In the last video in the systemic racism video series, Jay Smooth explains infant mortality in this short (1:01) video:

The text of the video reads:

Did you know that even though America’s infant mortality rate has gone way down in the last 50 years, Black babies are still almost 2.5 times more likely to die before reaching their 1st birthday? Did you know that Black mothers are 3 three times as likely to die during childbirth, that Black and Hispanic mothers are more than twice as likely not to receive proper prenatal care and Native American mothers are more than 3 times less likely to receive proper care?

Race Forward, the producers of the video series, lists several  sources for this short video. There is also a longer, and very good, video on the connection between systemic racism and infant mortality called, “When the Bough Breaks.”   Compared to the other areas covered in the series, the link between infant mortality and systemic racism is a more recent area of research – the last twenty years or so – but there is a growing literature here. If you’d like to dive deeper on this topic, see the titles listed below.

• Collins Jr, James W., Richard J. David, Arden Handler, Stephen Wall, and Steven Andes. “Very low birthweight in African American infants: the role of maternal exposure to interpersonal racial discrimination.” American journal of public health 94, no. 12 (2004): 2132-2138. Abstract: Objectives. We determined whether African American women’s lifetime exposure to interpersonal racial discrimination is associated with pregnancy outcomes. Methods. We performed a case–control study among 104 African American women who delivered very low birthweight (<1500 g) preterm (<37 weeks) infants and 208 African American women who delivered non–low-birthweight (>2500g) term infants in Chicago, Ill. Results. The unadjusted and adjusted odds ratio of very low birthweight infants for maternal lifetime exposure to interpersonal racism in 3 or more domains equaled 3.2 (95% confidence intervals=1.5, 6.6) and 2.6 (1.2, 5.3), respectively. This association tended to persist across maternal sociodemographic, biomedical, and behavioral characteristics. Conclusions. The lifelong accumulated experiences of racial discrimination by African American women constitute an independent risk factor for preterm delivery. (OA)

• David, Richard J., and James W. Collins Jr. “Bad outcomes in black babies: race or racism?.” Ethnicity & disease 1, no. 3 (1990): 236-244. Abstract: The gap between black and white infant death rates in the United States has grown over the last three decades. Epidemiologic and medical studies by investigators seeking to understand and reverse this adverse trend have been unsuccessful. Researchers have looked in vain for the combination of social and environmental risk factors that are more common among blacks and would therefore explain this group’s poor reproductive outcomes. The implicit alternate hypothesis is genetic differences between blacks and whites. In fact, there is more of a gap between black and white mothers of higher socioeconomic position than between overall black and white rates without socioeconomic stratification. An alternative to the genetic theory explains these results, however, on the basis of social risk factors that, because of the presence of widespread discrimination in the society under study, apply only to blacks. Such factors are the effects of racism, not race per se. Several lines of research are needed to investigate the effects of racism on perinatal outcomes, including studies on psychophysiological reactions to racial discrimination and on ethnic group differences in coping mechanisms, social supports, and physical environment. Analysis of trends over the past 37 years indicates that improvements in white (and total US) infant mortality rates cannot be anticipated until the racial gap is closed. (locked) 

• Dominguez, Tyan Parker. “Race, racism, and racial disparities in adverse birth outcomes.” Clinical obstetrics and gynecology 51, no. 2 (2008): 360-370. Abstract: While the biologic authenticity of race remains a contentious issue, the social significance of race is indisputable. The chronic stress of racism and the social inequality it engenders may be underlying social determinants of persistent racial disparities in health, including infant mortality, preterm delivery, and low birth weight. This article describes the problem of racial disparities in adverse birth outcomes; outlines the multidimensional nature of racism and the pathways by which it may adversely affect health; and discusses the implications for clinical practice. (OA) 

• Giscombé, Cheryl L., and Marci Lobel. “Explaining disproportionately high rates of adverse birth outcomes among African Americans: the impact of stress, racism, and related factors in pregnancy.” Psychological bulletin 131, no. 5 (2005): 662. Abstract: Compared with European Americans, African American infants experience disproportionately high rates of low birth weight and preterm delivery and are more than twice as likely to die during their 1st year of life. The authors examine 5 explanations for these differences in rates of adverse birth outcomes: (a) ethnic differences in health behaviors and socioeconomic status; (b) higher levels of stress in African American women; (c) greater susceptibility to stress in African Americans; (d) the impact of racism acting either as a contributor to stress or as a factor that exacerbates stress effects; and (e) ethnic differences in stress-related neuroendocrine, vascular, and immunological processes. The review of literature indicates that each explanation has some merit, although none is sufficient to explain ethnic disparities in adverse birth outcomes. There is a lack of studies examining the impact of such factors jointly and interactively. Recommendations and cautions for future research are offered. (OA)

Roberts, Killing the Black Body (1997)

• Roberts, Dorothy E. Killing the Black Body: Race, Reproduction and the Meaning of Liberty. New York: Pantheon Book (1997). Abstract:Roberts gives a powerful and authoritative account of the on-going assault – both figurative and literal – waged by the American government and our society on the reproductive rights of Black women. While not entirely focused on infant mortality, it offers invaluable context for this persistent health disparity. (locked)

• Williams, David R. “Race, socioeconomic status, and health the added effects of racism and discrimination.” Annals of the New York Academy of Sciences896, no. 1 (1999): 173-188. Abstract: Higher disease rates for blacks (or African Americans) compared to whites are pervasive and persistent over time, with the racial gap in mortality widening in recent years for multiple causes of death. Other racial/ethnic minority populations also have elevated disease risk for some health conditions. This paper considers the complex ways in which race and socioeconomic status (SES) combine to affect health. SES accounts for much of the observed racial disparities in health. Nonetheless, racial differences often persist even at “equivalent” levels of SES. Racism is an added burden for nondominant populations. Individual and institutional discrimination, along with the stigma of inferiority, can adversely affect health by restricting socioeconomic opportunities and mobility. Racism can also directly affect health in multiple ways. Residence in poor neighborhoods, racial bias in medical care, the stress of experiences of discrimination and the acceptance of the societal stigma of inferiority can have deleterious consequences for health. (OA) 

That’s the end of the video series on systemic racism.