0:00:01.155,0:00:04.219
If could turn back the clock[br]and bring Shalon back,

0:00:04.243,0:00:07.199
I would literally do anything.

0:00:09.078,0:00:11.084
I would happily give everything

0:00:11.108,0:00:13.983
if I could see her smiling[br]face once again.

0:00:14.861,0:00:18.095
But sadly, even if Shalon were here,

0:00:18.119,0:00:19.621
it would not change the fact

0:00:19.645,0:00:26.075
that between 700 to 800 women[br]die each year in America

0:00:26.099,0:00:29.872
from pregnancy- and[br]childbirth-related complications.

0:00:30.682,0:00:35.606
The choice to have a child[br]should never equate to a death sentence.

0:00:38.584,0:00:43.771
The rate of maternal deaths in America[br]is utterly appalling.

0:00:45.197,0:00:49.914
In 2017, NPR and ProPublica reported

0:00:49.938,0:00:56.104
that the United States has the highest[br]rate of maternal mortality

0:00:56.128,0:00:59.413
of any developed country in the world.

0:01:00.347,0:01:05.900
And the United States is the only country[br]where that rate is steadily rising.

0:01:08.029,0:01:12.293
Black mothers like Shalon[br]remain the primary group

0:01:12.317,0:01:14.298
for maternal mortality.

0:01:15.126,0:01:19.010
It is truly reprehensible

0:01:19.034,0:01:20.305
that Black women die

0:01:20.329,0:01:24.728
at a rate of three to four times[br]that of white women.

0:01:25.779,0:01:29.280
It is absolutely shameful

0:01:29.304,0:01:35.339
that 60 percent of those deaths[br]are totally preventable,

0:01:35.363,0:01:37.258
as was my daughter's.

0:01:37.846,0:01:39.981
And here's a shocking fact:

0:01:40.005,0:01:46.133
according to the report by Health[br]Resources and Services Administration,

0:01:46.157,0:01:51.507
the difference in risk[br]has been steadily unchanged

0:01:51.531,0:01:55.198
for the past six decades.

0:01:55.222,0:01:56.643
Six decades.

0:01:57.594,0:02:03.391
Clearly, current efforts to address[br]maternal mortality rates

0:02:03.415,0:02:08.240
and the racial and health[br]disparities in that area

0:02:08.264,0:02:10.512
remain woefully inadequate.

0:02:11.439,0:02:14.357
Only when race stops being the precursor

0:02:14.381,0:02:19.082
to how Black women are treated[br]or not treated in the health care system,

0:02:19.106,0:02:22.059
then outcomes will be[br]drastically different.

0:02:23.644,0:02:26.089
I want to be abundantly clear now.

0:02:27.532,0:02:33.107
The medical community is failing[br]Black mothers in America.

0:02:34.409,0:02:35.853
For decades,

0:02:35.877,0:02:40.488
Black women have been[br]dismissed, ignored, disregarded,

0:02:40.512,0:02:42.358
or at the very least,

0:02:42.382,0:02:46.465
they have been not taken seriously

0:02:46.489,0:02:49.199
in their interactions[br]with the health care system.

0:02:50.041,0:02:54.852
It's not uncommon for Black women[br]to experience racism and discrimination

0:02:54.876,0:02:56.510
by medical providers.

0:02:57.279,0:03:02.858
That racism can be blatantly overt[br]or covertly subtle,

0:03:02.882,0:03:05.469
but make no mistake -- it is there.

0:03:06.422,0:03:10.859
It didn't matter that Shalon[br]had a dual PhD

0:03:10.883,0:03:13.949
in Sociology and Gerontology;

0:03:13.973,0:03:17.313
it didn't even matter that Shalon[br]had two master's degrees,

0:03:17.337,0:03:20.849
one of them a Master's in Public Health[br]from Johns Hopkins.

0:03:21.428,0:03:25.514
It made no difference that Shalon[br]was a lieutenant commander

0:03:25.538,0:03:27.831
in the US Public Health Service,

0:03:27.855,0:03:33.496
an alumnus of the world-renowned[br]Epidemic Intelligence Service,

0:03:33.520,0:03:38.450
a highly respected epidemiologist[br]at the Centers for Disease Control

0:03:38.474,0:03:41.462
and president[br]of her own diversity company.

0:03:42.235,0:03:44.208
She was still a Black woman.

0:03:45.248,0:03:50.732
A Black woman accessing a system[br]that saw her as a stereotype

0:03:50.756,0:03:52.752
and responded to her as such.

