Of all mothers in the U.S., Black women are the most likely to die in childbirth, according to data released this week by the national Centers for Disease Control (CDC).
The death rate for Black mothers is 42.8 for every 100,000 live births. For Native American mothers, the second most at risk, mortality is 32.5 per 100,000. Non-Hispanic White mothers’ death rates are only 13 per 100,000.
But even U.S. White mothers’ mortality is far higher than women in all the other rich countries. America ranks 46th among nations in maternal mortality, even trailing the former Soviet republic of Kazakhstan.
No single factor
Like infant mortality, the death rate for mothers is linked to a broad range of health factors. “No single intervention is sufficient” to bring the death toll down, said the CDC report. “Reducing pregnancy-related deaths requires reviewing and learning from each death, improving women’s health, and reducing social inequities across the life span, as well as ensuring quality care for pregnant and postpartum women.”
In other words, the United States is an unhealthy place to live because its deplorable health care structure leaves people at the mercy of a cutthroat capitalist economy, while racism condemns its Black and Native citizens to shorter and sicker life spans than prevail in much of what used to be called “the Third World.” The Black maternal death rate in the U.S. roughly matches that of Cape Verde and Turkmenistan.
The best measure of a society’s overall health is infant mortality – the rate at which babies die before they reach their first birthday. The United Nations Population Division rates the U.S. at 38th worldwide, between Brunei and Belarus.
Cuba is No. 31 – an amazing feat, given that more than half its population is descended from slaves that were not freed until 1886, a generation after U.S. emancipation. Then Cuba fell under U.S. occupation, combining Dixie-style Jim Crow with White Latin American racism.
Yet despite 50 years of U.S. economic (and medical) blockade, Cuban infant mortality dropped from 81 deaths per 1,000 births in 1955, to 5.5 in 2010, slightly lower than the U.S. overall rate (5.97). In contrast, Black American infants die more than twice as often, at a rate of 11.4 per 1,000 births – about the same as babies in Thailand and Argentina.
Black America is a very different country from White America – no country for babies or pregnant women, or for young Black men between the ages of 15 and 34, for whom murder is the leading cause of death. Virtually every health indicator places Black Americans in Third World status, giving bloody statistical credence to those that describe Black America as an internal colony of U.S. empire. It is a captive nation that is grossly medically underserved.
Although Blacks make up about 13 percent of the U.S. population, they comprise only 6.8 percent of doctors, a huge proportion of whom were trained in a few historically Black medical schools. Although a single-payer system would be of most benefit to Blacks, Black people will continue to die at far higher rates than Whites, as the CDC report states, until “social inequities” are reduced “across the lifespan.”
Only a social and economic transformation can lift Black America to a First World state of well-being. Anti-Black racism is baked into every U.S. institution, including medicine and all the social sciences – the legacy of the U.S. as a White Man’s Country. And capitalism is the greatest organizer of killing fields – deaths fast and slow – in human history.
Can’t be copied
The Cuban system of neighborhood medicine, with double the proportion of primary care physicians as the U.S. at less than one-tenth the cost ($813 per person per year, compared to $9,403 in the U.S.) – is inseparable from the Cuban revolutionary process. Capitalists cannot copy it.
In an article titled “When Cuban Polyclinics Were Born” by Don Fitz, Cuban historian Hedelberto López admits that “the revolution in medicine would have been impossible if doctors had not fled the country. They would have disrupted everything.”
These doctors were wedded to a system that excluded the Black and poor. Most of them were White, and like other professionals, most of them fled Cuba after the revolution, forcing the state to recreate the medical profession from scratch. Cuban doctors now look like the Cuban people, and live among them. A crisis, once met, became a blessing.
As Fitz writes: “It became clear that medical care could only be improved if a country simultaneously addressed necessities such as food, housing and education; medical campaigns must be based on mass participation; it may be possible to cope with an obstructive institution such as mutualism by creating a better method of delivering care before abolishing the old one; an institution could be improved by undertaking two contradictory processes simultaneously (such as centralizing and decentralizing medicine); despite the short-term damage of 3,000 doctors leaving, the long-term ability to renovate medicine was blessed by their absence.”
A small step
In the U.S., single payer health care is only the first baby-step. The Black health crisis is a social and political crisis that demands a tsunami of new Black doctors to serve in new community health institutions that are answerable to the people – just as schools and police must be made accountable to the community.
The logical places to begin producing this flood of Black doctors are historically Black Howard, Meharry and Morehouse Colleges of Medicine, whose facilities and mission would be vastly expanded for a “Black New Deal” in health. Similarly, Black colleges should be central to a whole range of transformative public projects that build Black community economic and social capacity and power.
How’s that for a 2020 plank for Bernie Sanders, Elizabeth Warren or the Green Party?