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Thursday, October 27, 2016

The United States’ embarrassing maternal mortality figures are closely tied to extreme economic inequality, and better understanding of one will help the other.

Imagine that each year six U.S. passenger jets crashed, killing all passengers on board. Imagine that every person who died on those planes was a woman who was pregnant or recently gave birth. Instead of offering interventions and regulations that might prevent more planes from falling from the sky, lawmakers attempted to defund and repeal the very programs meant to improve air safety. That, in a nutshell, is the maternal mortality crisis in the United States.

Today, more U.S. women die in childbirth and from pregnancy-related causes than at almost any point in the last 25 years. The United States is the one of only seven countries in the entire world that has experienced an increase in maternal mortality over the past decade (joining the likes of Afghanistan and South Sudan), and mothers in Iran, Turkey, the United Arab Emirates, Serbia, and Greece (among many other countries) have a better chance of surviving pregnancy than do women in the United States.

It should be no surprise that maternal mortality rates (MMRs) have risen in tandem with poverty rates. The two are inextricably linked. Women living in the lowest-income areas in the United States are twice as likely to suffer maternal death, and states with high rates of poverty have MMRs 77 percent higher than states with fewer residents living below the federal poverty level. Black women are three to four times as likely to die from pregnancy-related causes as white women, and in some U.S. cities the MMR among black women is higher than in some sub-Saharan African countries.

New research suggests that one of the many factors driving this crisis might be inequality. We may have just celebrated the dawn of 2015, but in terms of economic inequality it might as well be 1929, the last time the United States experienced such an extraordinary gulf between the rich and the, well, everyone else. Today nearly 1 in 3 blacks and 1 in 4 Hispanics (compared to 1 in 10 whites) live in poverty, and in certain states those percentages are even higher. Since the 2008 financial crisis, the net worth of the poorest Americans has decreased and stagnant wages and increased debt has driven more middle-class families into poverty. Meanwhile, the wealthiest Americans have enjoyed remarkable gains in wealth and income. Those in the top 1 percent have seen their incomes increase by as much as 200.5 percent over the past 30 years, while those in the bottom 99 percent have seen their incomes grow by only 18.9 percent during that same time.

As the financial well-being of the majority of Americans has eroded, so too has their health. A recent study conducted by Amani Nuru-Jeter from University of California, Berkeley shows that inequality has very different impacts on black and white Americans. The study found that each unit increase in income inequality results in an additional 27 to 37 deaths among African-Americans, and – interestingly – 417 to 480 fewer deaths among white Americans. Nuru-Jeter and her colleagues were surprised to discover the inverse relationship between inequality and death for whites, and suggested that more research is needed to better understand it. “We do know that the proportion of high-income people compared to low-income people is higher for whites than for African-Americans. It’s possible that the protective effects we are seeing represent the net effect of income inequality for high-income whites,” she said.

The research shows us that rising tides might lift some boats, but it sinks others. And it is unclear if the boats of poor whites actually rise, or if it just appears like they rise because of the higher concentration of people benefiting from inequality in white communities compared to black communities.

Either way, we know that the boats of women of color have certainly not been rising in recent years, and these recent findings beg us to ask how inequality is impacting U.S. mothers specifically. After all, we know that women of color have been disproportionately impacted by the economic downturn. Today the poverty rate for black women is 28.6 percent, compared with 10.8 percent for white women. A 2010 study found that the median wealth for single black and Hispanic women was only $100 and $120 respectively, while the median wealth for single white women was just over $41,000. And in the years following the recession black women represented 12.5 percent of all American workers but accounted for more than 42 percent of jobs lost by all women. Black women have an unemployment rate nearly double that of white women.

Given these grim statistics, it should be no surprise that inequality and maternal-related deaths have increased on parallel tracks over the last decade. But while inequality – and its threats to the economy and the wellbeing of average people – has recently gained long overdue attention, maternal mortality remains an invisible health crisis (unless, of course, you live in one of the communities where it’s all too common for women to die from pregnancy). The media rarely talks about it, foundations aren’t collaborating to invest in initiatives to help us understand – let alone improve – the situation, and policy makers aren’t even pretending to care about it. In fact, the Republican-dominated Congress seems eager to trim or prevent the very programs that help mothers have a healthy foundation for pregnancy: food stamps, reproductive health coverage and access, and wage increases, just to name a few.

