Racism Increases Premature Births in America — the Data Is Now in to Prove that Point

We have important new information about the impact of racism on the pre-term birth rates in our country.

We now know that African American mothers who feel stress about the impact of racism on their children are more than twice as likely to give birth prematurely.

We have known for a few years that America has the highest levels of pre-term births in the industrialized world — and we have known for several years that our pre-term birth rates for African American mothers were the highest in our country — but we did not know why that was happening.

We have powerful new research from California that tells us that the pre-term birth rate is the highest for African American mothers who are experiencing stress from the impact of racism on their families. We can now link those numbers to stress during pregnancy and we can link them very specifically to racism linked stress at a level that exceeds the impact of the other 10 stress factors for expectant mothers that were studied in the California research.

Impact of Racism graph

We also now have new and better information on the relationship between education levels for mothers and their pre-term birth and infant mortality numbers.

That relationship between education levels for mothers and premature birth rates has been extremely confusing to our medical researchers for a number of years.

Several studies have shown that for premature birth rates and for infant mortality outcomes, the level of pre-term birth and infant mortality goes down for our white mothers based on having higher education levels, but the infant mortality rate and premature birth rate actually goes up significantly as education levels rise for our African American mothers.

We now have new research from Duke University that drilled down into that perplexing data and actually looked at specific education levels for each of the mothers to prove to us that those prior data points were accurate and to explicate them one step further.

That new Duke data shows that for expectant mothers who have earned a PhD — those highly educated mothers had the very lowest infant mortality rates for White mothers — but they had the very highest infant mortality rates for African American mothers.

The data on the chart below tells a powerful story.

Infant Mortality Rates (IMR):

Mean IMR graph

We owe the University of California at Berkeley a deep debt for discovering that first connection between the perceived racism stress for African American mothers and premature births and we owe Duke University an equally deep debt for more explicitly delineating that second set of connections between the higher education levels for African American mothers and higher prematurity rates and infant mortality rates for births.

The Berkeley study also repeated, affirmed, echoed and reinforced the key finding of the Duke study and in the very powerful work done earlier by Danyelle Solomon and others that the prematurity rate increased for African Americans and decreased for White Americans based on having higher education levels for the mothers.

So, we now know much more about both of those issues as the result of those two important studies. We need to use that information now to directly inform and help the most affected mothers and to help us all understand why we are so much different than the rest of the world in the rates and the levels of premature births for our mothers.

The fact that our African American mothers have much higher rates of pre-term birth and higher levels of infant mortality has been getting some attention in the current political debates and in public policy agenda for the country.

A growing number of people in America now know that our African American mothers have some of the highest pre-term birth rates in the world. A growing number of people who report and discuss that data tend to link it in various ways to racism as a possible and potential key factor for the higher rates of difficult and failed births.

Racism has been suspected as a factor in those births for some time.

Those new studies actually confirm that assumption about the racism link and they point us to some very specific factors that are doing the damage that is being done.

This is an issue we need to address as a nation. More than 130 other countries have lower pre-term birth rates than we do. The fact that large numbers of children are being born prematurely is one of the reasons our infant mortality rates are also among the worst levels in the world.

We actually have the highest number of babies who die the day they are born of any country in the industrialized world.

For 2017, the overall prematurity rate in this country just increased from 9.6 percent to 9.84 percent of all births.

By contrast, the pre-term birth rates in the most successful countries last year for that birth outcome were 5.5 percent of births in Ireland, 5.6 percent of births in Finland, and 6 percent of all births in Greece.

So we know from the success levels in those countries that significantly lower premature birth rates are both possible and affordable for a country.

We know those better outcomes are affordable because those countries who all spend significantly less money than we spend per capita on health care are currently achieving those lower and better premature birth rates and also achieving significantly lower levels of infant mortality and they are all spending significantly less money than we spend as a nation to achieve those goals.

Those are not small differences for either infant mortality rates or for premature birth rates. It is important for us to understand that our African American mother premature birth rate is the highest in the world by a large margin. Those numbers are more than double the rates in the best performing European countries.

Our prematurity rate is now slightly below 9 percent for our births for our white mothers — a number that was far from the best level in the world but that is just within the range of birth rates in other industrialized nations.

But our prematurity rate is significantly higher for our African American mothers, and that higher rate actually puts those numbers into the worst levels in the world.

