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Publication Date

10-29-2018

Keywords

infant mortality, racial disparity, ethnography, socioeconomic, women

Abstract

Background: In Milwaukee, black babies die nearly three times as often as white babies, and black women experience stillbirth two and a half times more often than white women. There are many contributors to this reality. While parental responsibility is one factor, deeper, more systemic issues related to racial inequality and class privilege are also at play. Even among groups with similar socioeconomic status, racial disparities in infant mortality persist.

Purpose: This project seeks to answer multiple research questions, foremost: How do socioeconomic and racial/ethnic factors relate to infant mortality in the concrete lives of black women in Milwaukee?

Methods: This research draws from ethnographic fieldwork as a type of qualitative method that puts Milwaukee women in conversation with those professionals who work to end racial disparities in infant mortality. Ethnography is a method that seeks to listen to particular persons from within their cultural milieu to better understand their values, beliefs, and practices and learn from them about matters that carry moral meaning. The type of triangulation common to ethnography, in which researchers integrate ethnographic interviews, quantitative studies, and ethical analysis, has been argued to be especially fitting to the goals of medicine. Collaborators for this project included 3 Milwaukee mothers; 5 church support group leaders, 3 of whom are nurses; 3 public health personnel; and 2 physicians.

Results: Analysis of interview recordings and transcripts uncovered 3 themes related to women and infant health: violence and stress; social hierarchy and “feeling less than;” and faith and resiliency. Women’s experiences of violence and stress provide particular instances that mirror statistical connections in the literature between stress and premature birth. Stories of feeling “less than” in health care situations point to data concerning racial health disparities in care quality and outcomes. Women practice faith and resiliency amid adversity to help overcome some of these barriers. The insights of these collaborators may prove helpful in redirecting efforts to improve racial disparities in infant mortality.

Conclusion: Those responsible for efforts to reducing racial disparities in infant mortality can learn important lessons from the experiences of black women in Milwaukee. Health care professionals in particular should learn from these experiences to inform how they can revise and implement strategies to reduce infant mortality.

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