The Affordable Care Act is providing much-needed health coverage to many poor women for whom it was previously out of reach, and if fully implemented could certainly help stem maternal deaths. But conservative members of Congress are doing their best to make it as ineffective as possible for the people who need it the most. Nearly 60 percent of uninsured black Americans who should qualify for Medicaid live in states that are not participating in Medicaid expansion. And a recent study found that as a result of conservative opposition to expansion, 40 percent of uninsured blacks who should have Medicaid coverage will not get it (compared to 24 percent of uninsured Hispanics and 29 percent of uninsured whites).

Nuru-Jeter’s research shows us that we will need a host of strategies to tackle deaths in the black community, and maternal deaths are certainly no exception. Better understanding how inequality might be driving unnecessary deaths among women of color would better enable us to identify exactly what those strategies should be and how they should be implemented. And perhaps we wouldn’t get all boats to rise immediately, but it just might get them all to float. It’s sad we aren’t even trying to accomplish that much.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Amnesty International via Flickr

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  • Dominick Vila

    Maternity mortality rates, malnutrition, an increase in the number of homeless Americans, foreclosures, under employment, and increases in part time employment, among other societal maladies, are the result of pervasive government policies designed to protect and expand the interests of the wealthy at the expense of the middle class and the poor. Corporate greed, the indifference of the well off for the well being of fellow citizens, a media more interested in sensationalism to improve their ratings, and the arrogance of wealth and power do the rest.
    The growing schism in financial inequality is not an accident, and its causes are not too difficult to understand. There are many reasons for what is happening, ranging from outsourcing of jobs, automation, the emergence of new technologies, inadequate education, resurgent prejudice, unrealistic expectations, to a highly effective anti-labor campaign that has managed to convince workers that organized labor is against their best interests, that “right to work” states are the solution, and that the preponderance of part time work in right to work states is an inevitable circumstance that they must accept without complaint.
    Last, but not least, is the role that “entertainers” and immoral politicians play in convincing the masses that social programs that help them during hard times, or when they can no longer work, is an evil concept. That we are number one and should not complain because, in spite of the evidence, we enjoy abundance that people in other countries don’t even dream of. Alas, I wonder what would happen if some managed to dispel the mirage of political rhetoric, and exposed the masses to the realities of their circumstances, who is to blame for it, and what needs to be done to overcome the challenges they face. A good place to start may be to expose those who oppose increasing the minimum wage, at a time when 20 states have already done it, and some companies, such as Aetna, have raised it to $16 an hour to attract qualified applicant and limit attrition.
    The declines we are experiencing in our standard of living are, in part, caused by the conclusion that “the government is the problem, not the solution”. Well, if we have to depend on private enterprise to improve our lot, we better we ready to shop at the company store, and accept our life expectancy to decline, while it increases in most industrialized countries. It doesn’t take a genius to understand why that is. Consider paying for what we need and benefit from, and stop dreaming about trickle down economics, charging, and borrowing.

    • mike

      Government is part of the problem. Name one product the govt. makes or produces??
      Minimum wage is not the answer, but jobs not from govt., but from the business community. The anti-business attitude by the Obama admin. in recent years is part of the problem. Not attacking the tax situation on corporations from bringing the monies back to this country does not help.

      As to the dastardly RTW states;

      I guess you think Obama is one of those immoral politicans, Right??? Didn’t Obama to get the ACA passed, tell drug companies he would silence fellow democrats that wanted to lower cost of drugs.
      Lets face it, look at the new standard in this country.
      68% black babies born to unwed mothers
      17% Asian babies born to unwed mothers
      53% Hispanic babies born to unwed mothers
      26% babies born to Non hispanic unwed mothers

      57% babies born to unwed mothers without High School diploma
      9% babies born to unwed mothers with bachelors or higher diploma

      69% babies born to households with incomes $10,000-$20,000
      9% households earning $200,000
      And Obama/left want the “Julia” scenario to be the new norm for all women.
      These children of single mothers have little to no chance of success. Very sad and ignored by the left.

      • Dominick Vila

        The Federal government is not expected or chartered to made products, their contractors do. The government often develops concepts or a vision, they appropriate funds to bring it to fruition, they provide oversight to minimize the probability of fraud and to ensure projects are completed in accordance with established requirements and schedules, and they make sure tax payers get their monies worth.
        Nice try to divert attention from the issue at hand: an unacceptable rate of mortality among pregnant women. They are not dying because they are unmarried, they are dying because they don’t have access to adequate medical care, because their incomes are insufficient to purchase what they – and their babies – need to survive, because of inadequate education, and other similar circumstances.
        The reason blue collar workers in Right to Work States are earning less, and more often than not are temporary workers, than what their counter parts in blue states earn and have is because they no longer have a voice – Unions – to fight on their behalf.

