Over the past several months, data has shown rising mortality rates among a surprising population - middle-age, largely rural white people. But many who study public health say focusing solely on that data ignores the historic disparities in other areas, such as the extraordinarily high maternal mortality rate among African-American women.
That particular area is of interest to journalist Rita Henley Jensen. Jensen is the founder of The Jane Crow Project, which is exploring the causes for poor health outcomes among African American women. Before working on this issue, Jensen founded Women's eNews, an organization that covers women's issues. In 2009, the organization received a grant from the Kellogg Foundation to investigate the underlying causes of the high African American maternal and infant mortality rates in the United States.
"I've been at it ever since. There are no simple answers," says Jensen. In order to investigate the subject fully, Jensen left Women's eNews to go back to reporting and writing. She says she plans to turn her research across the United States into a book.
"[The book is] focused on the reality that if you ask experts why African American women die more often, they'll give you the short answer - which is racism. That's not specific enough," contends Jensen. "It's an exploration of how racism can harm the health of African American women to the extent that they are vulnerable to dying or experiencing severe morbidity, which is harm from the labor or delivery process."
Jensen's research recently brought her from New York to Milwaukee to examine how segregation impacts the equation. In Wisconsin, African-American women die five times more often than white women due to complications related to pregnancy.
"How could that be? I think every good journalism project starts with that question," Jensen adds.
Although Jensen says it's apparent that segregation has a significant impact on maternal mortality, she admits that she doesn't completely understand how and why. However, she believes a major factor is the pressure and discrimination African American women face, making them more vulnerable to health concerns.
Jensen says her research in Milwaukee leads her to understand that the maternal mortality rate is "an issue that's very low on the totem pole." She argues the Milwaukee Health Department has "very little reflection of a concern" for the issue.
In addition to local government and organizations researched, Jensen met with African American mothers and those who help them navigate the daily stressors they face. Factors such as navigating Child Services, domestic abuse, imprisonment or having a record, and not being able to pay for daily expenses represent just a fraction of these issues.
"You go down the list of the stressors that African American women experience more often, not solely, obviously...but it's more likely if you're African American and it's certainly more likely if you're living in a segregated city," says Jensen. "Over and over again there's an issue."
Jensen says her book will explore the issue nationally. She notes that New York City's maternal mortality rate among African American women actually far surpasses Milwaukee's. With the city's public hospitals and generous Medicaid benefits, many wonder how this continues to happen.
One major hurdle is that there is no standard protocol in the United States to treat emergencies in the labor room according to Jensen. "If you've seen one labor room, you've seen one labor room."
Jensen notes that half of the births in United States are paid for by Medicaid, which is federal money regulated by the states. "So how can Medicaid begin to address this problem?" she asks. "We, the taxpayers are paying the bill for inadequate care that is causing mothers to die."
When the book does come to fruition, Jensen would like to see her work serve as a platform to encourage community involvement in changing hospitals, so that African American mothers can have access to the quality care other mothers receive. "Just start there," says Jensen. "Let's make them feel comfortable and safe."