Experts hope new universal basic income programs and an innovative mothering center will help protect black infants and mothers.
By Dan Ross, Capital & Main
This story is produced by the award-winning journalism association Capital and main and co-published here with permission.
Earlier this year, Los Angeles County opened the application window for a new Universal Basic Income (UBI) program called “Breathe,” which guarantees 1,000 residents $1,000 a month for three years. Entrants must be at least 18 years old, live in economically disadvantaged neighborhoods, and have a family income at or below 100% of the county’s median household income threshold.
Anyone who meets the criteria, including pregnant women, can apply to “Breathe”. Meanwhile, the state is rolling out other UBI pilot projects for vulnerable populations, including those specifically for pregnant women, building on the successes of similar programs elsewhere, such as the one in Manitoba, Canada.
“They’ve had amazing results,” says Zea Malawa, a pediatrician and public health professional with the San Francisco Department of Public Health, of Manitoba, where low-income women qualify for the equivalent of $59. per month over the past two years. trimesters of their pregnancy. The nearly 20-year program is linked to improved developmental health and birth outcomes, including a 19% reduction in low birth weight and an almost 17% decrease in preterm births among First Nations women.
In Los Angeles County, where black infants are three times more likely to die in their first year of life than white infants, universal basic income could be a way to solve a hitherto unsolvable problem. In 2018, the county launched the African American Infant and Maternal Mortality (AAIMM) initiative, which has a five-year goal to reduce the gap between black and white infant mortality in Los Angeles County by 30 percent by 2023. .
Through programs such as the Community Supported Village Campaign and a Home Visiting Network, the AAIMM initiative is now seen by many mothers, community advocates and stakeholders as key to redefining the experience of black childbirth in LA county.
“We’re giving them the support they need and saying, ‘You’re not alone,'” says Marquita Jones, community liaison officer for the Children’s Collective’s Black Infant Health Program, a nonprofit based in the south of Los Angeles.
UBI is seen as another potential layer of support for LA County’s most vulnerable mothers and families, especially at a time when income inequality is so gaping.
Malawa runs the Abundant Birth Project in San Francisco, the first income supplement program for pregnant women in the United States that is unconditional, meaning recipients can spend the money however they see fit. The program caters to the city’s Black and Pacific Islander communities; participants receive between $1,000 and $1,500 per month for the duration of their pregnancy and the first six months of the baby’s life.
By June, 104 mothers had registered and 37 babies had been born. Most of the mothers come from inner city neighborhoods with tiny household incomes compared to the city as a whole. According to Malawi, the average household income of project participants is about $21,000, compared to a citywide average that is nearly $100,000 higher.
Project designers say it’s too early to draw conclusions. But participating mothers expressed feelings of hope and empowerment, Malawa says. “They’re able to do planning in a way that they couldn’t do before when they were just trying to check live.”
Janette Robinson Flint, executive director of Black Women for Wellness, a nonprofit focused on health education, was a mainstay in rolling out the AAIMM initiative in South Los Angeles. She thinks UBI could be a game-changer for black mothers in Los Angeles, but understands that such interventions aren’t always an easy sell to the public. “What I want to do is minimize the fears and hesitations people might have around universal basic income, and talk about the potential for its success based on where it’s been successful,” she says.
Mothers, health officials, nurses, doulas, academic experts and community advocates interviewed for this story said black infant mortality in Los Angeles must be addressed through a range of solutions that bridge the gap. both gaps in health services and access as well as the impact of broader and deeper racial inequalities. Exploring options like UBI is part of the kind of multi-pronged approach they say is needed because black health is affected by poverty and racism as well as medical practices and levels. on duty.
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Too often, the most effective maternal and child health care interventions for Black people are smaller, more localized programs with limited reach, says Brandi Sims Desjolais, who sits on the steering committee of the AAIMM initiative and is maternal health expert at Charles R. Drew University. of medicine and science. And the reasons these programs have remained hyperlocal are “structural barriers” to their expansion, such as the institutionalized racism inherent in the country’s healthcare system, she says. “Black women, black families, have never been a target population for public health — hospitals —.”
To help break down these barriers and “solve this problem of black birth disparities,” Desjolais says, she and a team of experts have spent the past few years studying the different relationships between community health systems and local institutions. , such as nonprofits and universities both at home in LA County and abroad, to assess what works and what doesn’t.
The result is the Black Maternal Health Center of Excellence in South Los Angeles, where the black infant mortality rate is among the highest in the entire county. As Bita Amani, a social epidemiologist at Charles R. Drew University of Medicine and Science and co-director of the center with Desjolais, puts it, one of the center’s main goals is to provide a “dynamic” multi-tentacle intervention program. in order to “change the culture of care” for black mothers and black people giving birth.
So far, the center’s work has focused on increasing the number of black providers in hospitals and community facilities. This month, he will officially open a maternity ward for black women – a relatively new one in the United States – which provides free group prenatal services such as breastfeeding, mental health and physical therapy support, access to doula care and increased efforts to engage fathers. All of this, while “creating a space for emerging clinicians to observe and participate in a culturally competent intervention,” says Desjolais.
In addition to maternity, the center is launching a breastfeeding research project, opening a fellowship to support local emerging leaders in black maternal health, and rolling out a pilot program to improve hand sustainability. -work. According to Deborah Allen, deputy director of the LA County Department of Public Health, there is serious talk of opening a partner center in Antelope Valley, where black infant mortality rates are even higher than in southern THE.
The center takes important benchmarks of the health system in a country that has a fraction of the economic weight of the United States, but where infants enjoy a better survival rate. “When you look at infant mortality around the world, there’s a very strong link between national income and infant mortality,” Allen says. “But there are outliers, and Cuba is an outlier.”
Amani and Desjolais have made reconnaissance visits in recent years to the island, which has a significantly healthier infant mortality rate than the black infant mortality rate in LA County – 4.1 infant deaths per 1,000 births alive against 8.7. As Amani puts it, “Community health is deeply embedded in all parts of [Cuban society].” Indeed, while there is some disagreement over the figures Cuba reports, the country is widely praised for its universal healthcare model that prioritizes community-based primary care. As recently as 2008, the country had the highest doctor-to-patient ratio in the world.
Clearly, efforts to bring the county’s black infant mortality rate in line with countries like Cuba must be more carefully tailored to the particular needs of the black community. This is why many mothers, health professionals and other experts will follow the work of the center closely in the years to come, hoping that it will keep its first promises.
“It’s a grim situation,” Amani said of the county’s current delivery results. “But there is a break in the clouds and an opportunity here that we are definitely acting on.”
Copyright 2022 Capital & Main.
This article was produced as part of a project for the USC Annenberg Center for Health Journalism’s California Impact Fund 2022.