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00:00:01,155 --> 00:00:04,219
If could turn back the clock
and bring Shalon back,

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00:00:04,243 --> 00:00:07,199
I would literally do anything.

3
00:00:09,078 --> 00:00:11,084
I would happily give everything

4
00:00:11,108 --> 00:00:13,983
if I could see her smiling
face once again.

5
00:00:14,861 --> 00:00:18,095
But sadly, even if Shalon were here,

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00:00:18,119 --> 00:00:19,621
it would not change the fact

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00:00:19,645 --> 00:00:26,075
that between 700 to 800 women
die each year in America

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00:00:26,099 --> 00:00:29,872
from pregnancy- and
childbirth-related complications.

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00:00:30,682 --> 00:00:35,606
The choice to have a child
should never equate to a death sentence.

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00:00:38,584 --> 00:00:43,771
The rate of maternal deaths in America
is utterly appalling.

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00:00:45,197 --> 00:00:49,914
In 2017, NPR and ProPublica reported

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00:00:49,938 --> 00:00:56,104
that the United States has the highest
rate of maternal mortality

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00:00:56,128 --> 00:00:59,413
of any developed country in the world.

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And the United States is the only country
where that rate is steadily rising.

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00:01:08,029 --> 00:01:12,293
Black mothers like Shalon
remain the primary group

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00:01:12,317 --> 00:01:14,298
for maternal mortality.

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00:01:15,126 --> 00:01:19,010
It is truly reprehensible

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that Black women die

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00:01:20,329 --> 00:01:24,728
at a rate of three to four times
that of white women.

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00:01:25,779 --> 00:01:29,280
It is absolutely shameful

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00:01:29,304 --> 00:01:35,339
that 60 percent of those deaths
are totally preventable,

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as was my daughter's.

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00:01:37,846 --> 00:01:39,981
And here's a shocking fact:

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00:01:40,005 --> 00:01:46,133
according to the report by Health
Resources and Services Administration,

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00:01:46,157 --> 00:01:51,507
the difference in risk
has been steadily unchanged

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00:01:51,531 --> 00:01:55,198
for the past six decades.

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Six decades.

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Clearly, current efforts to address
maternal mortality rates

29
00:02:03,415 --> 00:02:08,240
and the racial and health
disparities in that area

30
00:02:08,264 --> 00:02:10,512
remain woefully inadequate.

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00:02:11,439 --> 00:02:14,357
Only when race stops being the precursor

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00:02:14,381 --> 00:02:19,082
to how Black women are treated
or not treated in the health care system,

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00:02:19,106 --> 00:02:22,059
then outcomes will be
drastically different.

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00:02:23,644 --> 00:02:26,089
I want to be abundantly clear now.

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00:02:27,532 --> 00:02:33,107
The medical community is failing
Black mothers in America.

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00:02:34,409 --> 00:02:35,853
For decades,

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00:02:35,877 --> 00:02:40,488
Black women have been
dismissed, ignored, disregarded,

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00:02:40,512 --> 00:02:42,358
or at the very least,

39
00:02:42,382 --> 00:02:46,465
they have been not taken seriously

40
00:02:46,489 --> 00:02:49,199
in their interactions
with the health care system.

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00:02:50,041 --> 00:02:54,852
It's not uncommon for Black women
to experience racism and discrimination

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00:02:54,876 --> 00:02:56,510
by medical providers.

43
00:02:57,279 --> 00:03:02,858
That racism can be blatantly overt
or covertly subtle,

44
00:03:02,882 --> 00:03:05,469
but make no mistake -- it is there.

45
00:03:06,422 --> 00:03:10,859
It didn't matter that Shalon
had a dual PhD

46
00:03:10,883 --> 00:03:13,949
in Sociology and Gerontology;

47
00:03:13,973 --> 00:03:17,313
it didn't even matter that Shalon
had two master's degrees,

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00:03:17,337 --> 00:03:20,849
one of them a Master's in Public Health
from Johns Hopkins.

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00:03:21,428 --> 00:03:25,514
It made no difference that Shalon
was a lieutenant commander

50
00:03:25,538 --> 00:03:27,831
in the US Public Health Service,

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00:03:27,855 --> 00:03:33,496
an alumnus of the world-renowned
Epidemic Intelligence Service,

52
00:03:33,520 --> 00:03:38,450
a highly respected epidemiologist
at the Centers for Disease Control

53
00:03:38,474 --> 00:03:41,462
and president
of her own diversity company.

54
00:03:42,235 --> 00:03:44,208
She was still a Black woman.

55
00:03:45,248 --> 00:03:50,732
A Black woman accessing a system
that saw her as a stereotype

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00:03:50,756 --> 00:03:52,752
and responded to her as such.

