A challenge in health from Dr. King and an opportunity

More than 50 years on from Dr. King’s transcendent “I have a dream” address at the Lincoln Memorial,[1] if there is one area where the dream remains deferred it is in health. There lies an opportunity.

In the United States, one’s lifespan is likely to be shorter, overall health poorer, health care less available and of lower quality, if one is black. Black mothers are less likely to survive childbirth. Black children are less likely to see their first birthdays in the United States than children of other racial backgrounds.[2]

It is not uncommon to hear that this is because African Americans are less economically well off than other people in the United States. As if that was a reasonable justification for such disparities in health and health care in America.

But two recent cases underscore that the issue goes beyond incomes.

Shalon MauRene Irving, PhD, a leading researcher at the Centers for Disease Control and Prevention in Atlanta and an African American woman, had health care and coverage. She died three weeks after she gave birth to her daughter. Postpartum high blood pressure, a condition that ran in her family, was not caught soon enough. Her precious Soleil survives her.[3]

Tennis champion Serena Williams ranks among our generation’s greatest athletes. Life-endangering blood clots interrupted her career in 2011. The day after she delivered her daughter via cesarean section last October, she felt short of breath. Aware of her own history she requested a CT scan. Her health care team provided an obstetrical exam. Her symptoms persisted. She asked again, this time more firmly. Her scan showed blood clots on her lungs. Six days of difficult treatment and recovery returned her to surgery to treat a serious hematoma.

Williams and daughter Alexis are fine in only the way Serena Williams can be:[4] a couple of months postpartum, the 23-time major singles champion returned to the tennis court. But for what accounts suggest were failures to listen the first time, Ms. Williams’ health remained at greater risk than it needed to be. Even for one of the world’s most notable people.

Many argue that the burden impairing the health of African Americans in the United States is poison fruit of racism. For this, the burden of evidence is great. Fortunately, Americans take up great challenges. This challenge is for us all every day.

The further question is who will take up the opportunity to improve health, care and coverage for African Americans?

Through her study and research, Dr. Irving did. It survives her. It guides us.

Through her exceptional achievements promoting health and fitness and leadership, and by speaking up for her own health, Serena Williams has.

Given a challenge, people of creativity and ingenuity in America take it up – knowing full well if it was easy it would have already been accomplished.

“I have a dream,” said Dr. King nearly 55 years ago, “that one day this nation will rise up, live out the true meaning of its creed: ‘We hold these truths to be self-evident, that all men are created equal.’”

We need not wait another 55 years for this dream to be more deeply fulfilled in America’s health, specifically for African American women, men and children.

People are on the job now. Perhaps you. For those on this work now and among those for whom it rests on the "to-do" column, there is still time.

Contact me here.

[1] King ML. I have a dream. Address from the Lincoln Memorial, Aug. 28, 1963. https://www.archives.gov/files/press/exhibits/dream-speech.pdf, retrieved 1/14/2018.

[2] For example, Angley M et al. Severe maternal morbidity, New York City 2008-2012. New York City Department of Health and Maternal Hygiene, Bureau of Maternal, Infant and Reproductive Health, 2016.  https://www1.nyc.gov/assets/doh/downloads/pdf/data/maternal-morbidity-report-08-12.pdf, retrieved 1/14/2018. Notably, “Black non-Latina women had the highest severe maternal morbidity rate – three times that of White non-Latina women. This rate remained high even after stratifying for other known risk factors such as low education, neighborhood poverty and pre-pregnancy obesity.” Also, Pathak EB. Mortality among black men in the USA. J Racial Ethn Disparities. Feb. 24, 2017. https://www.ncbi.nlm.nih.gov/labs/articles/28236289/, retrieved 1/14/2018. “Total mortality significantly declined for black men from 2000 to 2014, and the overall black to white disparity narrowed to (rate ratio of) 1.21 in 2014. However, significant black disadvantages to white men persisted for 10 leading causes of death.”

[3] Martin N, Montagne R. Nothing protects black women from dying in pregnancy and childbirth. ProPublica and National Public Radio, Dec. 7, 2017. https://www.propublica.org/article/nothing-protects-black-women-from-dying-in-pregnancy-and-childbirth, retrieved 1/14/18. “Put another way, a black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition.”

[4] Haskell R. Serena Williams on motherhood, marriage and making her comeback. Vogue, Jan. 10, 2018. https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018, retrieved 1/14/2018.