Implicit bias
31st May 2022 · 0 Comments
According to World Population Review, Louisiana’s maternal mortality is 58.1 per 100,000 live births, the highest in the United States and triple the United States average of 17.4 deaths per 100,000. A 2019 report in U.S. News has Louisiana as second-worst in the nation with 44.5 per 100,000 live births.
U.S. Senator Bill Cassidy (D-LA) set off a wave of criticism after implying that Louisiana wouldn’t rank as high in pregnancy-associated deaths if the state dropped Black women’s maternal mortality numbers from the state’s health data.
“About one-third of our population is African American. African Americans have a higher incidence of maternal mortality. If you correct our population for race, we’re not as much as an outlier as it otherwise appears,” Cassidy says in an interview with the Harvard Chan School of Public Health series “Public Health on the Brink,” according to POLITICO.
“Now, I say that not to minimize the issue but to focus the issue as to where it would be. For whatever reason, people of color have a higher incidence of maternal mortality,” he adds.
Cassidy pointed to Louisiana’s definition of maternal deaths as another reason for the high mortality rate. “Sometimes maternal mortality includes up to a year after birth and would include someone being killed by her boyfriend.”
The Louisiana Pregnancy-Associated Mortality Review (LA-PAMR) definition of pregnancy-associated death is rather dubious. The state attributes pregnancy-associated deaths to medical problems and non-specific causes like car crashes and suicide that may occur during pregnancy and up to a year after giving birth.
Dr. Cassidy’s specific inference demands that he cite statistics or percentages of incidents to back up his cavalier assertion. But until he provides us with that information, LA-PAMR states that, “Black birthing women were more than twice as likely (2.1 times) to die as white birthing women in Louisiana. This disparity is more prominent in pregnancy-related deaths. Among pregnancy-related deaths, over three Black birthing women (3.2) in Louisiana died for one white birthing woman.”
The review committee also concluded that most pregnancy-associated and pregnancy-related deaths could be prevented. Boyfriend killers didn’t figure in those stats.
Black pregnant women continue to face disproportionately high pregnancy-related deaths, with data from the Centers for Disease Control and Prevention indicating a 26 percent increase in the maternal mortality rate for Black women since the start of the pandemic, NBC News reported.
Though researchers do not have an explanation for the disparities, research suggests it’s a culmination of institutional racism and other health factors, such as the increased risk of obesity and hypertension in Black women. Stress and a lack of access to quality care are also factors.
Like many other politicians who get called out, Cassidy jumped to justify his statements when Black professionals like TV Host Joy-Ann Reid and Dr. Richina Bicette-McCain called him out for his insensitive, if not racist remarks.
Dr. Bicette-McCain, an emergency room physician and medical commentator to news commentator Don Lemon, that Black maternal deaths result from “systemic racism,” “implicit bias,” and “lack of access to health care for rural women,’ and insurance costs.”
“Senator Cassidy’s comments are not only ignorant and racist, but they also ignore the role Republicans’ policies have played in exacerbating the real maternal crisis in our country.” NARAL President Mini Timmaraju said.
Marcela Howell, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda, a national reproductive health advocacy group in Washington, D.C., said Cassidy’s comments reveal Louisiana is not taking proper action to address the issue.
Howell says the numbers of Black maternal deaths boil down to how health officials relate to Black women. This problem for Black pregnant women cuts across all education and economic levels.
Tennis star Serena Williams told Vogue magazine about her severe health complications after giving birth because doctors neglected to listen to her existing medical conditions.
Cassidy tried to rehabilitate himself by attacking critics. “Individuals are cutting off and misquoting my statements highlighting minority health disparities to create a malicious & fake narrative. My entire conversation was about my work to address racial bias in healthcare and address high maternal mortality among African American moms.”
Uh, no. Cassidy’s response indicates he is clueless about his own implicit bias.
Implicit biases are beliefs (stereotypes) and feelings (prejudice) activated without intent, control, and often conscious awareness.
In 2003, the “Unequal Treatment” report from an Institute of Medicine (IoM) panel made up of behavioral scientists, physicians, public health experts, and other health professionals concluded that even when access-to-care barriers such as insurance and family income were controlled for, racial and ethnic minorities received worse health care than non-minorities and that both explicit and implicit bias played potential roles, according to the American Psychological Association.
Yes, Cassidy offer legislation in 2020 and 2021 to provide remote monitoring tools to pregnant women to monitor their blood pressure and check for protein in their urine, among other conditions. However, Cassidy’s Connected Moms bi-partisan legislation is stuck in the Finance Committee, where the latest iteration of it has been for a year.
That bill says nothing about African-American women. However, in his comments on right-wing media, he noted African Americans tend to have high blood pressure, which could lead to pre-eclampsia, a life-threatening condition for pregnant women. The bill also didn’t address racial disparities in maternal health care.
Cassidy was also one of eight bipartisan co-sponsors of the 2021 Maternal Health Quality Improvement Act sponsored by Sen. Warnock, Raphael G. (D-GA). The bill focuses on eliminating racial disparities in maternal healthcare. The bill never made it to the Senate floor. Thankfully, the legislation is part of the recently passed Biden-Harris spending bill.
He also sponsored S. 320, the companion bill to the John Lewis NIMHD Research Endowment Revitalization Act of 2021. The bill provides funding for minority health research grants. President Biden signed the late Congressman John Lewis’ legislation into law in March 2022.
Cassidy’s willingness to improve healthcare through legislation is admirable, and he does deserve credit for those efforts.
His intentions are good, but his implicit biases aren’t.
This article originally published in the May 30, 2022 print edition of The Louisiana Weekly newspaper.
