0:00:01.155,0:00:04.356
If could turn back the clock[br]and bring Shalon back,

0:00:04.356,0:00:07.312
I would literally do anything.

0:00:09.078,0:00:11.212
I would happily give everything

0:00:11.212,0:00:14.087
if I could see her smiling[br]face once again.

0:00:14.861,0:00:16.210
But sadly,

0:00:16.210,0:00:18.310
even if Shalon were here,

0:00:18.310,0:00:19.701
it would not change the fact

0:00:19.701,0:00:26.099
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.

0:00:30.722,0:00:35.332
The choice to have a child should never[br]equate to a death sentence.

0:00:38.727,0:00:43.914
The rate of maternal deaths[br]in America is utterly appalling.

0:00:45.348,0:00:50.026
In 2017, NPR and ProPublica reported

0:00:50.026,0:00:56.169
that the United States has the highest[br]rate of maternal mortality

0:00:56.169,0:00:59.611
of any developed country in the world.

0:01:00.467,0:01:06.020
And the United States is the only country[br]where that rate is steadily rising.

0:01:08.196,0:01:12.349
Black mothers like Shalon[br]remain the primary group

0:01:12.349,0:01:14.641
for maternal mortality.

0:01:15.301,0:01:19.114
It is truly reprehensible

0:01:19.114,0:01:20.525
that Black women die

0:01:20.525,0:01:24.924
at a rate of three to four times[br]that of white women.

0:01:25.779,0:01:29.304
It is absolutely shameful

0:01:29.304,0:01:35.363
that 60 percent of those deaths[br]are totally preventable,

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

0:01:38.029,0:01:40.061
And here's a shocking fact:

0:01:40.061,0:01:46.205
according to the report by Health[br]Resources and Services Administration,

0:01:46.205,0:01:51.692
the difference in risk[br]has been steadily unchanged

0:01:51.692,0:01:55.439
for the past six decades --

0:01:55.439,0:01:56.860
six decades.

0:01:57.666,0:02:03.463
Clearly, current efforts to address[br]maternal mortality rates

0:02:03.463,0:02:08.462
and the racial and health[br]disparities in that area

0:02:08.462,0:02:10.710
remain woefully inadequate.

0:02:11.464,0:02:14.583
Only when race stops being the precursor

0:02:14.583,0:02:19.177
to how Black women are treated[br]or not treated in the health care system,

0:02:19.177,0:02:22.130
then outcomes will be[br]drastically different.

0:02:23.740,0:02:26.325
I want to be abundantly clear now.

0:02:27.581,0:02:33.156
The medical community is failing[br]Black mothers in America.

0:02:34.615,0:02:36.082
For decades,

0:02:36.082,0:02:38.307
Black women have been dismissed,

0:02:38.307,0:02:39.377
ignored,

0:02:39.377,0:02:40.595
disregarded

0:02:40.595,0:02:42.462
or at the very least,

0:02:42.462,0:02:46.713
they have been not taken seriously

0:02:46.713,0:02:49.423
in their interactions[br]with the health care system.

0:02:50.256,0:02:54.996
It's not uncommon for Black women[br]to experience racism and discrimination

0:02:54.996,0:02:56.630
by medical prodivders.

0:02:57.438,0:03:02.961
That racism can be blatantly overt[br]or covertly subtle,

0:03:02.961,0:03:04.620
but make no mistake --

0:03:04.620,0:03:05.756
it is there.

0:03:06.447,0:03:11.093
It didn't matter that Shalon[br]had a dual PhD

0:03:11.093,0:03:14.148
in Sociology and Gerontology;

0:03:14.148,0:03:17.456
it didn't even matter that Shalon[br]had two master's degrees,

0:03:17.456,0:03:20.968
one of them a Masters in Public Health[br]from Johns Hopkins.

0:03:21.532,0:03:25.641
It made no difference that Shalon[br]was a lieutentant commander

0:03:25.641,0:03:27.943
in the US Public Health Service,

0:03:27.943,0:03:33.607
an alumnus of the world-renowned[br]Epidemic Intelligence Service,

0:03:33.607,0:03:38.648
a highly respected epidimiologist[br]at the Centers for Disease Control

0:03:38.648,0:03:41.636
and president of her own[br]diversity company.

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

0:03:45.328,0:03:50.797
A Black woman accessing a system[br]that saw her as a sterotype

0:03:50.797,0:03:52.793
and responded to her as such.

