Professional Education: Myths vs. Facts

Myths vs. Facts: Learn the Difference

Abstract:
The root cause of the high incidence of BIM has not been clearly identified. Current literature indicates that neither income, education, maternal age, nor marital status are central factors. There is also strong evidence against a genetic cause. BIM is possibly the result of a cluster of causes, some psychosocial—like institutional racism, excessive stress, and cultural resignation—and others biological, such as poor prenatal weight gain, maternal vaginal infection, premature rupture of the membranes resulting in preterm delivery, and low birth weight. Some of these factors may interact. Interventions aimed at the prenatal period have not had clear, dramatic success; further research is required to find effective means to reduce risk to the infant in utero. Some authors speculate that the stress caused by racism may induce physiological changes resulting in a suppression of a black woman's immune system, creating a greater risk of infection. Further research is needed to increase knowledge about such theories.

In the decades that scientists have been trying to find the root causes of BIM, many theories were offered which later research proved inaccurate. However, because they sound reasonable to some ways of thinking, many of those myths are still believed today; in fact, confounding variables in study data can make these myths appear true.

Bear in mind this important distinction. While most of the conditions that are mentioned in these myths are indeed infant mortality risk factors, they do not define the black risk factor. Their presence contributes to but does not account for all of black infant mortality.

Myth:
Infant mortality is higher for blacks because so many black adolescents are giving birth.

Fact:
Studies by Friede using 1980 NIMS data on over 1.5 million births determined that blacks had higher mortality rates than whites in every age category.¹²

Myth:
BIM is high because too many black mothers are single.

Fact:
Kleinman and Kessel used 1983 national level data to study the relationship between maternal age, marital status, education, and parity on the incidence of moderately low birth weight and very low birth weight in blacks and whites. Their studies showed that the four factors had directionally similar but quantitatively different effects on both categories of birth weight in blacks and whites. In other words, blacks had higher rates than whites for every combination of maternal characteristics.

Myth:
BIM is high because too many black mothers are uneducated.

Fact:
Studies comparing rates of preterm delivery and low birth weight in African American and white women have found as large a racial disparity among those with college education as among less-educated women, a result that suggests an effect of race independent of social class. Studies of socioeconomic status and race show that while whites tend to have improved infant mortality rates when socioeconomic status improves, blacks do not.

Myth:
It's genetic. BIM is high because of genetic differences between blacks and whites.

Fact:
With a perniciously high rate of BIM continuing to make itself evident despite so many factors being controlled, some might argue for a genetic cause. However, studies by Cabral, Warner, and Kleinman have all shown a clear improvement in black infant outcomes from foreign-born black women.^14,15,16 For example, in a study of 201 foreign-born and 616 U.S.-born black women receiving prenatal care, the infants of foreign-born black women experienced greater intrauterine growth, were less likely to be low birth weight, and were less likely to be premature than those of U.S.-born black women.¹⁴

Myth:
BIM is high because too many black mothers do not receive adequate prenatal care.

Fact:
One might assume that the availability of prenatal care would effectively reduce BIM. Yet Rowley, in her review of those studies that have attempted such interventions, points out they have had only limited success.¹⁷ She suggests that to be effective, this care must also include interventions that reduce those risks that are highly prevalent among black women or unique to black women.

With these myths dispelled, we are still faced with the need to find the real causes of BIM. In the interim, it is important to have appropriate strategies for intervention.

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