Last year, more than 14 percent of births to African American mothers were premature.

That is more than twice as many premature births as Greece, Finland, Ireland, and a number of other countries who have much better levels for their births.

Multiple theories have been proposed over the past several years about those significant differences between the groups in our country.

Some people attribute the differences to possible disparities of some kind in the actual delivery of care for mothers in various settings. That issue has been examined in a couple of settings, and those studies have shown relatively minor differences in actual components of care.

They have shown that the care delivered to minority patients in a number of settings had disparities at various levels that need to be addressed and corrected, but they concluded that the differences in care were not sufficient to create the differences in those outcomes — and those studies reported being unable to explain the fact that the African American mothers with more wealth and higher income levels still had much higher levels of problems with their births.

The Ending Racial, Ethnic and Cultural Disparities in American Health Care Health Care book says that disparities in care delivery exist and they tend to have three basic patterns — biology, bias, and behavior.

The findings about racism at Duke and California seem to follow the biology path for these disparities, because they are linked to the stress levels of the mother during the pregnancy. Stress is a biological factor, because of the immediate and long-term physical impact and the epigenetic issues that it triggers.

The Journal of Health Disparities research team did an excellent paper on the topic of pre-term birth that not only addressed racism as a relevant factor, but also identified epigenetic issues, functional levels of racism-related PTSD for African American mothers. Their researchers also did some very insightful writing on the topic of “Gendered Racism” as being a combination of the discrimination levels that are faced by those mothers both for their race and for their gender.

“Gendered Racism” could become an important concept for a number of inter group issues in America.

Several of the studies in a number of settings that were trying to figure out those birth level differences looked directly at the relationship between the education levels of the mothers and the income levels of the mothers and the rate of pre-term births for each group of mothers

That was not an unexpected relationship for medical scientists. Multiple studies over time have shown that for almost every group of people, their general health status improves and the rate of both chronic and acute diseases go down with higher levels of education.

Some data has shown that high school drop outs from all groups tend to have higher rates of diabetes, asthma, and other chronic diseases compared to college graduates.

That pattern was only different in births for the African American mothers.

Asian American mothers and Hispanic mothers both had the same patterns of prematurity rates relative to the mother’s income levels as the White mothers experienced — with lower-income mothers in each group having more premature births and higher income mothers in each group having both lower infant mortality rates and fewer premature births.

Only the African American mothers did not follow and show that pattern in those studies.

Duke just added important information to our understanding of the situation by taking that research a level further down and drilling down to the specific and explicit education levels of each mother.

Duke University just did a very powerful analysis of pre term births in America that looked at those issues from a solid medical science perspective and they included in their study of infant mortality rates and the key education level impacts for mothers that exist by group.

One of the most important Duke charts is shown above. That analysis of infant mortality rates links the basic education degrees for each of the mothers to the actual mortality rates for the children.

The learned very important information about those links. When the researchers at Duke looked at mortality rates and education levels of mothers, they found that the mortality rate for white mothers with an eighth grade or lower education level was 12 births per 1,000 births. As expected from other studies, they reported that the mortality number dropped to five of the births when the white mothers had a master’s degree.

That number dropped even further to only three deaths per 1,000 when the white mothers had a PhD or equivalent very high education level.

That chart has very important data.

For white mothers, it shows us clearly that higher levels of education actually have a significant and positive reduction impact on the infant mortality rates for those mothers, and it actually shows that white mothers in America who have a PhD have some of the very lowest infant mortality rates in the world.

Their research then confirmed and affirmed the findings in the other studies in various settings that had found the exact opposite impact relative to the education levels and the rate of pre-term birth and infant mortality rates for African American Mothers. They showed patterns for those two sets of births that could not have been more different.

Higher education levels actually increased the rate of pre-term birth percentages for African American mothers. Higher education levels for that set of African American mothers who were studied by Duke somehow but significantly increased the infant mortality rate for their births.

Infant Mortality Rates (IMR):

Mean IMR graph

The Duke researchers reported that the African American mothers with an eighth-grade education had a 15 babies per 1,000 mortality rate — a number that it slightly higher than the rate for White women with the same level of education and that looks very much like the current national infant mortality average for all African American mothers.

However, their data showed that when the African American mothers had a master’s degree, the mortality levels actually increased to 19 of the births.

That is an extremely important and generically unexpected finding.

