Socio-economic deprivation can erode one’s sense of well-being and negatively influence public medical outcomes. The social disparity is determined by various factors, including gender identity, age, migration history, handicap, and residency location. The social determinants of well-being, which include better living standards and variables that impact the likelihood of having a healthier environment, are influenced by a broader set of issues. Academic achievement, earnings, and social discrimination in a community that faces exclusion are some of the social disadvantages that such individuals face. In addition, individuals’ financial resources can affect their capacity to maintain a healthy lifestyle. One or more of these circumstances may affect an individual’s health status, resulting in uneven health possibilities. This paper aims to analyze the relationship between social disadvantage and health outcomes, making a comparison between Black and White pregnant women in the United States. Additionally, the report evaluates how racial disparity among Black pregnant women in the United States leads to poor health outcomes compared to the White women. Finally, the essay provides recommendations on improving health outcomes among Black pregnant women to improve their well-being.
The Relationship between Social Disadvantages and Health Outcomes
There exists a direct relationship between social disadvantage and health outcomes. Inequality in health prospects is a result of social poverty. Income level is a highly accurate determinant of health inequalities, with those with low economic class typically having lower wellness than their colleagues with an elevated socio-economic status. Social discrimination throughout childhood can accumulate over time, exacerbating health inequities between those with higher and lower economic status (Alvidrez et al., 2019). A progressive disadvantage is founded on the premise that socioeconomic-related health inequities would rise over time. Thus, this is mostly due to the pluralistic approach to risk features such as smoking, physical activity, food, and accessibility to preventive measures. The following, as discussed herein, are the relationship between social disadvantage and health outcomes.
First, social deprivation enables the potential of susceptibility grouping. Children of low-income origins, for example, are more likely to be born with low birth weight, poor nutrition, exposed to passive smoking and microbial pathogens, and have fewer opportunities to pursue higher education (Alvidrez et al., 2019). Due to poor living standards and risky health practices, the socially underprivileged are frequently subjected to increased health consequences from birth. Rather than that, these variables have a significant impact on the behavior and lifestyle, affecting people’s health as well.
Second, societal and economic variables can encourage or limit health and wellness. For example, socially or economically disadvantaged people may find it difficult to consume or provide a balanced diet to their dependents if they reside in an area where such food is scarce or prohibitively expensive (Alvidrez et al., 2019). Similarly, individuals may be unable to work out effectively if they reside in an area that is not comfortable for walking or for toddlers to play outdoors. Employment, education, child care, and travel patterns, particularly on public transportation, may also leave insufficient time in the day for such healthy practices.
Third, social deprivation affects both accessibility and quality of healthcare delivery. For example, working hours, medical leave regulations at the workplace, clinic time, and commuting and childcare concerns can all complicate seeing a medical provider. Additionally, there is substantial evidence that those with limited education, poorer incomes, and persons of race all receive less-than-acceptable health care (Alvidrez et al., 2019). Thirdly, social and economic issues influence whether or not an individual is exposed to a desirable or hazardous physical environment. For instance, education level significantly influences career options, which in turn significantly influences income level.
These characteristics significantly impact the likelihood of being able to afford to live in a physically healthy ecosystem. Healthy environments include homes free of environmental pollution of all kinds and seclusion from commercial contaminating facilities. Lastly, social deprivation directly affects biology, penetrating the skin via persistent unrelenting stress and increasing anxiety hormone levels and epigenetic pathways (Petruccelli et al., 2019). Therefore, it is critical to have a wider scope of stressful events when examining the function of distress as a rationale for socio-economic disparities in health results. Psychosocial stressors, persistent role tensions, early adversity, negative experiences, pervasive anxieties, and daily annoyances are all causes of stress (Petruccelli et al., 2019). Petruccelli et al. (2019) claim that when persistent stresses and life circumstances are investigated independently, stressful situations cannot be completely absorbed, and acute and chronic shocks may be linked directly. Everybody experiences stress, but those with a greater standard of schooling, affluence, and social position have better resources to help them cope.
In contrast, lower earners probably have significantly fewer such services. Other elements, such as discriminatory practices of race, gender, socio-economic class, or other traits, can amplify the negative impact of chronic stress. For example, segregation may increase health inequities, according to research. Chronic, unresolved stress can also directly affect physiology via epigenetic alterations (Petruccelli et al., 2019). The genetic makeup is a collection of on-and-off switches that regulate which genes are expressed in which cells. For example, when adrenaline and cortisol levels are increased for an extended period, biochemical reactions in these switches modify the extent to which certain genes are expressed or not, culminating in detrimental health repercussions. Additionally, these epigenetic modifications can be transferred on to the next species, which means that a parent who endures high-stress levels can pass these modifications on to their children.
