecessary.com/

New study: 400,000 infants born to depressed mothers. What can we do?

Pregnancy is supposed to be a happy time. Those glossy pregnancy magazines would make you think every pregnant woman is running through green meadows with unmitigated joy.

But we all know the real deal. Broken relationships, economic hardships, thwarted life plans or just bad timing can create so much anxiety during pregnancy and can crowd out any joy you may want to feel. We'd like to think this sadder side of pregnancy is the exception to most experiences, but a new study says otherwise.

A recent report by American Academy of Pediatrics says every year, more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most under-diagnosed obstetric complication in America.

That's big news.

With so many babies being born to depressed mothers, what does that mean for the level of early bonding and care that they receive? When you're depressed you are probably less likely to breastfeed, especially when it can be very physically and emotionally demanding in the early days and months. And what about the moms? How healthy are their eating habits, also linked to their likelihood to breastfeed, if they are depressed?

The point is, sad moms are even sadder news for babies.

What can be done? For one, there needs to be a broader dialogue about depression during pregnancy and post partum. It would be great if we didn't only portray one pregnancy experience as the "right" pregnancy experience, doing so keeps moms in the closet about their real feelings and prevents them from getting the help they need.

In our community, we need to do more talking. Black people are socialized not to air dirty laundry, so to speak, so we are often reluctant to share our problems, particularly with strangers. But talk to your doctor, a friend or trusted relative. If this is difficult, call an anonymous hotline, if you must. Just don't try to face depression alone.

If you're depressed, take off the strong black woman superhero outfit and pack it away. If your belief system says, I'm strong and I should be able to handle all situations, when the occasion inevitably arises that you can't do these things, you think of yourself as a failure. Those feelings can only lead to deeper depression.

Can you lighten your load? Cut down on your chores, errands for others, and other stressful activities. Try to do more things that will help you relax and regroup.

And there's nothing wrong with a little couch time with a culturally competent therapist--one who understands the complexities of a black woman's life.

Our babies have enough challenges in this world, let's do our part to make sure our children are born to moms who are as happy and mentally healthy as possible.