Some people who have been theorizing about the pre-term birth rates in America had speculated that one possible path that might be tied to various important other social determinants of health factors for reducing those pre-term births might be to somehow increase the education levels and the income levels of the mothers.

That theory and that aspiration could not have been more wrong, based on the Duke research.

Duke has now shown us that having an advanced degree actually made the already problematic infant mortality situation for African American mothers even worse.

The Duke team discovered and reported that when the African American mothers had a PhD or equivalent degree, that infant mortality number for those mothers jumped to 28 of the births.

Twenty-eight is a very high number.

That is one of the highest numbers anywhere in the world.

We need to know and understand the discovery by Duke that the impact of having a graduate degree or a PhD had a massively different and functionally negative impact for pre-term birth rates and for the infant mortality rates for each set of mothers who were studied by that team of researchers.

That is important and entirely new information for us to have as a nation.

It isn’t information, a common belief or a working paradigm that people have been building into their thought processes for either premature birth or for education impact issues before now — because it is both completely unexpected and it seems to be extremely counter intuitive given everything we generally believe we know about many of those birth related issues.

The Duke researchers who reported those differences theorized in their analysis that some elements of racism were probably relevant to those major differences in birth outcomes for those sets of mothers with higher education levels.

The researchers looked at an array of factors — and they theorized that various kinds of stress related to racism might somehow have caused those very different results for mothers with higher levels of education. Their team speculated very logically and insightfully that the personal stress levels that are experienced relative to racism might somehow and sometimes be higher when African American women have higher degrees.

California Study of Stress During Pregnancy Proves a Direct Racism Link

They were entirely correct in that assumption.

Important new California research now says that assumption was accurate.

We now have some extremely important information that is directly embedded in important new California research that both confirms and quantifies that assumption about the higher stress levels related to racism having a very negative impact for many African American mothers.

We now have additional and extremely useful data from California research showing that those linkages do exist between racism and pre-term birth for expectant mothers at an extremely high level, and they directly linked that impact of stress to a particular aspect of racism relative to African American mothers.

Stress is the key differentiator for those births.

Doctors have known for a very long time that higher levels of stress during a pregnancy increase premature birth rates at a significant level. That is not new medical science. Stress that is significant enough to change brain chemistry for any mother during a pregnancy has long been shown to increase prematurity levels for births significantly.

What we have not known with any level of credibility and data analysis until this new California research was done was what levels and which categories of stress created the most problems for those births.

The extremely important new California research looked very directly at that issue for 10,000 California births. The new California study zeroed in on actual causes of stress for the relevant sets of mothers during their pregnancy and then identified the impact of each kind of stress on those births.

The new California research went beyond all earlier studies done in California about those topics. The researchers looked at the impact of a dozen specific and explicit stress factors that might be relevant to women during the pregnancy and they looked at the impact of those stress factors for each set of women.

The attached research that investigated those issues and reported those findings was presented to The California First Five Commission for Children and Families at their July, 2018 meeting. This set of linked slides are from that initial meeting of the Commission.

The First Five Commission was created and funded by the voters of California more than a decade ago as an initiative and program to help children and families in that state relative to multiple issues that are relevant to children before the age of Five.

The Commission concluded from looking at that new data from the 10,000 births that the linkages between racism and pre-term birth were very real and important for California to address, and they concluded that information about those linkages should be shared with any and all people who wanted to reduce the numbers of premature births in any setting.

Everyone who is interested in that set of findings should review the actual research. It is a significant piece of work about the impact of various stress factors on pregnancy outcomes that should particularly become common knowledge among researchers, policy makers, caregivers, community leaders, and anyone who is working on the issue of high and growing African American pre-term birth rates in America.

That research was done by the California Department of Health and by researchers from the University of California in San Francisco.

It is a significant and large-scale piece of research that is giving us several levels of information that are available from no other source.

The researchers were able to look at more than 10,000 births in California as their core research subject matter for doing the study.

California actually studies thousands of births every year as part of their public health agenda as a state. They have been studying birth related issues with survey and data gathering tools for years.

The newest version of that annual study broke extremely important new ground because it looked very directly at stress related issues for each of the mothers for the first time.

Medical science has been clear for years that increased levels of stress increased prematurity rates for mothers. The breakthrough research for this new study is that the researchers and the Commission wanted to know exactly which stress factors were happening for California expectant mothers and they wanted to determine and identify the impact of each stress factor on premature birth rates.

