Racial Disparities in Maternal Deaths: Another SJW Fraud

Dr. Jennifer Lee, director of the Virginia Department of Medical Assistance Services.

Virginia’s Medicaid program is targeting an alleged racial disparity in maternal deaths. African-American mothers have “consistently” died at more than twice the rate of white mothers during and after pregnancy, and they are more likely to die of natural causes, the Richmond Times-Dispatch informs us. (Black women are three times more likely to suffer a pregnancy-related death, according to The Virginia Mercury.)

“Maternal and infant deaths remain a troubling reality in our commonwealth and our nation,” said Dr. Jennifer Lee, director of the Department of Medical Assistance Services. “There remain stark racial disparities for African American mothers and their babies rooted in generations of racism and historical barriers to quality health care for people of color.”

This is the kind of rhetoric fostered by Governor Ralph Northam as he seeks atonement for dressing in blackface as Michael Jackson 35 years ago. “We have really tried to refocus our administration on a lot of inequities that exist in our society today,” he said yesterday. “One of the inequities that I really believe is quite glaring is the inequities of mothers of color and the mortality rate that not only they face but also that their children face. … This is unacceptable.”

So, how, precisely, will the Northam administration address inequities stemming from generations of racism? Aside from administrative changes designed to generate better data and enroll more women into the program, news accounts allude to two health-related initiatives: curbing tobacco use and connecting pregnant women with substance abuse treatment. If you are having trouble connecting the dots between “historical barriers to quality health care” and the decision of pregnant women to smoke, drink and take drugs, you’re not alone.

The data supporting the “generations of racism” argument are shockingly thin. Here’s what the RTD serves up:

From 2009 to 2013, maternal mortality rates among African-American ranged from 60 to 105 deaths per every 100,000 live births compared with 27 to 35 per 100,000 among white women, according to [the Virginia Department of Health]. Preliminary numbers show that the overall maternal death rate increased from 46 per 100,000 live births in 2015 to 61.3 per 100,000 live births in 2016.

It doesn’t take a PhD in statistics to observe that an increase in the maternal death rate for African-American women in the past 10 years does not support the argument that African-American deaths stem from “historical barriers to quality health care for women of color.”

In documenting its claim that three times more African-American women die from pregnancy- and birth-related causes, Virginia Mercury points to a 2010 document published by the Virginia Maternal Mortality Review team, “Pregnancy related Deaths in Virginia, 1999-2003.” The data is literally 15 to 20 years old, but apparently it’s the best we’ve got. So let’s take a closer look.

The first point worth noting is that the Mortality Review team defined “pregnancy-associated death” expansively as “women in Virginia who died while they were pregnant or within one year of being pregnant.”

Between 1999 and 2003, 210 Virginia women met this definition. The ratio of pregnancy-associated deaths to 100,000 live births over those five years averaged 42.6. Another way of looking at the data is the ratio of women who did not die from a pregnancy-associated death was 99,957.4 for every 100,000 live births. In other words, the percentage of pregnant women who die during pregnancy, birth, or within a year of giving birth is a miniscule fraction of the total number. But that miniscule number is driving assertions that the health care system is racist.

Here are the racial characteristics of the women who died:

White — 111
Black — 88
Asian — 5
Other — 6

More white women died than blacks. Of course, given the fact that whites comprise a larger percentage of the population than blacks, the percentage of deaths as a ratio to live births is higher for black women. According to Census data, there were 3.7 times more whites than blacks in Virginia in 2000. So, yes, it’s true, that the ratio of black women to white women was two to three times higher as a percentage of the general population. No one that I have seen has made the apples-to-apples comparison of maternal deaths as a percentage of the percentage of pregnant woman, not the population as a whole.

(An aside: For some unexplained reason, Asian women — deemed in leftist circles as “persons of color” — experience maternal mortality at a significantly lower rate than blacks and whites. Do Asian women enjoy superior access to health care? Is that racist?)

Now, let’s take a closer look to see what “pregnancy-associated maternal deaths” include. Of the 210 women who died over a five-year period,…

31 died in motor vehicle accidents
30 died in homicides
14 died from accidental overdoses
12 died from suicide
5 died from “other” accidents

In other words, 44% died from causes that had nothing to do whatsoever with access to pregnancy-related services in the healthcare system! The Mortality Review team concluded that only 53% of the “pregnancy” associated deaths were “definitely” or “probably” preventable by changes to clinical care, facility infrastructure, and community and/or patient factors.