57
00:03:54,375 --> 00:03:57,639
During the three weeks
after her child was born,

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00:03:57,663 --> 00:04:02,762
Shalon went to her health care providers
again and again in distress.

59
00:04:03,851 --> 00:04:07,057
Obviously, with her education
and training,

60
00:04:07,081 --> 00:04:12,315
she could and she did articulate
her concerns very clearly.

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00:04:15,021 --> 00:04:20,395
Yet her cries for help
were minimized and dismissed

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00:04:20,419 --> 00:04:23,608
by the covert bias
of her medical provider.

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00:04:24,510 --> 00:04:29,726
That very bias,
fueled by structural racism,

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00:04:29,750 --> 00:04:33,629
is the root cause
of disparities in health care.

65
00:04:34,494 --> 00:04:38,662
That very bias impacted Shalon's outcome.

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00:04:39,466 --> 00:04:41,689
That very bias

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00:04:41,713 --> 00:04:46,230
caused my daughter
to be among the statistics

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00:04:46,254 --> 00:04:48,340
for 2017.

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00:04:49,713 --> 00:04:54,238
As a result, I lost
my beautiful little girl.

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My baby girl.

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00:04:56,986 --> 00:04:59,493
I lost my confidant,

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00:04:59,517 --> 00:05:02,122
I lost my best friend,

73
00:05:02,146 --> 00:05:04,099
I lost my whole world.

74
00:05:05,784 --> 00:05:08,527
Shalon's daughter lost her mother

75
00:05:08,551 --> 00:05:11,237
and all of the relationship possibilities

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00:05:11,261 --> 00:05:14,065
that could have existed
between the two of them.

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00:05:16,362 --> 00:05:19,273
The society may have suffered
the greater loss.

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00:05:20,752 --> 00:05:23,030
Who knows how many medical advancements

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00:05:23,054 --> 00:05:27,518
or social-justice contributions
Shalon may have made

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00:05:27,542 --> 00:05:31,707
if only her medical provider
had listened to her

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00:05:31,731 --> 00:05:33,864
and heeded her cries for help.

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00:05:35,128 --> 00:05:36,571
We will never know.

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00:05:37,918 --> 00:05:39,666
But this much, we do know.

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00:05:40,595 --> 00:05:45,833
Behind every one
of those 700 to 800 women who die

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00:05:45,857 --> 00:05:47,653
is a family

86
00:05:47,677 --> 00:05:51,696
and a whole social network of loved ones,

87
00:05:51,720 --> 00:05:55,756
including the children
left behind, like Soleil.

88
00:05:57,909 --> 00:06:00,978
Shalon's daughter Soleil
is three years old now.

89
00:06:02,114 --> 00:06:03,915
She has a quick smile --

90
00:06:03,939 --> 00:06:06,545
every bit as brilliant
as her mother's was.

91
00:06:07,841 --> 00:06:09,676
Soleil is fearless.

92
00:06:09,700 --> 00:06:13,050
She's determined and she's so opinionated,

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00:06:13,074 --> 00:06:14,075
(Laughter)

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00:06:14,099 --> 00:06:15,586
so smart.

95
00:06:16,069 --> 00:06:18,949
Soleil constantly amazes me

96
00:06:18,973 --> 00:06:22,346
at how confidently
she is navigating her world.

97
00:06:23,703 --> 00:06:28,032
But Soleil only knows her mother
through photographs

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00:06:28,056 --> 00:06:32,619
and the cherished memories that I have
and share with her every day.

99
00:06:33,500 --> 00:06:36,490
Yet Soleil loves her mommy,

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00:06:36,514 --> 00:06:40,460
who was with her
for only three short weeks.

101
00:06:41,826 --> 00:06:43,753
She tells me so each day.

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00:06:44,777 --> 00:06:50,853
My heart aches each time
Soleil cries for her mommy.

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00:06:52,284 --> 00:06:56,326
It is during those times
Soleil has said to me,

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00:06:56,350 --> 00:07:01,307
"Nana, I want to go to heaven,
so I can be with my mommy."

105
00:07:02,771 --> 00:07:04,439
It should not be that way.

106
00:07:06,593 --> 00:07:08,843
It doesn't have to be that way.

107
00:07:09,681 --> 00:07:15,045
It can really no longer
continue to be that way.

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00:07:16,374 --> 00:07:20,874
When I said earlier that the medical
community is failing Black mothers,

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00:07:20,898 --> 00:07:24,524
some may have wondered
if I'm painting with too broad a brush.

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After all, it's individuals
who are to blame here, right?

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00:07:28,663 --> 00:07:32,650
Or perhaps we should say
that a relative handful of hospitals,

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00:07:32,674 --> 00:07:36,585
which happen to be the ones
that are largely used by Black women

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00:07:36,609 --> 00:07:38,220
and other minorities,

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00:07:38,244 --> 00:07:41,879
are at the epicenter of maternal
mortality in America.

