San Diego County Lunches "Black Legacy Now" To Address Racism in Maternal and Newborn Health Care

Speaker 1: 00:00 Racism pervades all aspects of our lives, including the quality of medical care we received. That's especially true for black mothers and babies. According to the most recent data from the California department of public health, black infants are three times more likely to die. And 60% more likely to be born prematurely than white infants and black mothers are three times more likely to die due to pregnancy or delivery complications than white mothers. This is happening because of racism in healthcare to address the disparities and create better outcomes for black families. San Diego County has launched a campaign called a black legacy. Now Dr. Thomas Coleman is the medical director of maternal child and family health services with the County, uh, Dr. Coleman. Welcome. Speaker 2: 00:46 Thank you, Jay. It's great to be with you. I really appreciate the opportunity. Speaker 1: 00:50 Name of the campaign is black legacy now, and that title conveys urgency for the County to address these disparities. Tell me about that urgency. Speaker 2: 01:00 Uh, it's really sort of a Clarion call to action that these inequities are fundamentally on just, and, you know, we need to, as a community, you know, we need to educate everyone. Then we need to come together as a community to rectify these structural inequities and have more equal outcomes in terms of, of, of particularly related to maternal and infant health in the black and African-American community. Speaker 1: 01:28 You know, despite the same levels of education, insurance coverage and preventative care, black women are still three times more likely than white women to die during pregnancy and babies are 60% more likely to be born premature. What's the root cause of this Speaker 2: 01:45 There's evidence that structural racism, as well as implicit bias in the clinical arena certainly, uh, leads to these, uh, tragic, inappropriate disparities that we all need to work direct defy. Speaker 1: 02:00 So you say that, you know, systemic racism and implicit biases have caused these negative outcomes for black mothers and black babies. Can you give me some common examples of how this plays out in the healthcare system on a day-to-day basis? Speaker 2: 02:13 There's ample evidence that, uh, there's a differential way that pain is treated and responded to in terms of the black and white communities. So I think on a, on a daily basis, you know, from the implicit bias perspective, we know that that impacts clinical management across multiple arenas, not just the obstetrical or perinatal arena, Speaker 1: 02:37 What are some common things you've heard from black women when they go to visit the doctor and they're expecting Speaker 2: 02:43 Being disrespected, not being heard, um, not being valued, being dismissed, um, not taken seriously and pregnancy should be one of those joyous things. But whenever we go to the doctor, there's at least on baseline, a differential of power, if you will, a lot of this relates to power and it's not that that is inherently set up. It's just people feel vulnerable when they go to the physician in general pregnancy really should be a joyous occasion. And, uh, you know, if you look at, uh, a again, a person or a patient centered, uh, perspective, it values the perspective of the woman and her family. It values the autonomy of the woman. It incorporates the woman's values and perspectives. It involves, uh, you know, active listening, sort of a collaborative relationship. Speaker 1: 03:44 The data highlights how the medical community fails. So many black mothers and families what's being done to fix what's broken within the system. And what interventions are being implemented through this program? Speaker 2: 03:55 Well, that's a great question. The, the two primary interventions are, uh, the implicit bias training, uh, that will soon be, um, implemented in terms of, uh, the healthcare arena. We're also, uh, we have the fatherhood initiative that we mentioned, but we have a longstanding history, uh, within the County and within, uh, public health services under Dr. Wound's leadership with a focus of everything that we do on health equity. So I mentioned the black infant health program, which, uh, is longstanding and is a group-based model that, you know, works with women from an empowering perspective. That's the other part of, you know, having a trauma informed lens in terms of all of our programs. So we work with black infant health. We also have a perinatal care network initiative within our maternal care maternal child and adolescent health funding, trying to get women into prenatal care earlier with a concerted focus for that, but also connecting them to ancillary services. Speaker 2: 05:01 There are multiple home visiting programs, both within the County and community partners. I think the other part too, is listening to the community. The community advisory board that we have for the perinatal equity initiative has been instrumental from the beginning, as far as, you know, the interventions that are put in place. So it's very much community driven. Uh, as far as what we look at, there are other programs, uh, you know, within our maternal child and adolescent health program, but all of the focus is really on health equity in terms of providing information and resources in a way that sort of lifts up in a positive perspective. Asset-based for all of the people that we serve within San Diego County, but certainly within the, uh, the arena of, uh, African-American mothers infants. I know Speaker 1: 05:58 The goal of the black legacy now campaign is to connect families with resources and information to address the problem what's available to people. And how can they reach out? Speaker 2: 06:07 I think the first place is to go to the black legacy now, sd.com website. There's a wealth of information. As I mentioned, it's, you know, it's a focus about why are we focused on this? What is the initiative? There's a focus on communities because we want this to be all of the community to be galvanized in terms of this critically important endeavor. There's a focus on the women that I mentioned. There's the fatherhood initiative. There's actually a section with a lot of different resources. That's explicitly title it for healthcare professionals for their review and incorporation into their clinical practice. So it's really meant to be a global multidisciplinary multi-focal program that incorporates all aspects of the community, again, sort of raising awareness of this pivotal issue, but then also us collectively moving forward to rectify these longstanding structural inequities that have led to these outcomes that are just unacceptable. Speaker 1: 07:13 I have been speaking with Dr. Thomas Coleman, who is the medical director of maternal child and family health services with the County of San Diego health and human services agency. Dr. Coleman, thank you very much. Thank you, Jay. My pleasure.