0:03:54.582,0:03:57.790
During the three weeks[br]after her child was born,

0:03:57.790,0:04:02.889
Shalon went to her health care providers[br]again and again in distress.

0:04:03.978,0:04:07.207
Obviously with her education and training,

0:04:07.207,0:04:12.441
she could and she did articulate[br]her concerns very clearly.

0:04:15.204,0:04:20.601
Yet her cries for help[br]were minimized and dismissed

0:04:20.601,0:04:23.908
by the covert bias[br]of her medical provider.

0:04:24.510,0:04:26.962
That very bias,

0:04:26.962,0:04:29.806
fueled by structural racism,

0:04:29.806,0:04:33.887
is the root cause[br]of disparities in health care.

0:04:34.558,0:04:38.726
That very bias impacted Shalon's outcome.

0:04:39.594,0:04:41.762
That very bias

0:04:41.762,0:04:46.302
caused my daughter[br]to be among the statistics

0:04:46.302,0:04:48.388
for 2017.

0:04:49.872,0:04:51.695
As a result,

0:04:51.695,0:04:54.002
I lost my beautiful, little girl.

0:04:54.310,0:04:55.873
My baby girl.

0:04:57.114,0:04:59.636
I lost my confidant;

0:04:59.636,0:05:02.194
I lost my best friend;

0:05:02.194,0:05:04.147
I lost my whole world.

0:05:05.991,0:05:08.734
Shalon's daughter lost her mother

0:05:08.734,0:05:11.297
and all of the relationship possibilities

0:05:11.297,0:05:14.101
that could have existed[br]between the two of them.

0:05:16.450,0:05:19.361
The society may have suffered[br]the greater loss.

0:05:20.752,0:05:23.169
Who knows how many medical advancements

0:05:23.169,0:05:27.542
or social justice contributions[br]Shalon may have made

0:05:27.542,0:05:31.810
if only her medical provider[br]had listened to her

0:05:31.810,0:05:34.111
and heeded her cries for help.

0:05:35.224,0:05:36.935
We will never know.

0:05:38.125,0:05:39.873
But this much we do know.

0:05:40.699,0:05:47.677
Behind every one of those 700[br]to 800 women who die is a family

0:05:47.677,0:05:51.720
and a whole social network of loved ones,

0:05:51.720,0:05:56.086
including the children[br]left behind, like Soleil.

0:05:57.957,0:06:01.217
Shalon's daughter Soleil[br]is three years old now.

0:06:02.186,0:06:04.100
She has a quick smile --

0:06:04.100,0:06:06.706
every bit as brilliant[br]as her mother's was.

0:06:07.841,0:06:09.526
Soleil is fearless.

0:06:09.851,0:06:11.180
She's determined

0:06:11.180,0:06:13.074
and she's so opinionated --

0:06:13.074,0:06:14.074
(Laughter)

0:06:14.074,0:06:15.561
so smart.

0:06:16.268,0:06:18.973
Soleil constantly amazes me

0:06:18.973,0:06:22.501
at how confidently[br]she is navigating her world.

0:06:23.703,0:06:28.096
But Soleil only knows her mother[br]through photographs

0:06:28.096,0:06:32.659
and the cherished memories that I have[br]and share with her every day.

0:06:33.627,0:06:36.640
Yet Soleil loves her mommy,

0:06:36.640,0:06:42.065
who was with her[br]for only three short weeks --

0:06:42.065,0:06:43.757
she tells me so each day.

0:06:44.873,0:06:50.949
My heart aches each time[br]Soleil cries for her mommy.

0:06:52.372,0:06:56.501
It is during those times[br]Soleil has said to me,

0:06:56.501,0:07:01.259
"Nana, I want to go to heaven[br]so I can be with my mommy."

0:07:02.907,0:07:04.575
It should not be that way.

0:07:06.625,0:07:08.875
It doesn't have to be that way.

0:07:09.745,0:07:14.993
It can really no longer [br]continue to be that way.

0:07:16.453,0:07:21.044
When I said earlier that the medical[br]community is failing Black mothers,

0:07:21.044,0:07:24.393
some may have wondered if I'm painting[br]with too broad a brush.

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

0:07:28.759,0:07:32.801
Or perhaps we should say[br]that a relative handful of hospitals,

0:07:32.801,0:07:36.828
which happen to be the ones[br]that are largely used by Black women

0:07:36.828,0:07:38.515
and other minorities,

0:07:38.515,0:07:42.150
are at the epicenter of maternal[br]mortality in America.