You will never hear those facts from the Northam administration, nor will you read them in the RTD or Virginia Mercury.

Here’s what the Health Review team did not do: It did not adjust for behavioral risk factors such as smoking cigarettes, drinking, and taking drugs. It did not adjust for pre-existing risk factors such as hypertension or obesity. If African-American women have these risk factors at a higher rate than white women, then one would expect a higher mortality rate from so-called natural causes. But we don’t know these numbers because the Health Review did not publish them.

Let’s sum up the problems with the assertion that African-American mothers die at two to three times the rate of white mothers:

  • The numbers include deaths that occur up to a year after birth.
  • 44% of the deaths had no connection to access to pregnancy-related services in the healthcare system.
  • The numbers are not adjusted for pre-existing risk factors such as hypertension and obesity, or the consumption of cigarettes, alcohol or drugs.
  • The “disparity” between whites and blacks only looks big because the number is vanishingly small. The percentage of black women who survive pregnancy for a year is greater than 99.9%.

The issue of racial disparities in maternal deaths is wildly exaggerated, if not totally fraudulent, concocted by social justice advocates determined to cast the numbers in the worst possible light. The reality, based on the published data: There was no meaningful racial disparity in the maternal mortality rate 20 years ago. If there has been a surge in maternal mortality in the past five years, look for other causes.

As a hypothesis, I would suggest that rural health care in communities with large African-American populations might have deteriorated as rural hospitals have closed and as it has become harder to recruit physicians to non-metropolitan areas. But if that’s the real problem, Medicaid’s emphasis is misplaced. As with so many things, the obsession with racial disparity misdiagnoses the real problem. Flawed policy responses will harm the very people they are designed to help.

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22 responses to “Racial Disparities in Maternal Deaths: Another SJW Fraud

  1. For purposes of comparison… While an average of about 10 Virginia African-American women died from natural-cause, “pregnancy-associated” deaths per year in 1999-2003, 52 African-American women died from murder and/or non-negligent manslaughter in 2017. Where are Ralph Northam’s initiatives to bring that number down?

  2. A deeper dive into the numbers does change the narrative a bit, clearly. The issue of premature and underweight birth is the one I’ve always heard was more common among women with African ancestry, and preventing that has been a major focus for decades. Until this, I would not have thought death from accident or homicide a year later was pregnancy-related, although depression and thus suicide can clearly be a tragic postnatal outcome. I tend to discount race and consider poverty instead, also apparently not tracked in those statistics? I guess worrying the issue might be poverty also makes me a SJW?

    One reason I admire the Governor’s focus on this issue is there is an easy way to measure success, the outcome sought is concrete. The goal should be good outcomes for everybody and that’s something we can all get behind, just ignoring the effort to mix in other issues.

    Oh, and Jim – those “sensible” gun restrictions coming to the GA next week, those will address the other problem! Fix it right up. No?

    • Underweight birth rates is indeed a separate issue, and one worth focusing attention on. I can’t begin to understand why the Northam administration didn’t pick that issue instead of maternal mortality.

  3. Jim,

    This is good work. It again illustrates that one should not take data at face value, but look behind them. When I saw this story, I was surprised that there were so many maternal deaths, especially in this era of fairly wide access to hospital care (hospitals have to take indigent emergencies). Now, it is clearer; many of these maternal deaths are not associated with pregnancy or childbirth at all. The problem for Northam will be that, because so many of deaths are not pregnancy-related, improving access to health care is probably not going to have the great results that he is hoping for.

    Like you and Steve, I think it would have been much more meaningful to focus on premature and underweight babies. In those cases, better access to prenatal care would probably show improvement.

  4. Agree with you about the misrepresented significance of the 1999-2003 gross numbers — but what about the 2015-16 data about “overall maternal health rate”; where is that from and does that source have a racial breakdown? Given the large swing from year to year, it does not look like a large database is involved.