Their approach for the new research was to look at multiple stress points during each pregnancy in an attempt to discern or determine what stress related issues and which stress relevant factors might currently have the biggest negative impact on the premature birth rates for California mothers from every group in California.

The underlying medical science concept of linking stress to prematurity is not new.

Medical science and medical practitioners have known for a number of years that higher stress levels during pregnancy do increase prematurity rates. That particular science is old and well established.

What the researchers did not know before this particular study of California births was done was exactly which stress factors were most relevant to higher levels of premature births.

The California research team did very important, innovative, useful and insightful work on that issue because they drilled down into very specific and relevant stress factors for the mothers.

The researchers identified a dozen key, explicit and functionally relevant stress factors for the mothers and then they checked that list of factors out against the experience of each mother during the pregnancy.

They gathered basic, critical and functionally needed baseline data about the age, the income, the ethnicity and the education levels of each of the 10,000 mothers as a foundation for their work to create relevant and useful context for their findings about the impact of specific sources of stress on each mother and each subset of mothers.

The specific list of potential stress factors is obviously relevant to California mothers, and it is probably universal enough to have broad relevance for births in a wide range of settings.

Loss of Jobs, Domestic Violence, and Racism Create Stress for Expectant Mothers

The researchers looked at loss of jobs, income stress, food shortages, multiple health conditions, domestic partner violence during pregnancy, divorce, separation during the pregnancy, binge drinking, smoking levels and whether or not the expectant mothers were personally worried about the impact of racism on them or their family.

Those are obviously highly relevant stress factors for expectant mothers. Knowing how widely those factors were experienced by the Mothers was important new information for both medical science and for well-informed public policy thinking.

The study of all of those births produced by that research is attached.

That was very good and highly important research to do. The California research has given us extremely useful information about the extent of each and all of those stress factors for each and all of the mothers.

That information gives us great and useful baseline data and macro data on a number of highly relevant maternal stress factors for future research as well as giving us highly useful information about the relative impact of each of those stress issues on premature births in California now.

The research team looked at all of the premature births and they did statistical analysis to see which stress factors during pregnancy, either alone or in combination with other specific factors, had actually increased the likelihood of premature birth for the California mothers.

Job loss, domestic partner violence, multiple health conditions, food shortages and other stress factors during pregnancy all now have important baseline data that can be used for future research.

The researchers did analytical reporting and analysis on the impact of each of those factors on the premature birth rate for each mother by age, income level and by each of the other demographic factors, and they looked at the data both alone and in all possible combinations with other risk factors to figure out which combinations of factors had the highest impact on the mothers.

Their numbers and the linkages they discovered to all of the stress factors and to the impact of racism on the birth rate tell a powerful story that very directly quantifies and reinforces earlier work done by The Center for American progress on those issues.

Racism had a massive negative impact in the California data.

A concern about racism by the mothers turned out to be, by far, the biggest, strongest, and best predictor of which mothers would give birth prematurely. The chart at the top of this paper shows the exact relative impact of that specific stress factor.

It was huge.

A concern by expectant mothers about the impact of racism had a bigger impact on premature birth levels than domestic violence, multiple medical conditions, food shortages and job loss combined.

In looking at the overall rate of pre-term birth, the Berkeley study found that 5.8 percent of the white mothers studied in that year gave birth prematurely. They discovered that 9.2 percent of African American mothers in California gave birth prematurely.

They drilled down to see which of those dozen explicit risk factors that they had identified had the biggest impact on the premature birth rate for African American mothers.

They did not expect the relative force and the disproportionate and major impact of one of those stress factors on the rate of premature birth for the African American mothers in California.

People need to look at those analysis and at the correlation charts for the risk factors in the paper that the researchers produced to see how significant that finding was in the actual data.

Racism won as the biggest negative impact factor by a wide margin.

Racism very clearly had the biggest impact on the rate of premature birth for that set of mothers in that California study.

The African American mothers who reported that they felt personal worry about the impact of racism on their children were far more likely to give birth prematurely. That single concern actually had more impact on the likelihood of giving birth prematurely than all of the other stress factors that happened during each pregnancy combined.