        • mike

          Since the contractors make the products for the govt. as you say, why aren’t the profits going to fund all the services. How could there be so much greed, your words, if the govt. is in control.

          What you seem to have missed by my numbers is to point to the fact, part and probably a major part, is the consequences of theirs and their mothers decisions. Single mothers and their children put them far behind in development and growth economically. That is a fact.

          As to education, Trillions have been put in the inner cities and poor areas to almost no avail. It is the culture that is consistently holding the majority of poor back.

          I would love to see all that research showing blue collar earning less in the RTW. Now, make sure you give all the numbers like cost of living, etc..

          As to unions, if they are so great by the loss in membership in those stalwart blue states?? Even you know real wage between RTW states and not RTW is very small, if at all. As long as union exist we will become less and less competitive in the manufacturing sector. But most important is the fact that RTW states don’t exclude unions, but allow the workers to make the decision to unionize or not.

          • Dominick Vila

            The government is not in the business of running profits. They appropriate funds to cover expenses. Contractors do make a profit, and it usually ends up in the pockets of shareholders, or are invested in business growth, buybacks, etc.

          • mike

            Thanks for the study, I can give rebuttal articles that just proves the back and forth of impacts of right to work rules. Some will show the difficulty of distinguishing the effect of the RTW laws to the actual state characteristics, as well as, other state policies that are unrelated with RTW laws.


            Brilliant, government is not in the business of making a profit, but they are sure in the business to tax and regulate them. Obama has taken Billions from the economy by new laws and regulations. I know you will say he has done fewer, but it is indisputable that his major rules/regs have had a major negative impact on the business community and growth.

          • Dominick Vila

            Most of the new regulations that have been put in place since President Obama was inaugurated are designed to limit the probability of another Great Recession, or a return to the days when fraudulent activities were the norm.
            What is going to surprise many Liberals, and make many “conservatives” uneasy is the fact that President Obama is going to work with the GOP on corporate tax reform. The changes are going to be designed to encourage domestic investment, slow down outsourcing, and encourage U.S. companies to bring jobs back to the USA. Cooperation between the administration and Congress is also going to be evident, in the not too distant future, on regulations and taxation dealing with trade. What you are going to find out is that President Obama is not a Liberal as some Republicans claim. The same is likely if Hillary Clinton is elected.

          • Allan Richardson

            If he is a communist, he is the most ineffective one ever, judging from the state of the economy today compared to when he first took office.

          • mike

            Really???? Keep dreaming.

          • mike

            Really!!! Most new regs. put in place by Obama designed to limit another recession, Baloney. Of the major regulations only a small part is financial.
            The top departments with the highest new costs are: EPA 40 BILLION, DOT-18 BILLION, DOE-9 BILLION, SEC-8, HHS-5 BILLION. Billions a year taken out of the economy.
            The SEC has had the most new regulations but are dwarfed when looking at the cost by the others as to economy.
            In 2015 another 2300+ are scheduled with heavy emphasis by the EPA.
            The GOP is already stated to try and change the tax codes but not without help from Obama.
            No, Obama is very liberal, he just sees his legacy going further down the tube because of intransigence in the past and his lack of concern with working with congress.

          • Dominick Vila

            The argument about regulation Vs deregulation boils down to (1) understanding the rationale behind government oversight designed to protect the best interests of the citizenry, (2) effectiveness, and (3) an analysis of the effects of regulations Vs deregulation.
            Yes, not all regulations are designed to limit Wall Street fraud. Some are focused on protecting the environment. Others involve safety in the work place. Others deal with legal matters, etc.
            Are all regulations necessary? There are many that should be reviewed, canceled, or modified, but on the whole they are necessary and serve a good purpose.
            A review of what happened when deregulation ran rampant indicates that when nobody is guarding the chicken coop, excesses by Wall Street, private industry, individuals, and government at all levels undermine our security, contribute to the destruction of our environment, compromise work safety, and lead to fraud, abuse, damage to sectors of our economy (S&L, Wall Street, consumers, investors), and can contribute to recessions, or worse.
            What is important is not the number of regulations we have, but whether or not they are effective and in our best interest.

          • mike

            20,000 thousand new rules and regulations just under Obama, 153% more major regulations than Bush. 20,000 is no small number and there are not 20,000 necessary changes in this country.

            How many reviewed or canceled 2012, just 1.2% of new costs, a whopping 12 rules, 857 million dollars. Billions of new costs and a total of 857 million reduced.