0:03:54.375,0:03:57.639
During the three weeks[br]after her child was born,

0:03:57.663,0:04:02.762
Shalon went to her health care providers[br]again and again in distress.

0:04:03.851,0:04:07.057
Obviously, with her education[br]and training,

0:04:07.081,0:04:12.315
she could and she did articulate[br]her concerns very clearly.

0:04:15.021,0:04:20.395
Yet her cries for help[br]were minimized and dismissed

0:04:20.419,0:04:23.608
by the covert bias[br]of her medical provider.

0:04:24.510,0:04:29.726
That very bias,[br]fueled by structural racism,

0:04:29.750,0:04:33.629
is the root cause[br]of disparities in health care.

0:04:34.494,0:04:38.662
That very bias impacted Shalon's outcome.

0:04:39.466,0:04:41.689
That very bias

0:04:41.713,0:04:46.230
caused my daughter[br]to be among the statistics

0:04:46.254,0:04:48.340
for 2017.

0:04:49.713,0:04:54.238
As a result, I lost[br]my beautiful little girl.

0:04:54.262,0:04:55.610
My baby girl.

0:04:56.986,0:04:59.493
I lost my confidant,

0:04:59.517,0:05:02.122
I lost my best friend,

0:05:02.146,0:05:04.099
I lost my whole world.

0:05:05.784,0:05:08.527
Shalon's daughter lost her mother

0:05:08.551,0:05:11.237
and all of the relationship possibilities

0:05:11.261,0:05:14.065
that could have existed[br]between the two of them.

0:05:16.362,0:05:19.273
The society may have suffered[br]the greater loss.

0:05:20.752,0:05:23.030
Who knows how many medical advancements

0:05:23.054,0:05:27.518
or social-justice contributions[br]Shalon may have made

0:05:27.542,0:05:31.707
if only her medical provider[br]had listened to her

0:05:31.731,0:05:33.864
and heeded her cries for help.

0:05:35.128,0:05:36.571
We will never know.

0:05:37.918,0:05:39.666
But this much, we do know.

0:05:40.595,0:05:45.833
Behind every one[br]of those 700 to 800 women who die

0:05:45.857,0:05:47.653
is a family

0:05:47.677,0:05:51.696
and a whole social network of loved ones,

0:05:51.720,0:05:55.756
including the children[br]left behind, like Soleil.

0:05:57.909,0:06:00.978
Shalon's daughter Soleil[br]is three years old now.

0:06:02.114,0:06:03.915
She has a quick smile --

0:06:03.939,0:06:06.545
every bit as brilliant[br]as her mother's was.

0:06:07.841,0:06:09.676
Soleil is fearless.

0:06:09.700,0:06:13.050
She's determined and she's so opinionated,

0:06:13.074,0:06:14.075
(Laughter)

0:06:14.099,0:06:15.586
so smart.

0:06:16.069,0:06:18.949
Soleil constantly amazes me

0:06:18.973,0:06:22.346
at how confidently[br]she is navigating her world.

0:06:23.703,0:06:28.032
But Soleil only knows her mother[br]through photographs

0:06:28.056,0:06:32.619
and the cherished memories that I have[br]and share with her every day.

0:06:33.500,0:06:36.490
Yet Soleil loves her mommy,

0:06:36.514,0:06:40.460
who was with her[br]for only three short weeks.

0:06:41.826,0:06:43.753
She tells me so each day.

0:06:44.777,0:06:50.853
My heart aches each time[br]Soleil cries for her mommy.

0:06:52.284,0:06:56.326
It is during those times[br]Soleil has said to me,

0:06:56.350,0:07:01.307
"Nana, I want to go to heaven,[br]so I can be with my mommy."

0:07:02.771,0:07:04.439
It should not be that way.

0:07:06.593,0:07:08.843
It doesn't have to be that way.

0:07:09.681,0:07:15.045
It can really no longer[br]continue to be that way.

0:07:16.374,0:07:20.874
When I said earlier that the medical[br]community is failing Black mothers,

0:07:20.898,0:07:24.524
some may have wondered[br]if I'm painting with too broad a brush.

0:07:24.548,0:07:28.030
After all, it's individuals[br]who are to blame here, right?

0:07:28.663,0:07:32.650
Or perhaps we should say[br]that a relative handful of hospitals,

0:07:32.674,0:07:36.585
which happen to be the ones[br]that are largely used by Black women

0:07:36.609,0:07:38.220
and other minorities,

0:07:38.244,0:07:41.879
are at the epicenter of maternal[br]mortality in America.