Racism Stress Significantly Increased Pre-term Births

Slightly more than a third — 39 percent — of the African American mothers reported that they personally felt that explicit concern about racism for them or for their family in the survey.

Those mothers who felt that concern had very different birth results.

The mothers who expressed that concern about the impact of racism on their family were literally more than twice as likely to have a premature birth as the white mothers who gave birth in California.

For the African American mothers in the California survey who reported that worry, 12.5 percent gave birth prematurely.

As the studies done by the Duke researchers and by the Center For American Progress study and several other large scale studies have also clearly noted, the Berkeley researchers who looked at those 10,000 births also found increased premature birth rates for the mothers were highest for the African American California mothers with the highest education levels and with the highest income levels.

That previously somewhat confusing and previously unexplained piece of data that had been reported in multiple earlier studies about higher income levels somehow resulting in higher prematurity rates for African American mothers now has a very important medical research relevancy and a direct stress related research context that helps explain why that linkage exists.

We now know from that new California study that the African American mothers with higher education levels and higher income levels were significantly more likely to worry about racism for themselves and their family — and we can conclude that the increased level of stress for those mothers created did exactly the kind of damage that researchers have known for years results from stress that is experienced by a mother during pregnancy.

That factor from the new California stress research helps explain the important Duke data showing that the African American expectant mothers with a PhD were the most likely to have a negative birth outcome.

Those highly educated mothers live in a world where they know better than almost anyone else could possibly ever know how challenging it can be to be African American at this point in time for us as a country and how challenging it can be to be an African American woman even when you have a PhD.

We should understand and appreciate what that data is telling us as a nation.

We have the highest pre-term birth rates in the world and they are highest for our African American mothers, and we now have, for the first time ever, have information telling us why that is true.

That major damaging impact and level of stress that results at very high levels from the worry about racism for many of the women who are giving birth is important for us all to know.

It explains why that set of mothers has had higher rates of premature births for decades, in spite of the fact that some studies showed that the health care system, itself, had not seemed to be significantly different during the pregnancy for those higher income mothers.

Some of the earlier studies that looked at education levels of the mothers had been puzzled by the fact that their research did not show a significant difference in the care delivery infrastructure or in the actual care levels received by those mothers. This research explains why the prematurity levels and infant mortality levels were significantly different even when the differences in care functionality for those mothers were either small or not existent in many settings.

That is useful information. The major prematurity issue isn’t care. It is stress levels for the people receiving care.

The new data from The Journal of Health Disparities research had speculated about those linkages and causality factors and functions — and we now know they are real.

That very powerful set of data should now allow us to do some targeted and effective support for those highest risk expectant mothers, that might help us to reduce some levels of pregnancy related stress in some caring and targeted ways for those mothers during that period of time.

That is extremely useful information — and it does not say that there are other care disparity and racism issues for those births in America. Those numbers do not explain the entire situation and the entire difference between the premature birth rates between groups in either California or the rest of the country.

Those numbers are also obvious and clear. We now know that, overall, 12.5 percent of the African American mothers in California who reported having that worry about the impact of racism had a premature birth.

But we also know that compares to a 7.2 percent premature birth rate for the African American mothers in California who did not report that concern for the survey.

That’s an important number as well. It is significantly higher than the number for White mothers.

Both of those numbers for African American women in California stand in clear and painful contrast to the 5.8 percent premature birth rate that was reported for the white mothers in the California study.

There clearly are other factors that are creating those higher levels of premature birth for the African American mothers who did not have that racism concern, and we need to look at those issues as well.

We know from the Duke data that the mortality rate for African American births it is higher than the rate for White women at every single education level. Those levels were close at the lowest education levels but they were not ever equal or lower at any level.

We also know that there are multiple levels of care system related disparities and challenges that we need to address as a nation. The book Ending Racial, Ethnic and Cultural Disparities in America discusses some of those issues.

The mortality rates were very close for the mothers at the very lowest education levels, but they were still higher for African American mothers at every level.

We need far more research to drill down into those findings at multiple levels. That information about those birth outcomes is just the tip of an iceberg of relationships and realities that we need to understand. More research, analysis and expert thinking needs to be done to understand that situation more completely and to help us improve those results for everyone.

But even without further research, that particular number tied to that concern in this study is extremely important information for us to have as a nation because it shows that racism has a direct and powerful impact on the premature birth rates in this country, and it is clear that we definitely need to use that information about that impact of racism on those births in some useful and effective ways simply because we now know it.