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But I would argue that focusing
on a handful of individuals

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or a handful of hospitals

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is defining the problem way too narrowly.

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The problem behavior
isn't about the actions

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of specific individuals or hospitals --

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00:08:00,286 --> 00:08:02,495
it's much more systemic than that.

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What's more,

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00:08:04,951 --> 00:08:10,896
the prevalence of the problem
is deeply entrenched --

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00:08:10,920 --> 00:08:17,030
embedded in the very foundation
of our health care system.

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00:08:19,403 --> 00:08:24,200
It is this broad-based failure
that continues to allow disparities

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00:08:24,224 --> 00:08:26,919
in maternal health and death,

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00:08:26,943 --> 00:08:31,384
which result in Black women,
just like Shalon,

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00:08:31,408 --> 00:08:36,426
dying at rates 300 percent higher
than white women.

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It's been well documented,

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00:08:39,010 --> 00:08:41,139
year after year,

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00:08:41,163 --> 00:08:43,514
decade after decade,

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00:08:43,538 --> 00:08:46,412
generation after generation,

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00:08:46,436 --> 00:08:50,444
and nothing effective
has been done to fix it.

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How do we fix it?

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Is there a definitive answer
to eradicating disparities

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00:08:58,242 --> 00:08:59,857
in maternal mortality?

136
00:09:00,271 --> 00:09:04,725
Well, improvements
in data accuracy are critical

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00:09:04,749 --> 00:09:06,391
but not nearly enough.

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00:09:06,944 --> 00:09:09,959
Algorithms, checklists, apps --

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00:09:10,762 --> 00:09:12,453
they all play an important role,

140
00:09:12,477 --> 00:09:14,349
but they're no panacea either.

141
00:09:15,564 --> 00:09:19,202
And I really can't emphasize enough

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00:09:19,226 --> 00:09:24,229
that implicit bias training
without explicit,

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00:09:24,253 --> 00:09:27,917
explicit measures of accountability

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00:09:27,941 --> 00:09:30,313
will make absolutely no difference at all.

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It is time --

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00:09:34,502 --> 00:09:37,772
it is long past time

147
00:09:37,796 --> 00:09:43,186
that leaders in the medical community
take steps to transform

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00:09:43,210 --> 00:09:46,084
the health care system status quo.

149
00:09:47,917 --> 00:09:49,997
The first step must be acknowledging

150
00:09:50,021 --> 00:09:53,536
that the inherent problem
in the health care system

151
00:09:53,560 --> 00:09:55,473
is more than a problem;

152
00:09:55,497 --> 00:09:56,900
it's a failure.

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The next step requires
taking responsibility

154
00:10:01,239 --> 00:10:03,039
and owning that failure.

155
00:10:03,751 --> 00:10:05,716
But the most important step

156
00:10:05,740 --> 00:10:09,677
is actively taking the necessary actions

157
00:10:09,701 --> 00:10:13,136
to right the wrongs
created by that failure.

158
00:10:15,743 --> 00:10:17,553
A wise woman once told me,

159
00:10:17,577 --> 00:10:19,581
"If you want something different,

160
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you have to do something different."

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00:10:22,596 --> 00:10:26,188
My daughter was committed
to doing something different.

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00:10:26,860 --> 00:10:29,868
Shalon was known
as a woman of great integrity

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00:10:29,892 --> 00:10:31,873
and high moral values.

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00:10:32,436 --> 00:10:35,346
When asked about her driving
principles in life,

165
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she would respond,

166
00:10:36,825 --> 00:10:40,113
"I see inequity wherever it exists.

167
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I'm not afraid to call it by name,

168
00:10:43,053 --> 00:10:45,223
and I work hard to eliminate it.

169
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I vow to create a better earth."

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00:10:49,870 --> 00:10:54,492
Shalon put those words into action
every day of her life.

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00:10:55,712 --> 00:10:59,483
Former Surgeon General
David Satcher once said,

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"Leaders must care enough,

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00:11:01,925 --> 00:11:04,397
leaders must know enough,

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00:11:04,421 --> 00:11:07,215
leaders must be willing to do enough

175
00:11:07,239 --> 00:11:12,042
and leaders must be willing
to persist until the work is done."

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00:11:12,682 --> 00:11:15,023
Shalon was such a leader.

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00:11:16,947 --> 00:11:20,058
Though there will never be
another leader like Shalon,

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00:11:20,082 --> 00:11:23,748
we can each persist
until the work is done.

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00:11:24,654 --> 00:11:26,996
Here's what I'm doing to persist

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00:11:27,020 --> 00:11:29,969
until the work to save
Black mothers is done.

