Pre-Term Birth Rate Hits 15-Year High
March of Dimes, the nation’s leader in mom and baby health, recently released its 2022 Report Card, revealing that the U.S. preterm birth rate increased to 10.5% in 2021 – a significant 4% increase in just one year and the highest recorded rate since 2007. Despite reporting a slight decline last year, the preterm birth rate has steadily increased since 2014, earning the country a D+ grade in the Report Card.
The data also shows persistent racial disparities across maternal and infant health measures that were compounded by the COVID-19 pandemic, making the U.S. among the most dangerous developed nations for childbirth.
The report shows that the number of preterm births increased from 364,487 to 383,082 for women of all races. Black and Native American women are 62% more likely to have a preterm birth and their babies are twice as likely to die as compared to white women. In 2021, preterm birth rates for Black mothers increased from 14.4% to 14.7% and increased from 11.6% to 12.3% for Native American/Alaskan Native mothers. What’s more, while Asian women saw a 3% decline in births, they had the largest increase (8%) in preterm births compared to all other women.
Several factors may contribute to the high rate of preterm births, including inadequate prenatal care and preexisting maternal health conditions such as hypertension and diabetes. Over 21.1% of Black women and 26.8% of American Indian/Alaskan Native women in the U.S. do not receive adequate prenatal care. The pandemic has further exacerbated the struggle for parents to access maternal care from hospitals and other prenatal providers.
“It’s clear that we’re at a critical moment in our country and that’s why we’re urging policymakers to act now to advance legislation that will measurably improve the health of moms and babies,” said Stacey D. Stewart, president and CEO of March of Dimes.
The report also reveals that low-risk Cesarean births remain alarmingly high, with the highest rates among Black mothers (31.2%). Overall Cesarean delivery rates increased from 31.8% to 32.1% in 2021 and represent nearly one-third of all births. While Cesarean birth is lifesaving in medically necessary situations, this form of delivery is major surgery and does have immediate and long-term risks. With about eight in 10 maternal deaths now preventable according to the CDC, reducing rates of Cesarean births may reduce adverse maternal health outcomes associated with medically unnecessary Cesarean birth.
To better understand and address the social drivers to healthcare, this year’s report includes the Maternal Vulnerability Index (MVI) – a new measure of the social determinants of health that impact pregnant people and their babies. Developed in partnership with Surgo Ventures, the MVI is the first county-level, national-scale, open-source tool to identify where and why moms in the U.S. are vulnerable to poor health outcomes. The MVI shows that Black women in the lowest vulnerability counties are still at higher risk of death and poor outcomes than white women living in the highest vulnerability counties.
Each year, the March of Dimes releases its Report Card with grades for individual states, Washington, D.C., Puerto Rico and the 100 cities with the greatest number of births. Between 2020 and 2021, 45 states, Washington D.C. and Puerto Rico experienced an increase in preterm birth rates.
- 9 states and Puerto Rico earned an “F” (Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, West Virginia)
- 4 states earned a “D-” (Missouri, Nevada, Tennessee, Texas)
- 6 states earned a “D” (North Carolina, Nebraska, Florida, Indiana, Delaware, Wyoming)
- 5 states earned a “D+” (Ohio, Illinois, Michigan, Maryland, South Dakota)
Alongside the release of the report, March of Dimes is delivering the Mamagenda for #BlanketChange, an emergency call-to-action to Congress to improve the health of moms and babies. The Mamagenda calls for immediate action to advance policies that support equity, access and prevention, advocating for the enactment of the Black Maternal Health Act of 2021 (H.R. 959/S. 346) and the Pregnant Workers Fairness Act (H.R. 1065/S.1486) to help prevent racial and ethnic discrimination in maternity care, expand access to midwifery care, provide reimbursements for doula support, and more.
It calls for adopting Medicaid expansion and permanently extending Medicaid postpartum coverage to 12 months as authorized under the American Rescue Plan Act.
Visit BlanketChange.org to learn more. To download the full 2022 Report Card, visit (MarchOfDimes.org/Report-Card).
Black Life Texas
Let’s Talk About Those Safe Spaces Again
By Caleb Alexander
For many years, whenever I would hear the term “Safe Space,” my mind would immediately envision privileged, whiny college students who’ve been triggered by some imaginary slight. An eye roll and a sigh usually accompanied that vision. And then, I learned about epigenetics, what it meant, its triggers, and how it affects each of us. And suddenly, I realized we could all use a little bit of a safe space.