Important knowledge can create own obligation level and can create its own ethical requirement for use by people who learn it when the information is truly important.

There has been some very good work done on the issues of racism and pregnancy damage.

Danyelle Solomon wrote the very powerful piece for the Center for American Progress on racism and births that was noted above that very clearly described many of those same issues and also reported that strange unexpected relationship between higher income levels and higher rates of pre-term birth for African American mothers.

Solomon did not have that final link from the brand-new California Research that tied higher levels of premature births to having that concern about racism in a measurable way — but she did predict that it would exist — and she was correct in her assessment and her prediction.

The University of Michigan just released a major study that also looked at birth related problems for African American women that goes beyond pre-term birth rates into other related health issues and deals very directly with some important disparities in the delivery of care.

All of those studies are important — and the information about the stress damage caused by the Racism concerns are very high on the list of things we need to understand and address as a country.

Now that we understand this information about the impact of those concerns, we have an ethical, logistical, moral, and functional obligation to use that information in beneficial ways.

Knowledge is power and important knowledge about relevant information directly triggers both power and accountability. We need people who are working on issues of premature birth to understand this information and these processes and to be able to factor it into their thinking about this entire set of issues and processes.

We Need Every Pregnant African American Woman with a PhD to Understand Those Findings Now

We particularly need to use and share this information about the impact of those particular concerns immediately with every African American woman with a master’s degree or a PhD or a law degree or any equivalent education level who is expecting a child or who is planning to have a child.

If nothing else, we need to have people who care provide support and give a respectful and loving hug equivalent and a warm, clear and beneficial level of direct support to each pregnant African American woman to help reduce the new mother’s current levels of stress at this exact highly relevant point in time for each mother.

We very obviously need every African American woman in this country with a master’s degree or PhD who plans to have a child to know that information about that impact and those outcomes immediately.

Sharing that information with every African American woman with a PhD or a master’s degree should be possible for us to do if we each take that obligation seriously and act accordingly because the Internet can reach everyone and because we all need to be personally accountable to extend that information to every relevant person in every way so that we can actually reach that set of women individually and do it as soon as possible for each woman.

Share this piece by e mail with anyone who is in that category in your life.

We can’t end racism in our country — but we can mitigate some part of the impact and we can work to reduce stress for individual people in direct and caring ways at important key points in time that can help increase the likelihood of a full-term birth for those mothers.

The next question that we need to deal with is — so what do we do with that entire set of information about the impact of racism on births once we know it?

We Need to Share that Information with the People who Are Most Damaged by that Stress

We need care givers and family members and friends, and community members all to be sympathetic and supportive and to do a wide range of things to help reduce the stress levels for African American expectant mothers with a particular immediate focus on the mothers who are most affected by this information.

We unfortunately are unable to end or eliminate racism in America. Racism is a problem for us as a country that we do clearly need to address at multiple levels.

There are things we can do now to help, however.

We can’t solve those inter group interaction behaviors, beliefs and issues quickly enough to have a positive impact on prematurity levels for the children who are in the hospital being born at this very moment, but we actually can each do very important things to help every child being born in America today to have a much better life relative to a number of basic capabilities and underlying learning level abilities and achievements and relative to extremely important life trajectories for both security and achievement for each child.

We can and should make a huge difference for each child being born now.

We can offset some of the damage done by racism in our country over time and today by helping every single child in America in the first weeks, months, and years of their lives in important ways that are specific to each child.

We are and have been a racist country at many levels. We have been improving relative to racism in very good ways in a number of important areas — and the very fact that there were enough African American mothers with a master’s degree or a PhD to be a statistically valid category, sample, and measurable group in the Duke study tells us that we have made some progress in some areas. That number of African American mothers with graduate degrees would have been much smaller 20 years ago and it would have been statistically invisible or non-existent 50 years ago.

Progress has been made in some key areas related to racism, and we should celebrate and build on that progress.

But we also need to understand and accept the truth that we are far from resolving multiple issues of racism as a country at this point in time.

We should all recognize that the worry felt by those African American mothers about racism is entirely legitimate and accurate and prescient and appropriate and entirely valid at both functional and social levels at this point in time for each of those mothers because the truth is that racism exists and because racism is doing damage to real people in our country today.