0:07:43.187,0:07:47.908
But I would argue that focusing[br]on a handful of individuals

0:07:47.932,0:07:50.437
or a handful of hospitals

0:07:50.461,0:07:53.139
is defining the problem way too narrowly.

0:07:54.472,0:07:57.484
The problem behavior[br]isn't about the actions

0:07:57.508,0:08:00.262
of specific individuals or hospitals --

0:08:00.286,0:08:02.495
it's much more systemic than that.

0:08:03.728,0:08:04.927
What's more,

0:08:04.951,0:08:10.896
the prevalence of the problem[br]is deeply entrenched --

0:08:10.920,0:08:17.030
embedded in the very foundation[br]of our health care system.

0:08:19.403,0:08:24.200
It is this broad-based failure[br]that continues to allow disparities

0:08:24.224,0:08:26.919
in maternal health and death,

0:08:26.943,0:08:31.384
which result in Black women,[br]just like Shalon,

0:08:31.408,0:08:36.426
dying at rates 300 percent higher[br]than white women.

0:08:37.190,0:08:38.986
It's been well documented,

0:08:39.010,0:08:41.139
year after year,

0:08:41.163,0:08:43.514
decade after decade,

0:08:43.538,0:08:46.412
generation after generation,

0:08:46.436,0:08:50.444
and nothing effective[br]has been done to fix it.

0:08:52.073,0:08:53.594
How do we fix it?

0:08:55.066,0:08:58.218
Is there a definitive answer[br]to eradicating disparities

0:08:58.242,0:08:59.857
in maternal mortality?

0:09:00.271,0:09:04.725
Well, improvements[br]in data accuracy are critical

0:09:04.749,0:09:06.391
but not nearly enough.

0:09:06.944,0:09:09.959
Algorithms, checklists, apps --

0:09:10.762,0:09:12.453
they all play an important role,

0:09:12.477,0:09:14.349
but they're no panacea either.

0:09:15.564,0:09:19.202
And I really can't emphasize enough

0:09:19.226,0:09:24.229
that implicit bias training[br]without explicit,

0:09:24.253,0:09:27.917
explicit measures of accountability

0:09:27.941,0:09:30.313
will make absolutely no difference at all.

0:09:32.272,0:09:34.478
It is time --

0:09:34.502,0:09:37.772
it is long past time

0:09:37.796,0:09:43.186
that leaders in the medical community[br]take steps to transform

0:09:43.210,0:09:46.084
the health care system status quo.

0:09:47.917,0:09:49.997
The first step must be acknowledging

0:09:50.021,0:09:53.536
that the inherent problem[br]in the health care system

0:09:53.560,0:09:55.473
is more than a problem;

0:09:55.497,0:09:56.900
it's a failure.

0:09:57.730,0:10:01.215
The next step requires[br]taking responsibility

0:10:01.239,0:10:03.039
and owning that failure.

0:10:03.751,0:10:05.716
But the most important step

0:10:05.740,0:10:09.677
is actively taking the necessary actions

0:10:09.701,0:10:13.136
to right the wrongs[br]created by that failure.

0:10:15.743,0:10:17.553
A wise woman once told me,

0:10:17.577,0:10:19.581
"If you want something different,

0:10:19.605,0:10:22.104
you have to do something different."

0:10:22.596,0:10:26.188
My daughter was committed[br]to doing something different.

0:10:26.860,0:10:29.868
Shalon was known[br]as a woman of great integrity

0:10:29.892,0:10:31.873
and high moral values.

0:10:32.436,0:10:35.346
When asked about her driving[br]principles in life,

0:10:35.370,0:10:36.801
she would respond,

0:10:36.825,0:10:40.113
"I see inequity wherever it exists.

0:10:40.137,0:10:43.029
I'm not afraid to call it by name,

0:10:43.053,0:10:45.223
and I work hard to eliminate it.

0:10:45.659,0:10:48.507
I vow to create a better earth."

0:10:49.870,0:10:54.492
Shalon put those words into action[br]every day of her life.

0:10:55.712,0:10:59.483
Former Surgeon General[br]David Satcher once said,

0:10:59.507,0:11:01.901
"Leaders must care enough,

0:11:01.925,0:11:04.397
leaders must know enough,

0:11:04.421,0:11:07.215
leaders must be willing to do enough

0:11:07.239,0:11:12.042
and leaders must be willing[br]to persist until the work is done."

0:11:12.682,0:11:15.023
Shalon was such a leader.

