How the US medical community fails Black mothers
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0:01 - 0:04If could turn back the clock
and bring Shalon back, -
0:04 - 0:07I would literally do anything.
-
0:09 - 0:11I would happily give everything
-
0:11 - 0:14if I could see her smiling
face once again. -
0:15 - 0:18But sadly, even if Shalon were here,
-
0:18 - 0:20it would not change the fact
-
0:20 - 0:26that between 700 to 800 women
die each year in America -
0:26 - 0:30from pregnancy- and
childbirth-related complications. -
0:31 - 0:36The choice to have a child
should never equate to a death sentence. -
0:39 - 0:44The rate of maternal deaths in America
is utterly appalling. -
0:45 - 0:50In 2017, NPR and ProPublica reported
-
0:50 - 0:56that the United States has the highest
rate of maternal mortality -
0:56 - 0:59of any developed country in the world.
-
1:00 - 1:06And the United States is the only country
where that rate is steadily rising. -
1:08 - 1:12Black mothers like Shalon
remain the primary group -
1:12 - 1:14for maternal mortality.
-
1:15 - 1:19It is truly reprehensible
-
1:19 - 1:20that Black women die
-
1:20 - 1:25at a rate of three to four times
that of white women. -
1:26 - 1:29It is absolutely shameful
-
1:29 - 1:35that 60 percent of those deaths
are totally preventable, -
1:35 - 1:37as was my daughter's.
-
1:38 - 1:40And here's a shocking fact:
-
1:40 - 1:46according to the report by Health
Resources and Services Administration, -
1:46 - 1:52the difference in risk
has been steadily unchanged -
1:52 - 1:55for the past six decades.
-
1:55 - 1:57Six decades.
-
1:58 - 2:03Clearly, current efforts to address
maternal mortality rates -
2:03 - 2:08and the racial and health
disparities in that area -
2:08 - 2:11remain woefully inadequate.
-
2:11 - 2:14Only when race stops being the precursor
-
2:14 - 2:19to how Black women are treated
or not treated in the health care system, -
2:19 - 2:22then outcomes will be
drastically different. -
2:24 - 2:26I want to be abundantly clear now.
-
2:28 - 2:33The medical community is failing
Black mothers in America. -
2:34 - 2:36For decades,
-
2:36 - 2:40Black women have been
dismissed, ignored, disregarded, -
2:41 - 2:42or at the very least,
-
2:42 - 2:46they have been not taken seriously
-
2:46 - 2:49in their interactions
with the health care system. -
2:50 - 2:55It's not uncommon for Black women
to experience racism and discrimination -
2:55 - 2:57by medical providers.
-
2:57 - 3:03That racism can be blatantly overt
or covertly subtle, -
3:03 - 3:05but make no mistake -- it is there.
-
3:06 - 3:11It didn't matter that Shalon
had a dual PhD -
3:11 - 3:14in Sociology and Gerontology;
-
3:14 - 3:17it didn't even matter that Shalon
had two master's degrees, -
3:17 - 3:21one of them a Master's in Public Health
from Johns Hopkins. -
3:21 - 3:26It made no difference that Shalon
was a lieutenant commander -
3:26 - 3:28in the US Public Health Service,
-
3:28 - 3:33an alumnus of the world-renowned
Epidemic Intelligence Service, -
3:34 - 3:38a highly respected epidemiologist
at the Centers for Disease Control -
3:38 - 3:41and president
of her own diversity company. -
3:42 - 3:44She was still a Black woman.
-
3:45 - 3:51A Black woman accessing a system
that saw her as a stereotype -
3:51 - 3:53and responded to her as such.
-
3:54 - 3:58During the three weeks
after her child was born, -
3:58 - 4:03Shalon went to her health care providers
again and again in distress. -
4:04 - 4:07Obviously, with her education
and training, -
4:07 - 4:12she could and she did articulate
her concerns very clearly. -
4:15 - 4:20Yet her cries for help
were minimized and dismissed -
4:20 - 4:24by the covert bias
of her medical provider. -
4:25 - 4:30That very bias,
fueled by structural racism, -
4:30 - 4:34is the root cause
of disparities in health care. -
4:34 - 4:39That very bias impacted Shalon's outcome.
-
4:39 - 4:42That very bias
-
4:42 - 4:46caused my daughter
to be among the statistics -
4:46 - 4:48for 2017.
-
4:50 - 4:54As a result, I lost
my beautiful little girl. -
4:54 - 4:56My baby girl.
-
4:57 - 4:59I lost my confidant,
-
5:00 - 5:02I lost my best friend,
-
5:02 - 5:04I lost my whole world.
-
5:06 - 5:09Shalon's daughter lost her mother
-
5:09 - 5:11and all of the relationship possibilities
-
5:11 - 5:14that could have existed
between the two of them. -
5:16 - 5:19The society may have suffered
the greater loss. -
5:21 - 5:23Who knows how many medical advancements
-
5:23 - 5:28or social-justice contributions
Shalon may have made -
5:28 - 5:32if only her medical provider
had listened to her -
5:32 - 5:34and heeded her cries for help.
-
5:35 - 5:37We will never know.