According to the Centers for Disease Control and Prevention, epigenetics is the study of how your behaviors and environment can cause changes that affect how your genes work. Let me put it in layman’s terms. Your DNA is the instructions, and epigenetics determines how your genes read and interpret those instructions. This is why you can have identical twins, who grow to have different likes, abilities, behaviors, skill sets, and different levels of achievement. Simply put, their bodies read their instructions in slightly different ways.
Why is this important? It is crucial because epigenetics has been linked to cancer, high blood pressure, heart disease, immuno-resistance to germs, aging, brain development, memory retention, and intelligence. Now, here is the kicker: your environment, socialization, and even the food you eat play a part in determining your epigenetics.
According to the US Department of Agriculture, 39.5 million Americans live in what is known as a food desert. A food desert is defined as a census tract of at least 100 houses that are located in areas without access to affordable healthy food. Nineteen million of those people reside in urban areas. Lack of access to healthy food and living in a stressful environment are two of the prime contributing factors to a person’s epigenetics. The CDC says there is a direct correlation between epigenetics, cancer, and heart disease.
According to Harvard University’s Center on the Developing Child, another crucial factor of epigenetics is that environmental influences – children’s experiences – affect the expression of a child’s genes. Negative influences such as stressful life circumstances or environmental toxins can negatively affect children. At the same time, positive experiences, supportive relationships, and learning opportunities help build future capacities for health, life and learning skills, and immuno-resilience.
The good news – epigenetic changes are reversible. The CDC says a person’s epigenetics respond to changes in behavior or environment. The National Human Genome Research Institute says a person’s epigenome continuously changes during their life cycle. The epigenetics a person has when they’re young will not be the same epigenetics they have when they’re old.
Hurray for us! We can help to save ourselves from a premature grave through environmental changes, changes in nutrition, and changes in socialization. Remember when Nana used to tell you that you are what you eat? Or what about when she admonished you to watch out for who you hang around? Changing your diet, changing your environment, and reducing your stress can all contribute to changing your epigenetics.
More importantly, we can help our children to develop into healthy adults. Epigenetics affect multiple organ systems; therefore, by creating a nurturing environment, we can create positive mental, physical, and behavioral outcomes and increase a child’s future learning capacity. Epigenetic research has shown that repeated activation of the brain circuits dedicated to memory and learning through reciprocal “serve and return” interaction with adults, combined with positive social and emotional support from a child’s family and community, will leave positive epigenetic signatures on their genes.
We can change our health. We can reduce the risk of cancer, heart disease, diabetes, high blood pressure, and various other ailments. We can also set our children up for a bright future filled with learning and success. It appears that all we need to do is act like those whiny little college students I referenced before and create safe spaces for ourselves and our children. Spaces free of stress, spaces where healthy food is the norm and not the exception, spaces where we park a little further out in the parking lot and get a little exercise by walking a little further into the store, spaces where we fill our children and one another with positive words of encouragement, love, and support.
My apologies to the whiny little college kids. Your generation got the safe space thing right!
Black Life Texas
The High Rate of Colon Cancer in the Black Community
By Gabriel Wheatley
Black and African American people have higher rates of getting cancer and have the highest death rate for cancer overall, according to the Centers for Disease Control (CDC). Sadly, Black people have a lower five-year cancer survival rate than white people. Also, African Americans are more likely than white people to be diagnosed with female breast, lung, and colorectal cancers at a late stage. Cancer is harder to treat after it spreads from where it started to other body parts.
Moreover, colon cancer is of particular concern, which is one of the most common cancers that can be avoided. The large intestine, made up of the colon and rectum, stores solid waste until it is eliminated from the body and takes in water and some nutrients from food that has been digested. Regular screenings can easily detect and prevent colon cancer in its early stages if you are older than 45 or suffer from other conditions that make you more likely to get it. When there are no symptoms of the disease, a colon cancer screening looks for polyps (a small growth protruding from a mucous membrane) and other cancerous growths on the inner wall of the colon and rectum. A polyp is a growth that is not cancerous but can be. In the future, some polyps might develop into cancer and lead to death within five years. Colorectal polyps and malignant tumors can be detected and removed early, preventing complications and death from colon cancer.