Racial Disparities among Black Pregnant Women in the United States
Complications during pregnancy are also strongly associated with newborn fatalities. Almost two-thirds of newborn deaths occur within the first month of life, frequently due to congenital defects and difficulties associated with premature births. In addition, premature birth contributes significantly to racial differences in infant deaths. Infant mortality is a critical measure of well-being, but it remains alarmingly prevalent in the United States and is even escalating.
Medical breakthroughs and enhancements in maternity care, literacy, and overall level of life have significantly decreased infant deaths in the United States. However, between 1990 and 2015, the maternal mortality ratio (MMR) in the United States, defined as the value of neonatal mortality per 100,000 live births, climbed from 16.9 to 26.4 per 100,000 live births, while the worldwide MMR decreased by 30%. (Vilda et al., 2019). Nonetheless, no additional drop in maternal death has occurred over the last 25 years, and the US now has the worst child mortality among industrialized economies (Vilda et al., 2019). While advancements partly explain the rising trend in detecting and addressing maternal fatalities, perhaps more troubling is the continuous, enormous, and growing mortality disparity between Black women and all White women in the United States.
Regarding neonatal mortality, determinants of health such as income threshold, literacy, and economic factors are not important mechanisms for African Americans as they are for White Americans. Between 2017 and 2019, the March of Dimes formed a workgroup comprised of experts in biomedicine, clinical care, and epidemiology to research the determinants of the persisting Black-White gap in preterm birth (PTB) (Braveman et al., 2021). Social determinants of health are factors that influence an individual’s well-being in a particular setting, such as where they live, their income, or employment status. Racism is inextricably linked to being Black in the United States, jeopardizing the wellness of African American pregnant woman. Therefore, it is vital to interpret this fundamental public health concern via a social equality lens.
Structural racism is characterized as a network in which official regulations, institutional arrangements, and cultural depictions contribute to the reinforcement and perpetuation of racial inequality. It is fostered by White supremacist mechanisms that create power inequalities among racial minorities (Taylor, 2020). Reproductive justice acknowledges that women’s ability to control their biological fate is contingent on their society’s surroundings, including healthcare access, low-cost housing, income equality, and other variables. As a result, policy suggestions must focus on minority communities and their circumstances if discriminatory practices in infant and maternal mortality are properly addressed (Taylor, 2020). In the United States, significant racial gaps in reproductive health outcomes exist. According to Taylor (2020), Black women face a more than threefold increased risk of dying from pregnancy problems than White women. Racial prejudice in healthcare coverage can also express structurally in other ways.
Racial discrimination includes the accumulation of Black pregnant women in areas lacking quality medical centers and practitioners; severe external conditions and pollutants in overwhelmingly minority communities. There is highly concentrated undernourishment within Black communities; or restrictive new regulations to insurance schemes that inordinately serve racial minorities, such as Medicaid (Taylor, 2020). Taylor (2020) enumerates that 30% of Black pregnant women live communities that lack adequate health facilities as compared to White pregnant mother. It is worth noting that biases based on other social characteristics such as intellectual ability, wealth, gender identity, handicap, and ethnic background can also harm individuals’ encounters in healthcare environments and their medical outcomes.
Additionally, the interconnectedness of racism and misogyny frequently results in Black pregnant women, notably African American women, constantly reporting discriminatory practices in clinical settings on race and femininity compared to their White women. Thus, this exacerbated prejudice makes minority women feel isolated or disregarded when seeking medical assistance or voicing concerns about discomfort during and after childbirth. Racism hurts the psychological, emotional, and overall well-being of Black women throughout their lives.
Inequities in health results across maternal and infant clinical scenarios, such as maternal depression. Consequently, disorders such as sudden infant death syndrome (SIDS), sudden unexpected infant deaths (SUID), and cesarean section deliveries (C-sections) give insight into how institutional racism and prejudices can affect health status (Braveman et al., 2021). For example, SIDS and SUID are among the principal contributors to newborn death among expectant Black women in the United States. C-section births are linked to an increased risk of maternal death and macrosomia morbidity (Braveman et al., 2021). In 2017, Black women had a C-section at 36%, opposed to 30.9 % for White women (Braveman et al., 2021). Furthermore, in 2013, the SIDS and SUID rates for Black women were around double those for White women (Braveman et al., 2021). Underinsurance and an absence of health facilities and institutions providing high-quality maternity and newborn care in underprivileged populations also contribute significantly to these discrepancies.