0:07:43.283,0:07:47.932
But I would argue that focusing[br]on a handful of individuals

0:07:47.932,0:07:50.461
or a handful of hospitals

0:07:50.461,0:07:53.665
is defining the problem way too narrowly.

0:07:54.615,0:07:59.018
The problem behavior isn't about[br]the actions of specific individuals

0:07:59.018,0:08:00.286
or hospitals,

0:08:00.286,0:08:02.803
it's much more systemic than that.

0:08:03.824,0:08:05.173
What's more,

0:08:05.173,0:08:11.048
the prevalence of the problem[br]is deeply entrenched --

0:08:11.048,0:08:17.158
embedded in the very foundation[br]of our health care system.

0:08:19.546,0:08:24.366
It is this broad-based failure[br]that continues to allow disparities

0:08:24.366,0:08:27.046
in maternal health and death,

0:08:27.046,0:08:31.495
which result in Black women[br]just like Shalon

0:08:31.495,0:08:36.513
dying at rates 300 percent higher[br]than white women.

0:08:37.333,0:08:39.152
It's been well documented,

0:08:39.152,0:08:41.203
year after year,

0:08:41.203,0:08:43.538
decade after decade,

0:08:43.538,0:08:46.555
generation after generation,

0:08:46.555,0:08:50.563
and nothing effective[br]has been done to fix it.

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

0:08:55.146,0:08:58.242
Is there a definitive answer[br]to eradicating disparities

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

0:09:00.485,0:09:04.867
Well, improvements in data[br]accuracy are critical

0:09:04.867,0:09:06.509
but not nearly enough.

0:09:07.071,0:09:10.874
Algorithms, checklists, apps --

0:09:10.874,0:09:12.549
they all play an important role,

0:09:12.549,0:09:15.041
but they're no panacea either.

0:09:15.755,0:09:19.226
And I really can't emphasize enough

0:09:19.226,0:09:24.286
that implicit bias training[br]without explicit --

0:09:24.286,0:09:28.075
explicit measures of accountability

0:09:28.075,0:09:30.945
will make absolutely no difference at all.

0:09:32.416,0:09:34.629
It is time --

0:09:34.629,0:09:37.868
it is long past time

0:09:37.868,0:09:43.360
that leaders in the medical community[br]take steps to transform

0:09:43.360,0:09:46.234
the health care system status quo.

0:09:47.957,0:09:51.939
The first step must be acknowledging[br]that the inherent problem

0:09:51.939,0:09:53.680
in the health care system

0:09:53.680,0:09:55.616
is more than a problem;

0:09:55.616,0:09:57.019
it's a failure.

0:09:57.969,0:10:01.310
The next step requires[br]taking responsibility

0:10:01.310,0:10:03.269
and owning that failure.

0:10:03.926,0:10:05.938
But the most important step

0:10:05.938,0:10:09.749
is actively taking the necessary actions

0:10:09.749,0:10:13.415
to right the wrongs[br]created by that failure.

0:10:15.799,0:10:17.754
A wise woman once told me

0:10:17.754,0:10:19.605
if you want something different,

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

0:10:22.723,0:10:26.267
My daughter was committed[br]to doing something different.

0:10:26.924,0:10:30.038
Shalon was known as a woman[br]of great integrity

0:10:30.038,0:10:32.019
and high moral values.

0:10:32.540,0:10:35.473
When asked about her driving[br]principles in life,

0:10:35.473,0:10:36.927
she would respond,

0:10:36.927,0:10:40.037
"I see inequity wherever it exists.

0:10:40.238,0:10:43.204
I'm not afraid to call it by name

0:10:43.204,0:10:45.374
and I work hard to eliminate it.

0:10:45.803,0:10:48.781
I vow to create a better earth."

0:10:49.910,0:10:54.532
Shalon put those words into action[br]every day of her life.

0:10:55.792,0:10:59.667
Former Surgeon General[br]David Satcher once said,

0:10:59.667,0:11:02.084
"Leaders must care enough,

0:11:02.084,0:11:04.501
leaders much know enough,

0:11:04.501,0:11:07.402
leaders must be willing to do enough

0:11:07.402,0:11:12.205
and leaders must be willing[br]to persist until the work is done."

0:11:12.738,0:11:15.395
Shalon was such a leader.