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To get things started,

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00:11:31,988 --> 00:11:35,917
I joined forces with several
of Shalon's friends

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00:11:35,941 --> 00:11:37,773
and CDC colleagues.

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00:11:37,797 --> 00:11:39,580
We founded a nonprofit.

185
00:11:40,191 --> 00:11:44,785
We're working hard to eliminate
preventable deaths among Black mothers.

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00:11:45,496 --> 00:11:47,143
And here's how we're doing it:

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00:11:47,167 --> 00:11:51,243
with action, action and more action.

188
00:11:52,315 --> 00:11:53,999
We're engaging stakeholders

189
00:11:54,023 --> 00:11:58,459
at every point of the public health
and health care spectrum.

190
00:11:58,483 --> 00:12:01,488
We're actively working
with the legislative office.

191
00:12:01,512 --> 00:12:05,436
We're promoting accountability
measures and postpartum bills,

192
00:12:05,460 --> 00:12:08,433
and we want them enshrined in the law.

193
00:12:09,226 --> 00:12:13,071
We're embarking upon
a community-based research project

194
00:12:13,095 --> 00:12:17,694
which will redefine quality
of medical care for Black women.

195
00:12:18,820 --> 00:12:24,050
Ultimately, we will tilt more power
into the hands of Black women.

196
00:12:24,750 --> 00:12:26,612
How are we going to do that?

197
00:12:26,636 --> 00:12:30,629
By empowering Black women
and their birthing partners

198
00:12:30,653 --> 00:12:35,573
to effectively counteract the bias
and racism they experience

199
00:12:35,597 --> 00:12:41,133
at any given point during pregnancy,
childbirth and postpartum.

200
00:12:42,528 --> 00:12:43,678
Look around you.

201
00:12:44,851 --> 00:12:48,226
Each one of us in this room
has a circle of influence.

202
00:12:48,754 --> 00:12:55,048
I invite you to consider
how powerful an impact we could make

203
00:12:55,072 --> 00:13:00,384
if we focused that collective
influence on this problem,

204
00:13:00,408 --> 00:13:02,118
on making a difference.

205
00:13:02,823 --> 00:13:06,544
What if we, like Shalon,
acknowledged inequity

206
00:13:06,568 --> 00:13:09,211
wherever it existed in our communities

207
00:13:09,235 --> 00:13:11,360
and we weren't afraid to call it by name?

208
00:13:11,895 --> 00:13:15,524
What if we were each committed
and passionate

209
00:13:15,548 --> 00:13:18,698
about using the full range
of our resources

210
00:13:18,722 --> 00:13:20,615
to eliminate that inequity?

211
00:13:21,208 --> 00:13:22,742
Could we change things?

212
00:13:23,057 --> 00:13:27,409
Could we really overturn
centuries of prejudice

213
00:13:27,433 --> 00:13:29,684
and decades of bad practice?

214
00:13:31,046 --> 00:13:32,478
I know we could.

215
00:13:33,060 --> 00:13:35,676
I know we could,

216
00:13:35,700 --> 00:13:39,616
if we were focused on that issue,

217
00:13:39,640 --> 00:13:42,791
if we focused that collective energy.

218
00:13:43,866 --> 00:13:45,975
To quote Nelson Mandela,

219
00:13:45,999 --> 00:13:48,724
"When people are determined

220
00:13:48,748 --> 00:13:51,431
they can overcome anything."

221
00:13:52,653 --> 00:13:56,624
But "action without vision --

222
00:13:56,648 --> 00:13:58,247
it's only passing time.

223
00:13:58,572 --> 00:14:02,482
Vision without action
is merely daydreaming.

224
00:14:03,062 --> 00:14:08,648
But vision with action
can truly change the world."

225
00:14:09,540 --> 00:14:14,221
Shalon's life was the perfect
embodiment of the vision.

226
00:14:14,678 --> 00:14:18,091
Shalon's death is our call to action.

227
00:14:18,757 --> 00:14:23,707
So today, let each of us vow
to do whatever we can.

228
00:14:24,189 --> 00:14:26,847
Let us vow to right this wrong.

229
00:14:27,329 --> 00:14:30,690
Let us vow to be a part of the solution

230
00:14:30,714 --> 00:14:35,546
until Black women are no longer
marginalized and dying needlessly

231
00:14:35,570 --> 00:14:37,396
in the health care system.

232
00:14:38,050 --> 00:14:40,013
And like my daughter,

233
00:14:40,037 --> 00:14:42,797
(Voice breaking)
Dr. Shalon MauRene Irving,

234
00:14:42,821 --> 00:14:46,571
let us each vow to create a better earth.

235
00:14:47,150 --> 00:14:48,301
Thank you.

236
00:14:48,325 --> 00:14:54,238
(Applause)