            Most are not in our best interest or even effective for a economy to start growing again.

            Your point was that the rules and regulations were mostly to stop another financial downturn. What I have pointed out is it goes well beyond that and effects every aspect of our lives and not always in our best interest.

            The massive rules and regulations batter the middle class by increasing the cost of good and services.

            Office of Management and Budget in 2013 said in their report to Congress on cost and benefits of regulations, that administration lied about both benefits and costs.

          • Dominick Vila

            I consider a 153% increase in regulations under President Obama over the deregulation of his predecessor, which contributed to Wall Street abuses and gambling, ENRON, AIG, Lehman Brothers, Bernie Maddoff, and the new collapse of the U.S. economy a desperately needed achievement.

          • mike

            Why am I not surprised by your comments. You and your ilk love big government control of all aspects of the American people and only govt. is the answer to life.
            What gives me a good chuckle is that in your eyes, the meltdown is all the fault of Bush, has nothing to do with Clinton and the laws he signed. Keep living in the past old boy.
            You said the rules and regulations by Obama had to do “mostly” about the meltdown, which is absolutely wrong. The vast majority of this153% increase goes far beyond the financial sector and permeates every aspect of our lives, to do one thing and that is for control. Yes, other presidents have gone before Obama but Obama has perfected it to an art.

          • Dominick Vila

            I agree with one of the points you made, President Clinton should have told the Republicans pushing for the repeal of Glass-Steagal to take a hike. He didn’t and he is now paying a price for his decision. As for Bush’s “ownership” society, deregulation, and the resultant cases of fraud, I guess that was all a mirage.
            The efforts made by the Obama administration to invest in areas conducive to economic growth and job creation, to end the economic slide, and to end the loss of 800,000 jobs a month that existed when President Obama was inaugurated, were not “regulations”. The same goes for Bush’s TARP by the way.

          • mike

            Back to “it’s the fault of the right”, baloney!
            What you seem to forget is the Clinton/Reno attacks and threats to banks if they didn’t lower their established underwriting criteria and lower the standards in approving loans to those not qualified in the past. In doing so the secondary Subprime mortgages was formed and was start of the meltdown under Bush. You ignore the changes CRA. You also, like to ignore the fact when Bush did try to make changes he was blocked by Democrats. Remember, good old Barney and saying there was nothing wrong with Fannie and Freddie or Sen Dodd and the filibuster in the Senate.
            No, neither party is innocent, but your attempts to make it all on the Right and Bush “ownership” is nothing more than out right lies and horse manure.
            Now what areas did Obama invest in that helped and made the recovery happen in just 6 short years. What investments made for all those high paying jobs and economic growth.

          • Dominick Vila

            Here is a short list of Laws and Regulations signed by President Obama:

            Banking and financial services regulation package

            Cash for clunkers
            Title XIII, P.L.111-32

            COBRA, extend benefits period; extend termination date eligibility

            Div. B, P.L.111-118

            Congressional pay raise, none for 2010, none for 2011
            H.R.1105, HR 5146
            Div. J, P.L.111-8, PL 111-165

            Credit card regulations, tighten

            Deepwater Horizon oil spill, authorize advances from Oil Spill Liability Trust Fund

            Derivatives, government regulation of over-the-counter markets
            Title VII, P.L.111-203

            Economic Stimulus

            Executive compensation, expand regulatory oversight
            Title IX, P.L.111-203

            Haiti, accelerate income tax benefits, and debt relief
            H.R.4462, HR 4573
            P.L.111-126, PL 111-158

            Hate crimes, expand federal definition to include gender, sexual orientation, gender identity and disability
            Div. E, P.L.111-84

            Health care reform

            Home buyer tax credit, extend and modify
            Sec. 11-13, P.L.111-92

            Iran, broad range of sanctions and penalties (opposed by Bush-Cheney in 2003)

            Jobs package

            Mortgages, allow bankruptcy judges to modify terms

            National service, expand programs

            PATRIOT Act, extend certain provisions

            Student aid, modify loan programs
            Title II, P.L.111-152

            Tobacco, give FDA the authority to regulate

            Unemployment benefits, extend
            H.R.3548, HR 3326, HR 4691, HR 4851, HR 4213
            P.L.111-92, P.L.111-205

          • mike

            Really??? Keep going!! Why not list the 157(153% increase over Bush) new major(those costing 100 million or more) that play a major role in our everyday lives. The Billions that are taken out of the economy each and every year.
            They don’t call the US “Regulation Nation” for nothing.