We Need to Take Steps to Reduce Racism and Inter Group Anger

We need to understand those issues that link to racism and inter group anger and division — and we need to recognize that we need to take steps now as a nation to remedy them, because if we don’t deal effectively now with those issues that divide us, we are at risk of going down the same ugly and destructive paths that are happening today in over 200 settings in the world today where people are killing each other based on Us/Them instincts and based on their inability in those settings to be aligned and at Peace with each other.

The InterGroup Understanding books and website education and thought pieces about instinctive inter group behaviors explain why we have those racist components to both our history and to our current interactions as a people, and why it is so dangerous to activate our Us/Them instincts and identify other people as Them in any setting.

To create a safe and internally aligned America — and to end some of those damaging inter tribal and inter group behaviors, emotions, and beliefs as an American people — we need to understand why we have those beliefs and we need to understand what we need.

The internal conflicts we are having today in many communities and as a nation in some very visible ways will not disappear of their own accord. We need to do the right things and we need to do them well to succeed as a nation and as a people at multiple areas.

Probably the single most important thing that we can do now to build a sense of inter group Peace and inter group alignment for us as a country is to help our children.

We need to help every child.

We now know from amazing and powerful new brain science that the first weeks, months and years of each child’s life are when the neurons connect in the brain of every child and we need to have every child benefit from that process.

The children who do have direct contacts in those initial days and initial years build neuron contacts by the billions. The children who do not have those contacts in the first years do not have those neuron connections in their brains — and they do note build them later.

The brains actually change in a couple of important ways for all children from every group at age four. Brains of our 4-year-old children purge themselves of unused neurons, and our children cannot do anything later after that age to bring those absent neurons back into use.

It is an extremely biological process. It isn’t racial or ethnic or even economic. All of those labels are misleading and wrong. It is biological and it is extremely individual and that neuron connection process is based on the situational and direct interactions that happen for each child.

The damage done by not helping every child in those first weeks, months and years is massive and it is focused on too many people who already have been damaged by discrimination, racism, and various levels of inter group negative consequences.

We imprison more people than any country in the world by a large margin — and we disproportionately imprison our minority Americans.

We also disproportionately imprison people who have dropped out of school.

African American males who have dropped out of high schools tend to end up in prison. Sixty percent of African American males in their 30s who have dropped out of school are in jail today. Eighty percent will be in jail during their lifetime.

That compares to 10 percent of African American males in their 30s who graduated from high school who are in jail. Ten percent is a very bad number — but it isn’t as bad as 80 percent.

Those paths are set before age two for almost all children.

Because of the new brain science, we could now know by 80 percent accuracy by age three which children were on that path to drop out of school.

We have more African American males in jail today than were enslaved at the beginning of the Civil War.

It will obviously be very difficult to create inter group Peace in America and reduce the impact of racism if we keep putting so many people from some of our groups in prison.

We also now know that we can cut the number in prison from 80 percent to under 10 percent by providing interaction and direct support to every child before the age of three.

So we need to make a commitment to each other to do several things for each other that can help give us a future where we are not tribalized, polarized, living in well-armed, fenced, and gated communities, and doing the same kinds of damaging things to each other that we see happening today in more than 100 multi group nations who currently are at war with themselves.

As a foundation for that work, we need to help every single child born in America to get the support needed in the first weeks and months to build strong neuron connections in their brain.

We need to invest in those months and years for every child — including using our Medicaid program and our WIC programs to educate mothers and to get books to children. The opportunity for us to do that exists because more than half of the births in America this year will be in our Medicaid program.

More than half of the Medicaid homes in America do not have a single book. Children suffer biological deprivation and damage without books, because they do not have billions of neurons connected in their brains without having someone having someone reading to them in ways that make those connections.

The children in homes with no books hear fewer than 5,000 words spoken to them in those first key and essential years when neurons connect for each child. The children in homes that have books and that read at least once a day hear nearly 300,000 words — and those children physically have trillions of neurons connected in their brains that would not exist without hearing those spoken and read words.

It is wonderful to have the parents reading to children — and that creates both trillions of neuron connections and levels of emotional bonding that both parents and children cherish and love.

But it does not have to be a parent to trigger those neuron connections from either talking or reading for any child. Any trusted adult can have that pure biological impact on a child — so we need as a nation to invest whatever we need to spend to make that essential resource available in that absolutely critical window of time to every American child.

