Recently the New York Times wrote about the nation's infant mortality crisis in southern African-Americans communities.
Whether the rises continue or not, federal officials say, rates have stagnated in the Deep South at levels well above the national average. Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1.
http://www.nytimes.com/2007/04/22/health/22infant.html?ex=1187150400&en=6023c90dd0adfb2b&ei=5070There have been many causes suggested for this epidemic of infant mortality. The problem may well be multi-factorial. One problem that needs to be considered is our nation's long history of dumping toxic waste in parts of the south where African-Americans live.
In
Dumping in Dixie: Race, Class and Environmental Quality Robert D. Bullard describes how predominantly African-American areas of the South came to targeted by polluting industries.
Many industrial firms especially waste disposal companies and industries that have a long history of pollution violations, came to view the black community as a "pushover lacking community organization, environmental consciousness, and with strong and blind pro-business politics."<26> These communities were ripe for exploitation. Residents of economically impoverished areas---intimidated by big corporations and deserted by local politicians---were slow to challenge private and governmental polluters of their neighborhoods. Moreover, the strong projobs stance, a kind of "don't bite the hand that feeds you" sentiment, aided in institutionalizing risks at levels that are unacceptable in the larger society.
http://www.ciesin.columbia.edu/docs/010-278/010-278chpt2.html Growing empirical evidence shows that toxic-waste dumps, municipal landfills, garbage incinerators, and similar noxious facilities are not randomly scattered across the American landscape. The siting process has resulted in minority neighborhoods (regardless of class) carrying a greater burden of localized costs than either affluent or poor white neighborhoods. Differential access to power and decision making found among black and white communities also institutionalizes siting disparities.
How does this affect infant mortality? I will refer to only one of the many common toxins which are encountered in a typical contaminated site, PCBs, used as a cooling or insulating fluid for industrial transformer or capacitors, their manufacture and use was all but banned in the 1970s and 80s, however, because of the nature of these compounds, they persist in toxic waste dumps to this day.
http://en.wikipedia.org/wiki/Polychlorinated_biphenylPCBs are carcinogens. They have also been linked to reproductive problems including stillbirth and early infant death in the case of Taiwanese women poisoned with oil laced with PCBs and followed for years ( Menstruation and Reproduction in Women with PCB poisoning: Long Term Follow-Up Interviews of the Women from the Taiwan Yucheng Cohort, from
International Journal Epidemiology 2000). A study done in the US has shown that living in a zip code where there is a toxic waste dump known to contain PCBs increases a woman's chance of having a low birth weight infant. (Full text of article available via link below)
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1241618&blobtype=pdfThere are several ways that people can come into contact with PCBs. One way is through the diet. Fish caught from contaminated waters concentrate the chemicals and can poison if they are consumed. Persons who have poor nutrition, perhaps for economic reasons and who are dependent upon locally caught fish as a protein source may be at increased risk for PCB poisoning through this route.
Fish are not the only way that people come into contact with PCBs. Another report, called "Risk Assessment of PCBs at Hazardous Waste Sites" put out by Cal EPA in 2003 mentions that at some sites soil levels have been high enough that indoor residential air has had high levels of the chemicals.
http://www.dtsc.ca.gov/AssessingRisk/upload/Risk-Assess-PCB.pdfNow consider an African-American community, where the soil may be contaminated with PCBs from a toxic waste dump that operated in the 1960s and early 70s. If it is located in the South, there is likely to be some kind of area lake or body of water for drainage. Fishing for recreation and as a source of food is popular in the south. So are outdoor sports like swimming in fresh water, team sports like softball, basketball and other games which children play for most of the year since the weather is mild. Parks built around a body of water like a lake are a preferred community meeting ground.
If the women who have grown up in this community have eaten the local fish and have gone swimming in the local river or lake and have played games in the dirt, they have accumulated a dose of PCB, which will affect them when they get pregnant. And, being members of a minority community, they are also at risk for having fewer job opportunities, less access to health insurance and less access to state of the art obstetric care---which they need even more than other women since their toxic chemical exposure has increased their risk of pregnancy complications.
And PCBs are just one of many toxic chemicals that can be found in waste dumps.
Our current system of allocating prenatal health care as a kind of luxury item--if you have the money, you can get deluxe prenatal care, if you don't, you get bare bones or no care--makes absolutely no sense from a public health or social justice perspective. The women whom society has put at the most risk by literally shitting in their communities, need to be offered the most in terms of prenatal prevention. At the same time, efforts need to be stepped up to identify and clean up toxic areas and to warn residents of the environmental dangers in which they live.
There are undoubtedly other factors at play in the African-American infant mortality epidemic. Lack of equal access to health care may be a major factor. However given what the research has shown so far, it is inconceivable that environmental toxins are not at least partly to blame. Efforts to cast all the blame on the women themselves, by portraying them as lax in seeking prenatal care are just more "blame the victim" rhetoric from a government that would rather protect business interests than look after the wellbeing of citizens whom it considers "second class."
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