-
5:38 - 5:40But this much, we do know.
-
5:41 - 5:46Behind every one
of those 700 to 800 women who die -
5:46 - 5:48is a family
-
5:48 - 5:52and a whole social network of loved ones,
-
5:52 - 5:56including the children
left behind, like Soleil. -
5:58 - 6:01Shalon's daughter Soleil
is three years old now. -
6:02 - 6:04She has a quick smile --
-
6:04 - 6:07every bit as brilliant
as her mother's was. -
6:08 - 6:10Soleil is fearless.
-
6:10 - 6:13She's determined and she's so opinionated,
-
6:13 - 6:14(Laughter)
-
6:14 - 6:16so smart.
-
6:16 - 6:19Soleil constantly amazes me
-
6:19 - 6:22at how confidently
she is navigating her world. -
6:24 - 6:28But Soleil only knows her mother
through photographs -
6:28 - 6:33and the cherished memories that I have
and share with her every day. -
6:34 - 6:36Yet Soleil loves her mommy,
-
6:37 - 6:40who was with her
for only three short weeks. -
6:42 - 6:44She tells me so each day.
-
6:45 - 6:51My heart aches each time
Soleil cries for her mommy. -
6:52 - 6:56It is during those times
Soleil has said to me, -
6:56 - 7:01"Nana, I want to go to heaven,
so I can be with my mommy." -
7:03 - 7:04It should not be that way.
-
7:07 - 7:09It doesn't have to be that way.
-
7:10 - 7:15It can really no longer
continue to be that way. -
7:16 - 7:21When I said earlier that the medical
community is failing Black mothers, -
7:21 - 7:25some may have wondered
if I'm painting with too broad a brush. -
7:25 - 7:28After all, it's individuals
who are to blame here, right? -
7:29 - 7:33Or perhaps we should say
that a relative handful of hospitals, -
7:33 - 7:37which happen to be the ones
that are largely used by Black women -
7:37 - 7:38and other minorities,
-
7:38 - 7:42are at the epicenter of maternal
mortality in America. -
7:43 - 7:48But I would argue that focusing
on a handful of individuals -
7:48 - 7:50or a handful of hospitals
-
7:50 - 7:53is defining the problem way too narrowly.
-
7:54 - 7:57The problem behavior
isn't about the actions -
7:58 - 8:00of specific individuals or hospitals --
-
8:00 - 8:02it's much more systemic than that.
-
8:04 - 8:05What's more,
-
8:05 - 8:11the prevalence of the problem
is deeply entrenched -- -
8:11 - 8:17embedded in the very foundation
of our health care system. -
8:19 - 8:24It is this broad-based failure
that continues to allow disparities -
8:24 - 8:27in maternal health and death,
-
8:27 - 8:31which result in Black women,
just like Shalon, -
8:31 - 8:36dying at rates 300 percent higher
than white women. -
8:37 - 8:39It's been well documented,
-
8:39 - 8:41year after year,
-
8:41 - 8:44decade after decade,
-
8:44 - 8:46generation after generation,
-
8:46 - 8:50and nothing effective
has been done to fix it. -
8:52 - 8:54How do we fix it?
-
8:55 - 8:58Is there a definitive answer
to eradicating disparities -
8:58 - 9:00in maternal mortality?
-
9:00 - 9:05Well, improvements
in data accuracy are critical -
9:05 - 9:06but not nearly enough.
-
9:07 - 9:10Algorithms, checklists, apps --
-
9:11 - 9:12they all play an important role,
-
9:12 - 9:14but they're no panacea either.
-
9:16 - 9:19And I really can't emphasize enough
-
9:19 - 9:24that implicit bias training
without explicit, -
9:24 - 9:28explicit measures of accountability
-
9:28 - 9:30will make absolutely no difference at all.
-
9:32 - 9:34It is time --
-
9:35 - 9:38it is long past time
-
9:38 - 9:43that leaders in the medical community
take steps to transform -
9:43 - 9:46the health care system status quo.
-
9:48 - 9:50The first step must be acknowledging
-
9:50 - 9:54that the inherent problem
in the health care system -
9:54 - 9:55is more than a problem;
-
9:55 - 9:57it's a failure.
-
9:58 - 10:01The next step requires
taking responsibility -
10:01 - 10:03and owning that failure.
-
10:04 - 10:06But the most important step
-
10:06 - 10:10is actively taking the necessary actions
-
10:10 - 10:13to right the wrongs
created by that failure. -
10:16 - 10:18A wise woman once told me,
-
10:18 - 10:20"If you want something different,
-
10:20 - 10:22you have to do something different."
-
10:23 - 10:26My daughter was committed
to doing something different. -
10:27 - 10:30Shalon was known
as a woman of great integrity -
10:30 - 10:32and high moral values.
-
10:32 - 10:35When asked about her driving
principles in life, -
10:35 - 10:37she would respond,
-
10:37 - 10:40"I see inequity wherever it exists.
-
10:40 - 10:43I'm not afraid to call it by name,
-
10:43 - 10:45and I work hard to eliminate it.
-
10:46 - 10:49I vow to create a better earth."