          • Dominick Vila

            If you want to analyze the 157 regulations you mentioned, you are welcome to search for them on the Internet.
            As incredible as it may seem, many of us welcome action designed to minimize the ability of crooks to defraud the government and consumers, we welcome effective regulation and oversight to restore honest and fair entrepreneurship, we support safety at the work place, we support protecting our environment, and we support an end to discrimination. In summary, we support honesty and fairness over activities that border on criminality.

          • mike

            Well at least you can admit that you know they are real and pervasive.
            And I have analyzed them and they are for real and they are effecting every aspect of our lives and not for the better.
            Again, financial sector is just a very small part of these Major regulations, not most, as you have tried to claim.

          • 788eddie

            Mike: “Obama has taken Billions from the economy by new laws and regulations.”

            Well, somebody has to help us pay for the hole in the economy that the Bush administration dug for us.

          • mike

            Stay under the rock, it fits you!!!

          • 788eddie

            RE: taxes. To Mike: Grow up, shut up, pay your fair share, or leave the country to those of us who want to grow and move ahead.

          • mike

            Back at you!! Grow up! Now that is funny, coming from a low info person.
            Thanks for the chuckle.

          • ikihi

            what did bush do. if i remember, the democrats are the ones who controlled congress in 2007 and 2008

          • 788eddie

            From 2001 to 2007, Repubs controlled all three branches of the government (in fact they still control SCOTUS).

          • Wedge Shot

            Mike go away, you are showing how stupid you are by the minute.

          • mike

            And let you to continue to be so unenlightened. i don’t think so.

      • Wedge Shot

        The government is not the problem you are. Only 9% of the families in the US earn $200 K so that is why 9% of the babies born are from families that earn $200 K. How stupid can you be?
        The Bush administration passed a law making it illegal for the government to negotiate drug prices.They did it as a part of the part “D” drug program.Try getting an education and then post something that is intelligent. I have much disdain for stupid people, of which you are a charter member.
        Oh, you just showed that education is what is needed. How does someone earning minimum wage pay for an education when they can barely afford food?

        • mike

          I think you just Shanked again. Actually, 200K is closer to 6% of the country. So, you better get your foot wedge out.

          Read and weep!!!

          The one lacking an education seems to be you. Yes, Bush set it up but Obama extended it to to get ACA pasted. He had to make a deal with the drug companies to go along against the wishes of his party.

          • ikihi

            democrats are the party of racism and hate

          • mike

            Their Superiority Complex keeps getting in their way. If you don’t agree with them, they become the most intolerant and hateful people. Like Obama, there is only one side to an issue, theirs.

        • mike

          Since you have shown your ignorance, I thought I would enlightened you with more just so you know for sure how ignorant and stupid you are.

        • ikihi

          the government is the problem. less government = good

        • ikihi

          the democrats have let in too many immigrants. too many immigrants depresses wages and creates too much unemployment and welfare dependence

  • Theodora30

    Our maternal and infant mortality rates have been the highest among developed countries for years. Why liberals have not made this an issue is beyond me. The supposedly pro life crowd that does all it can to make sure poor people so not have health care or well paying jobs should have been pilloried over this yet Democrats and the “liberal” media have ignored the issue so few people know about this disgraceful fact.

    • Allan Richardson

      These same heartless legislators are trying to tear down what may be the last hope of poor women to get professional health care and screening (which ERs cannot do; they just try to fix the IMMEDIATE threat to life), whether pregnant or not, wanting to get pregnant or wanting to avoid getting pregnant: clinics run by Planned Parenthood and similar organizations.

      The fact is, only 1-3 percent of the patients who visit PP and others like it are looking for an abortion, and most PP clinics only refer them to private doctors if they can afford to pay for one. But the false image created by RWNJs who call them “abortion” clinics is one of hundreds of pregnant women a day coming in one door, hundreds of non-pregnant women going out the other door, hundreds of fetuses piling up in the trash, and millions of dollars of profit (from whom, if these women are mostly poor, is not clear), and high pressure sales tactics (comparable to a used car dealer) used to persuade women to get pregnant just so they can then get an abortion. And by passing laws which shut down these imaginary “abortion mills” they are actually shutting down the closest thing to a primary care physician which uninsured poor women can get.

  • Buro Cratz

    Obama is totally delusional.

    • Wedge Shot

      What does Obama have to do with Materinty Mortality you stupid bastar%

    • ikihi

      obama is the worst president in history. inequality doesn’t exist

  • ikihi

    democrats are the party of hatred

  • Tomas Newtham

    I think we can all agree that Barack Obama is dangerously delusional.