We have not closed the learning gaps in our schools in 30 years. They are actually getting worse because the schools keep trying to close those gaps at 15 years old and the biological reality we now know for every single child from every single group is that we need to close them at 15 months for each child or it can’t be done.

We could and should save every child who is born in America by providing that support to every child in those golden months and years and by building billions and trillions of neuron connections in every kid’s brain.

We should prove to each other that we do want to be in a win-win world as Americans where everyone wins by giving the ability to win to all of our children.

We should make that investment as a nation.

It will have a massive payoff for everyone — because the alternatives to creating win-win outcomes in every community and setting will be terrible and grim and there is no bigger win than helping our children at the point where they love, engage and blossom and then thrive from getting that help.

We can have a wonderful and successful future as an aligned and mutually supportive nation, and we can leave our grandchildren a future where they are both successful and safe instead of being at war with one another if we start by investing in every child.

We should choose to have America be a wonderful, and supportive place where our grandchildren are safe, prosper, and thrive.

To achieve that goal, we need to make clear, intentional, and direct commitments to each other as an American people to help all of our groups thrive and prosper and do well.

We Need Children from Every Group to Get the Right Support in the First Months and Years

As part of that commitment that we make to each other, we need to give children from every group the right levels of brain strengthening and neuron linkages in the first months and years of life that will end and prevent the major disparities we have in our education and prison systems today.

There are a number of other things we need to do as a country to give our grandchildren a future where we will not look just like 100 other multi-group countries in the world who currently are at war with themselves, and where the impact of racism will diminish over time rather than grow.

The InterGroup books explain those conflicts in those other countries today as well. Syria, Sri Lanka, Fiji, Yemen, and 100 other multi-tribal nations currently have people whose most negative inter group instincts are fully activated who are very intentionally and very deliberately doing damaging things to one another every day. We all have those sets of instincts — and we cannot allow them to be activated at those kinds of ugly and damaging levels here.

This particular study of the impact of racism on California births has an immediacy to it that should lead us to do things now for a number of mothers that will help reduce the number of pre-term births in this country. We now know from the great research done at Duke that there are some mothers at highest risk — and we should each reach out now to all of those mothers to reduce their risk and to help them have healthy, happy full-term babies and births.

We should be investing in every child to tell those mothers who worry about the impact of racism that racism will be doing less damage to their children than will happen without those investments.

Very intelligent women worried about the impact of racism on their families could feel less worried if we begin to help every child get a better start and a higher chance of not being damaged by imprisonment or inter group violence.

We need our best and brightest caregivers to work together to support all African American and also all other American mothers relative to those issues.

And we need all of our best and brightest caregivers now to be coaching every single mother even before their baby is born on the extreme importance for neuron connection building for each child’s brain that will come from talking directly to their children beginning immediately at birth.

We do a horrible job as a country now in teaching that information to every new mother — but there is no reason for us not to get much better at that teaching process for every birth beginning immediately because Medicaid will pay for more than half of the births this year and that pure functional and financial fact gives us potential access to every Medicaid caregiver on a constant basis for as long as that is true.

We very definitely need our caregivers in both health care and child care to encourage reading and to help mothers find access to books.

The logistical realities are extremely grim.

More than half of the low-income homes in America do not have one single book. That is wrong — and it will feed and reinforce the levels of racist evil and inter group anger that we need to prevent as a country rather than encourage it.

So we need every community to get books to every low-income home, and we need people to step up and read if that is what a given child needs to get that right start in those golden weeks, months and years of life.

We can make a difference. That difference needs to be made.

Please share this information with anyone who might be thinking or working with those mothers and those care sites where the premature birth rates are the highest in the world.

Also — please share both the Duke study and the California study with anyone who might be able to share it with any African American mothers who might somehow be in your world and with any caregivers who have African American expectant mothers as patients.

Knowledge is power.

Now that we have this particular knowledge, we need to use it to change the future for a number of people in important ways that will enhance lives and give us all a better result.

Racism should not define us. Racism needs to be in our history and not our future — and we will need to become more enlightened and collectively aligned to make that happen.

We need to be aligned based on our core beliefs and values, and not our race, tribe, or ethnicity. Beliefs and values need to ground us.

Racism needs to be history. Not our future.

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This post was written by Institute for InterGroup Understanding

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