0:11:16.947,0:11:20.058
Though there will never be[br]another leader like Shalon,

0:11:20.082,0:11:23.748
we can each persist[br]until the work is done.

0:11:24.654,0:11:26.996
Here's what I'm doing to persist

0:11:27.020,0:11:29.969
until the work to save[br]Black mothers is done.

0:11:30.514,0:11:31.964
To get things started,

0:11:31.988,0:11:35.917
I joined forces with several[br]of Shalon's friends

0:11:35.941,0:11:37.773
and CDC colleagues.

0:11:37.797,0:11:39.580
We founded a nonprofit.

0:11:40.191,0:11:44.785
We're working hard to eliminate[br]preventable deaths among Black mothers.

0:11:45.496,0:11:47.143
And here's how we're doing it:

0:11:47.167,0:11:51.243
with action, action and more action.

0:11:52.315,0:11:53.999
We're engaging stakeholders

0:11:54.023,0:11:58.459
at every point of the public health[br]and health care spectrum.

0:11:58.483,0:12:01.488
We're actively working[br]with the legislative office.

0:12:01.512,0:12:05.436
We're promoting accountability[br]measures and postpartum bills,

0:12:05.460,0:12:08.433
and we want them enshrined in the law.

0:12:09.226,0:12:13.071
We're embarking upon[br]a community-based research project

0:12:13.095,0:12:17.694
which will redefine quality[br]of medical care for Black women.

0:12:18.820,0:12:24.050
Ultimately, we will tilt more power[br]into the hands of Black women.

0:12:24.750,0:12:26.612
How are we going to do that?

0:12:26.636,0:12:30.629
By empowering Black women[br]and their birthing partners

0:12:30.653,0:12:35.573
to effectively counteract the bias[br]and racism they experience

0:12:35.597,0:12:41.133
at any given point during pregnancy,[br]childbirth and postpartum.

0:12:42.528,0:12:43.678
Look around you.

0:12:44.851,0:12:48.226
Each one of us in this room[br]has a circle of influence.

0:12:48.754,0:12:55.048
I invite you to consider[br]how powerful an impact we could make

0:12:55.072,0:13:00.384
if we focused that collective[br]influence on this problem,

0:13:00.408,0:13:02.118
on making a difference.

0:13:02.823,0:13:06.544
What if we, like Shalon,[br]acknowledged inequity

0:13:06.568,0:13:09.211
wherever it existed in our communities

0:13:09.235,0:13:11.360
and we weren't afraid to call it by name?

0:13:11.895,0:13:15.524
What if we were each committed[br]and passionate

0:13:15.548,0:13:18.698
about using the full range[br]of our resources

0:13:18.722,0:13:20.615
to eliminate that inequity?

0:13:21.208,0:13:22.742
Could we change things?

0:13:23.057,0:13:27.409
Could we really overturn[br]centuries of prejudice

0:13:27.433,0:13:29.684
and decades of bad practice?

0:13:31.046,0:13:32.478
I know we could.

0:13:33.060,0:13:35.676
I know we could,

0:13:35.700,0:13:39.616
if we were focused on that issue,

0:13:39.640,0:13:42.791
if we focused that collective energy.

0:13:43.866,0:13:45.975
To quote Nelson Mandela,

0:13:45.999,0:13:48.724
"When people are determined

0:13:48.748,0:13:51.431
they can overcome anything."

0:13:52.653,0:13:56.624
But "action without vision --

0:13:56.648,0:13:58.247
it's only passing time.

0:13:58.572,0:14:02.482
Vision without action[br]is merely daydreaming.

0:14:03.062,0:14:08.648
But vision with action[br]can truly change the world."

0:14:09.540,0:14:14.221
Shalon's life was the perfect[br]embodiment of the vision.

0:14:14.678,0:14:18.091
Shalon's death is our call to action.

0:14:18.757,0:14:23.707
So today, let each of us vow[br]to do whatever we can.

0:14:24.189,0:14:26.847
Let us vow to right this wrong.

0:14:27.329,0:14:30.690
Let us vow to be a part of the solution

0:14:30.714,0:14:35.546
until Black women are no longer[br]marginalized and dying needlessly

0:14:35.570,0:14:37.396
in the health care system.

0:14:38.050,0:14:40.013
And like my daughter,

0:14:40.037,0:14:42.797
(Voice breaking)[br]Dr. Shalon MauRene Irving,

0:14:42.821,0:14:46.571
let us each vow to create a better earth.

0:14:47.150,0:14:48.301
Thank you.

0:14:48.325,0:14:54.238
(Applause)