Graphic by Karina Wu ‘23
by Catelyn Fitzgerald ’23
The interconnectedness of climate change and systemic racism begins early, with the pregnancy of a mother and the birth of a child. A review published in the Journal of the American Medical Association on June 18 found evidence that negative health effects caused by climate change start before birth. The review analyzed 68 scientific research articles that examined the effects of climate change-related heat exposure and/or pollution, including particulate matter and ozone, on pregnancy throughout the United States.
These studies consistently concluded that exposure to heat and air pollutants during pregnancy corresponds with “adverse birth outcomes” such as low birth weights or miscarriages. These pregnancy outcomes are occurring at a growing rate as Americans are increasingly exposed to high heat and pollution due to climate change.
Studies in the report that examined racial disparities in adverse pregnancy outcomes found that Black Americans were consistently at highest risk. Black Americans are exposed to higher levels of pollutants and face the brunt of climate change due to generations of environmental racism.
The report’s conclusion that Black people are most likely to have negative health consequences due to climate change is particularly devastating because Black parents have more difficulties accessing proper prenatal care than their white counterparts. They also experience higher rates of pregnancy-related deaths. According to the CDC’s pregnancy mortality surveillance system, there are approximately 40 pregnancy-related deaths per 100,000 births for African Americans, compared to the United States’ average of approximately 16 deaths per 100,000 births.
Many of these deaths are preventable, being caused by discrimination in medical treatment. In a story published in the Journal of Perinatal Education, a group of African American health providers pointed to a lack of professional resources and available information to the Black community as a cause of this racial disparity. In both their personal and professional experience, the group experienced dismissive attitudes from medical professionals towards African American patients, particularly young women. Rather than ensure their patients understood the details of their own health and prenatal care options, medical professionals refused to offer detailed information on the assumption that their patients would not understand it or heed their advice. The health care providers also said that Black parents are less inclined to go to parenting classes because of cost, inconvenience and the underrepresentation of minorities in those environments, and instead give preference to family resources. The exclusion of Black parents from proper prenatal care can have serious health impacts, and the health effects of climate change only worsen the situation.
The risks to pregnant Black Americans are multifaceted and have no easy fix, but there are actions that can be taken to improve pregnancy outcomes. Slowing the progression of climate change or making systematic changes to redistribute its effects away from communities of color will reduce the negative impacts on pregnancy due to air pollution and heat. Additionally, improving access to and quality of prenatal care for Black Americans will help identify underlying health problems caused by climate change or other factors before they prove fatal to the expectant parent or newborn child. An article from the CDC said that hospitals and health care systems must “standardize coordination of care and response to emergencies” and “identify and address unconscious bias in healthcare” to improve pregnancy outcomes for Black patients.
Opportunities for change exist in every level of the health care system, from national policies down to individual practitioners, which gives hope for the health of expectant parents and their children to improve if these issues are brought to light.