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When Zip Codes Matter More Than Genetics

May 18, 2017


  • Susan Hibbard Executive Director, BUILD Initiative

I was on a Healthy People 2020 webinar today and learned that this week is National Women’s Health Week. The webinar, “Who’s Leading the Leading Health Indicators?” focused on maternal, infant and child health. BUILD’s work on health equity had already made me familiar with the horror of infant mortality statistics in the United States and the extremely troubling, ongoing disparities between preterm births among Black and White mothers as well as the infant mortality rate disparities—twice as high among African American babies as white babies. I had even heard about many of the efforts in Ohio to reduce infant mortality (although I learned great deal about Cradle Cincinnati). BUILD is well-aligned with the webinar speakers’ emphasis on the multiple, interconnected factors that can lead to preterm births and infant mortality and the need for multi-pronged, collaborative, collective approaches focused on shared goals and outcomes.

I have always been wary of the focus on maternal smoking, drinking, or drug use because it can sound like just another way to place the blame on women who have often faced barriers to education, decent-paying jobs, stable housing, etc.

The focus of the webinar, however, was on the multiple factors that contribute to pregnancy outcomes from the mother’s socioeconomic status to maternal conditions—including psychological stress—as well as risky or unsafe behaviors. We need to address what research has uncovered: a person’s zip code has greater bearing on health outcomes and life expectancy than do genes. This is about the impact of access – or the lack thereof – to opportunity. It is also about racism. Research studies have repeatedly documented that psychological stress as a result of racial discrimination contributes to racial health disparities, on top of the ways in which racial discrimination impacts access to high-quality programs and services.

BUILD will continue its focus on the deep connections between early learning and health, and the clear interdependence between the well-being of the adults in a child’s life and the child’s own well-being; this is central to our early childhood systems-building framework. When we work on improving maternal and child health, let’s remember to include work on combatting racism, which diminishes everyone and is also central to the development of effective systems that promote adult and child well-being.

We want to hear from you. Please tell us how your state system, program, or community is trying to address racism and racial disparities in your work. Click here.

Download the webinar PowerPoint presentation here.

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