-
10:50 - 10:54Shalon put those words into action
every day of her life. -
10:56 - 10:59Former Surgeon General
David Satcher once said, -
11:00 - 11:02"Leaders must care enough,
-
11:02 - 11:04leaders must know enough,
-
11:04 - 11:07leaders must be willing to do enough
-
11:07 - 11:12and leaders must be willing
to persist until the work is done." -
11:13 - 11:15Shalon was such a leader.
-
11:17 - 11:20Though there will never be
another leader like Shalon, -
11:20 - 11:24we can each persist
until the work is done. -
11:25 - 11:27Here's what I'm doing to persist
-
11:27 - 11:30until the work to save
Black mothers is done. -
11:31 - 11:32To get things started,
-
11:32 - 11:36I joined forces with several
of Shalon's friends -
11:36 - 11:38and CDC colleagues.
-
11:38 - 11:40We founded a nonprofit.
-
11:40 - 11:45We're working hard to eliminate
preventable deaths among Black mothers. -
11:45 - 11:47And here's how we're doing it:
-
11:47 - 11:51with action, action and more action.
-
11:52 - 11:54We're engaging stakeholders
-
11:54 - 11:58at every point of the public health
and health care spectrum. -
11:58 - 12:01We're actively working
with the legislative office. -
12:02 - 12:05We're promoting accountability
measures and postpartum bills, -
12:05 - 12:08and we want them enshrined in the law.
-
12:09 - 12:13We're embarking upon
a community-based research project -
12:13 - 12:18which will redefine quality
of medical care for Black women. -
12:19 - 12:24Ultimately, we will tilt more power
into the hands of Black women. -
12:25 - 12:27How are we going to do that?
-
12:27 - 12:31By empowering Black women
and their birthing partners -
12:31 - 12:36to effectively counteract the bias
and racism they experience -
12:36 - 12:41at any given point during pregnancy,
childbirth and postpartum. -
12:43 - 12:44Look around you.
-
12:45 - 12:48Each one of us in this room
has a circle of influence. -
12:49 - 12:55I invite you to consider
how powerful an impact we could make -
12:55 - 13:00if we focused that collective
influence on this problem, -
13:00 - 13:02on making a difference.
-
13:03 - 13:07What if we, like Shalon,
acknowledged inequity -
13:07 - 13:09wherever it existed in our communities
-
13:09 - 13:11and we weren't afraid to call it by name?
-
13:12 - 13:16What if we were each committed
and passionate -
13:16 - 13:19about using the full range
of our resources -
13:19 - 13:21to eliminate that inequity?
-
13:21 - 13:23Could we change things?
-
13:23 - 13:27Could we really overturn
centuries of prejudice -
13:27 - 13:30and decades of bad practice?
-
13:31 - 13:32I know we could.
-
13:33 - 13:36I know we could,
-
13:36 - 13:40if we were focused on that issue,
-
13:40 - 13:43if we focused that collective energy.
-
13:44 - 13:46To quote Nelson Mandela,
-
13:46 - 13:49"When people are determined
-
13:49 - 13:51they can overcome anything."
-
13:53 - 13:57But "action without vision --
-
13:57 - 13:58it's only passing time.
-
13:59 - 14:02Vision without action
is merely daydreaming. -
14:03 - 14:09But vision with action
can truly change the world." -
14:10 - 14:14Shalon's life was the perfect
embodiment of the vision. -
14:15 - 14:18Shalon's death is our call to action.
-
14:19 - 14:24So today, let each of us vow
to do whatever we can. -
14:24 - 14:27Let us vow to right this wrong.
-
14:27 - 14:31Let us vow to be a part of the solution
-
14:31 - 14:36until Black women are no longer
marginalized and dying needlessly -
14:36 - 14:37in the health care system.
-
14:38 - 14:40And like my daughter,
-
14:40 - 14:43(Voice breaking)
Dr. Shalon MauRene Irving, -
14:43 - 14:47let us each vow to create a better earth.
-
14:47 - 14:48Thank you.
-
14:48 - 14:54(Applause)
- Title:
- How the US medical community fails Black mothers
- Speaker:
- Wanda Irving
- Description:
-
In the US, Black women are nearly 300 percent more likely to die as a result of childbirth than white women. Sharing appalling statistics on maternal mortality as well as her own tragic story of loss, Wanda Irving explains how racism and bias in health care minimizes and dismisses Black women's pain -- and makes a personal plea for leaders in the medical community to take steps toward reform.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 15:07
Erin Gregory edited English subtitles for How the US medical community fails Black mothers | ||
Erin Gregory approved English subtitles for How the US medical community fails Black mothers | ||
Erin Gregory edited English subtitles for How the US medical community fails Black mothers | ||
Krystian Aparta accepted English subtitles for How the US medical community fails Black mothers | ||
Krystian Aparta edited English subtitles for How the US medical community fails Black mothers | ||
Leslie Gauthier edited English subtitles for How the US medical community fails Black mothers | ||
Leslie Gauthier edited English subtitles for How the US medical community fails Black mothers | ||
Leslie Gauthier edited English subtitles for How the US medical community fails Black mothers |