Return to Video

How the US medical community fails Black mothers

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

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.

more » « less
Video Language:
English
Team:
TED
プロジェクト:
TEDTalks
Duration:
15:07

English subtitles

改訂 Compare revisions