Medical insurance for expectant mothers is crucial to ensuring women have accessibility to postnatal care, their infant’s well-being, and the wellness of their families. Uninsured postpartum women and their kids may suffer negative health and economic repercussions. It may also play a role in mortality rates, especially among Black women, who have the largest incidence of prenatal mortality in the United States (Lee et al., 2020). While the explanations of the United States’ increased maternal deaths, notably among black women, are complicated, a lack of sufficient maternity care may be a fundamental and legislation component. Extending pregnancy-related Medicare eligibility postpartum may affect mortality rates, in part, due to the present prevalence of uninsurance among new moms and ethnic and racial variations in inclusion (Lee et al., 2020). It has been demonstrated that disparities in health insurance by ethnicity lead to Black women having less access to affordable healthcare than White women.
Evidence-Based Intervention to Reduce Racial Disparity in Health Care among Black Pregnant Women
Consolidating current health initiatives and providing access to reproductive well-being for pregnant Black women
Legislators must fight to modernize the different components of the USA’s medical system, particularly Medicaid, the Affordable Healthcare Act, and the Children’s Health Insurance Program (CHIP), which cover masses of women and kids (Taylor et al., 2020). Extensive, affordable insurance protection is crucial throughout a woman’s life, but it is extremely crucial during pregnancy and after childbirth. Additionally, when women are covered and have accessibility to maternity coverage, their benefits and their children’s health can be easily maintained. Without health insurance, a woman may forego regular maternal and neonatal treatment necessary to establish and avoid health repercussions (Taylor et al., 2020). Medicaid, a joint state-federal-funded initiative that covers millions of low-income Americans, is a critical source of medical cover for expectant mothers. Accessibility to maternity services, fertility control, and other contraceptive services is critical to the array of interventions women require to have healthy babies.
Screening and treatment of pregnant Black women at risk of premature birth
Preterm birth, which occurs before 37 weeks of gestation, is the main cause of child death. According to Taylor et al. (2020), PTB accounted for nearly 17% of all baby deaths in 2017. Comorbidities like breathing difficulties and viral infections are also far more dangerous in premature infants. Taken together, these preterm-related fatalities contributed to more than 36% of all newborn deaths in 2013 (Taylor et al., 2020). However, considerable discrepancies exist; the infant mortality rates associated with preterm birth are more than three times that of infants born to White mothers. Preterm death rates are much higher in these two categories, accounting for more than half of the racial inequalities in child mortality.
Put an end to the disproportionate use of C-sections in the United States
Even after adjusting for medical and demographical characteristics, mothers who receive prenatal instruction and delivery care from experienced doulas have a decreased risk of C-sections and premature births than women who do not. A C-section in which the fetus is extracted via an opening in the woman’s womb and endometrium is an effective surgical technique with a higher risk than vaginal births. These hazards include physical harm to the fetus, infections, neonatal complications, thrombosis, and potential complications in subsequent pregnancies (Center for American Progress, 2021). Maternal deaths and adverse pregnancy morbidity are approximately thrice greater in women with C-sections than natural births. In the United States, black women are more likely than White women to undertake C-sections, even for reduced-risk births.
Socio-economic disadvantage can degrade a people’s sense of wellness and have a detrimental effect on public health outcomes. Numerous factors contribute to the social difference, including sexual orientation, ethnicity, racial background, and resident region. Social deprivation and health consequences are inextricably linked. Socio-economic factors can either promote or impede health and wellness. For example, socially underprivileged people may struggle to eat or provide a healthy diet for their dependents if they live in a location where such foodstuff is rare or unreasonably expensive.
Additionally, social inequality affects both the supply and accessibility of medication. African American women and children dying is a horrible crisis in the U.S. The United States must eradicate racial differences in maternal and neonatal deaths a focus. Overcoming institutional racism in maternity and childhood mortality requires prioritizing Black Women and newborns and combating discrimination and prejudice at America’s structural and institutional levels.
As discussed in the paper, some of the recommendations to help reduce racial disparity among Black women include integrating existing health programs and ensuring expectant Black women have access to reproductive health care. Policymakers must strive to update the United States’ clinical program’s multiple aspects, especially Medicaid, the Affordable Healthcare Act, and the Children’s Health Insurance Program (CHIP), which cover a significant number of women and children. Despite the nation’s awful traditional principles of racism, as outlined in this research, actual policy initiatives can tackle racism’s representations and how they contribute to poor maternal health results. There is a need to carry out more research about racism in the United States. It is a menace that people still practice, and there may be black pregnant women who still are discriminated against at medical institutions.
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