The Black population is disproportionately affected by colorectal or colon cancer. They have the highest colon cancer rate of any ethnic group in the United States. Compared to other ethnic groups, African-Americans have a 40% higher risk of dying from colorectal cancer and a 20% higher risk of developing it. In addition to genetics, colon cancer risk factors include excess weight, inactivity (no or little exercise), smoking for a long time (including marijuana and barbecue smoke), eating a lot of red or processed meat (rare steaks), not getting enough calcium, vitamins C and E, drinking moderately to a lot of alcohol (including a lot of alcohol on weekends), not eating enough fruits and vegetables, and not getting enough fiber. One must remember that any kind of smoke entering your lungs is not natural and is harmful. Do not believe the weed-head hype that marijuana smoke is harmless. It might be good for pain, but any smoke is dangerous if it goes into your body. Lack of good clean vegetables and organic meats are often on the high end or scarce in supermarkets in communities of color. The medical community is also discovering new links to colon cancer. Interestingly, lower amounts of sunlight may be a contributing factor. One obvious result of this difference is that African Americans have considerably lower vitamin D levels than white people, particularly in the northern regions of the United States. Get familiar with foods high in vitamin D, and get out in the sun, especially if you plan on living in the cold North.
Due to the higher disease and death rate, most experts advise that Black men and women begin routine colorectal cancer screenings at 45. All adults with an average risk, regardless of race (ethnicity is more accurate as “race” is an invented term), should start getting screened at 45.
However, we already know that accessing health insurance and cancer screenings can be a challenge in marginalized communities. Along with access to healthcare, better data and analysis on African Americans and colon cancer rates are needed. What has been hopeful is the advancements in screening.
According to some studies, stool-based testing, as an alternative to a colonoscopy, appears to increase screening rates among African Americans. Because they are invasive, many men of all races dislike colonoscopies. Many men will probably choose a “Colon Guard Test” that can be sent in by mail. If a stool-based test is positive, a mandatory colonoscopy should be performed as a follow-up, and annual testing should be performed again if negative. However, according to some research, the Cologuard at-home test can only detect 42% of large polyps, while a colonoscopy can see 95% of large polyps. Rectal exams and endoscopic procedures are seen as invasive by both Black and white men, and research shows that this is sometimes due to cultural notions of masculinity and homophobia. More research is needed to address these perceptions.
According to the American Journal of Preventive Medicine (AJPM), “Researchers emphasize that Blacks may be more responsive to programs that promote stool testing; however, this preference may vary between communities and how patients are invited for screening. An environment with resources for colonoscopy and a relatively receptive Black community may succeed with this modality. A community with scarce colonoscopy resources . . . may be more appropriate for a stool-card screening program. Overall, the message from gastroenterology associations for all patients is that ‘the best test is the one that gets done.’ A good program should accurately assess its resources and population and simultaneously develop a campaign to address barriers of fear, lack of education, and physician mistrust.”
Black Life Texas
National Low Vision Awareness Month
By Devon Mathews
February is National Low Vision Awareness Month and every year the eye specialists across the country bring awareness to the millions of people with low vision across America. Low vision itself is classified as constant blurry vision that makes it difficult to do everyday tasks such as reading, driving, or looking at a computer.
There are many different types of low vision and it depends greatly on the disease or medical diagnosis that caused the low vision in the first place. The most common types are: central vision loss, peripheral vision loss, night blindness, and of course blurry or hazy vision which is like a cloud over your eyes that won’t go away. Certain eye conditions can cause low vision such as age-related macular degeneration (AMD), cataracts, diabetic retinopathy, and glaucoma.
Age-related macular degeneration is an eye disease that can blur your central vision. AMD happens when aging causes damage to the macula — the part of the eye that controls sharp, straight-ahead vision. The macula is part of the retina (the light-sensitive tissue behind the eye). There are two different types of AMD and they are dry AMD (when the macula gets thinner) and wet AMD (when abnormal blood vessels grow in the back of the eye and damage the macula).
A cataract is a cloudy area in the lens of your eye (the clear part of the eye that helps to focus light). Cataracts are very common as we age and in fact, more than half of Americans over 80 have either had cataracts or had some sort of treatment or surgery to remove them. Over time, cataracts can make your vision blurry, hazy, or less colorful.
Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). If you are diabetic, it’s important to get a comprehensive dilated eye exam at least once a year and to follow your health plan.
Glaucoma is the country’s leading cause of blindness, affecting an estimated 3 million Americans of all ages. It causes pressure in the eye, damaging the optic nerve and causing irreversible loss of vision around the edge of the eye, or “tunnel vision.” The optic nerve, located at the back of the eye, carries visual information from the eye to the brain. Glaucoma causes a buildup of excess fluid in the eye that puts increasing pressure on the optic nerve, leading to permanent damage of nerve fibers. You are at risk if someone in your family developed glaucoma, you are an African American over age 40, you are Latino over age 60, or you have diabetes, hypertension, or extreme nearsightedness.
Remember, low vision does not mean blindness. They are treatments and services in place to assist with your eye health. Please visit your doctor to find out what options are available to you.
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