0:11:17.050,0:11:20.327
Though there will never be[br]another leader like Shalon,

0:11:20.327,0:11:23.892
we can each persist[br]until the work is done.

0:11:24.718,0:11:30.009
Here's what I'm doing to persist until[br]the work to save Black mothers is done.

0:11:30.555,0:11:32.154
To get things started,

0:11:32.154,0:11:36.017
I joined forces with several[br]of Shalon's friends

0:11:36.017,0:11:37.651
and CDC colleagues.

0:11:38.028,0:11:39.811
We founded a nonprofit.

0:11:40.485,0:11:44.762
We're working hard to eliminate[br]preventable deaths among Black mothers.

0:11:45.528,0:11:47.378
And here's how we're doing it:

0:11:47.378,0:11:51.454
with action, action and more action.

0:11:52.466,0:11:56.625
We're engaging stakeholders[br]at every point of the public health

0:11:56.625,0:11:58.492
and health care spectrum.

0:11:58.661,0:12:01.511
We're actively working[br]with the legislative office.

0:12:01.663,0:12:05.596
We're promoting accountability[br]measures in postpartum bills

0:12:05.596,0:12:08.569
and we want them enshrined in the law.

0:12:09.417,0:12:13.285
We're embarking upon[br]a community-based research project

0:12:13.285,0:12:17.634
which will redefine quality[br]of medical care for Black women.

0:12:18.963,0:12:24.006
Ultimately, we will tilt more power[br]into the hands of Black women.

0:12:24.838,0:12:26.502
How are we going to do that?

0:12:26.827,0:12:30.765
By empowering Black women[br]and their birthing partners

0:12:30.765,0:12:35.685
to effectively counteract the bias[br]and racism they experience

0:12:35.685,0:12:41.221
at any given point during pregnancy,[br]childbirth and postpartum.

0:12:42.528,0:12:43.962
Look around you.

0:12:44.907,0:12:48.259
Each one of us in this room[br]has a circle of influence.

0:12:48.787,0:12:55.185
I invite you to consider how powerful[br]an impact we could make

0:12:55.185,0:13:00.576
if we focused that collective[br]influence on this problem,

0:13:00.576,0:13:02.286
on making a difference.

0:13:02.982,0:13:06.807
What if we, like Shalon,[br]acknowledged inequity

0:13:06.807,0:13:09.496
wherever it existed in our communities

0:13:09.496,0:13:11.839
and we weren't afraid to call it by name?

0:13:12.150,0:13:15.628
What if we were each committed[br]and passionate

0:13:15.628,0:13:18.801
about using the full range[br]of our resources

0:13:18.801,0:13:20.694
to eliminate that inequity?

0:13:21.360,0:13:22.894
Could we change things?

0:13:23.216,0:13:27.275
Could we really overturn[br]centuries of prejudice

0:13:27.275,0:13:29.945
and decades of bad practice?

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

0:13:33.060,0:13:35.764
I know we could

0:13:35.764,0:13:39.831
if we were focused on that issue,

0:13:39.831,0:13:42.982
if we focused that collective energy.

0:13:43.970,0:13:45.999
To quote Nelson Mandela,

0:13:45.999,0:13:48.870
"When people are determined

0:13:48.870,0:13:51.553
they can overcome anything.

0:13:52.757,0:13:56.712
But "action without vision --

0:13:56.712,0:13:58.311
it's only passing time.

0:13:58.819,0:14:02.608
Vision without action[br]is merely daydreaming.

0:14:03.190,0:14:08.776
But vision with action can truly[br]change the world."

0:14:09.628,0:14:14.207
Shalon's life was the perfect[br]embodiment of the vision.

0:14:14.742,0:14:18.155
Shalon's death is our call to action.

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

0:14:24.396,0:14:26.970
Let us vow to right this wrong.

0:14:27.441,0:14:30.891
Let us vow to be a part of the solution

0:14:30.891,0:14:35.746
until Black women are no longer[br]marginalized and dying needlessly

0:14:35.746,0:14:37.572
in the health care system.

0:14:38.328,0:14:40.215
And like my daughter,

0:14:40.215,0:14:43.155
Dr. Shalon Maureen Irving,

0:14:43.155,0:14:46.905
let us each vow to create a better earth.

0:14:47.254,0:14:48.371
Thank you.

0:14:48.526,0:14:51.260
(Applause)