  5. One would think that journalists would give up their quest to be woke and start researching and reporting facts even when it doesn’t help Democrats. https://www.bloomberg.com/news/articles/2019-07-01/journalism-layoffs-are-at-the-highest-level-since-last-recession

    As a person who read both the morning and evening papers everyday growing up, I love the karma.

    Low birth weight is a problem even if it cannot advance the cause of government-controlled medicine. Why isn’t that a good enough story? Does everything have to help rehabilitate Ralph “Coonman” Northam?

  6. When it comes to race and data – Jim is a dog on a bone!

    I think he has made some decent points (but ignored others) but he’s so hard over on the SJ stuff and Northam (over and over) that it just feels like he’s on a mission.

    Last time I checked – the RTD was considered one of the more Conservative media in Virginia,.. I’m trying to think of another that is more Conservative.

    And I do agree – some folks are really “pushing” the data further than it ought to be and Northam is out to “prove” that he is not that blackface guy even if it means playing social justice stuff.

    It’s probably just me but I consider the BEST of BR when it focuses things not so racially focused or for that matter just how bad government is…

    Steve’s and Dicks tomes along with TomH and Acbar have informed many of us on issues we should know more about if we are going to form informed views.

    I just don’t know what to make of the SJW stuff… though I do agree in this case, we need a better standard definition of what “death due to pregnancy is or is not so on that basis without all the racial goulash, I agree. Still trying to get my head around the idea that the RTD is a liberal rag! 😉 This coming from Russell, KS this evening where the Mexican restaurant was less than wonderful – probably run by a bunch of Hispanic social justice warriors or worse some illegals or deamers! LORD!

    • “Last time I checked – the RTD was considered one of the more Conservative media in Virginia,.. I’m trying to think of another that is more Conservative.”

      You obviously haven’t checked in quite a while.

    • “I consider the BEST of BR when it focuses things not so racially focused or for that matter just how bad government is…”

      For years, I hardly wrote about race at all. But I’m not the one who racialized issue after issue. When I write about race, I’m almost always responding to news stories in which someone (often the reporter) is making an issue of race. The RTD and other newspapers are full of reporters and editors who view every issue now through the prism of race, and they seek only one side of the issue — almost every story supports the Narrative of Racial Oppression. I don’t see any differing perspectives on the RTD editorial page — indeed, I know from personal experience in my brief eight-day tenure there that other perspectives are snuffed out.

      I don’t see or hear anyone here in Virginia confronting the Left’s perspectives on race in a rational manner by looking at the data. You won’t find the information I presented in this post anywhere else. Given the near-total blackout of conservative perspectives in the locally reported “news,” I feel all the most compelled to fill the void. If I don’t no one else will.

      • Jim Bacon’s post is devastating. Racism and race baiting are evil enough when they infect a mere thoroughly corrupt and depraved Governor, but when these twin evils infect not only the Virginia Governor but also the director of the Virginia Department of Medical Assistance Services, the Commonwealth is rotting down into its core and its citizens are in deep trouble.

  7. Larry, to a point I agree with you, but has we head into the 2019 and then 2020 elections racial and ethnic tensions are proving to be a major playing card for both teams. Trying to separate fact from fiction from fantasy from defamation is a laudable goal. Another explosion yesterday over, of all things, shoes with the Betsy Ross flag. I’m sorry, that’s a bunch of crap. Having driven the Stars and Bars underground (and I’m fine with that, the affiliation with slavery is strong), some people now need another target for their Hate America First campaign. The colonial era flag is racist? And Michael Paul Williams in today’s RTD arguing that the persistent violence in Shockoe Bottom is due to the slave market 200 years ago. Hell, it’s just a bunch of drunks with guns who think violence is acceptable, enabled by a cultural norm against telling anything to the police. Is there any doubt that 20 people know who engaged in the gunplay that killed that little girl in the city park? Of course they know. Any doubt that changing THAT norm of “never snitch!” is the key to reducing the violence?

    Jim correctly points out the real problems are not being addressed. But the whole Republican “Democrat Blackface” meme also doesn’t open the path to discuss the real issues. As I said, both sides are seeking advantage.

    And I’m a fan of Pam Stallsmith and a deep daily reader of the RTD editorial page, and it is trying desperately to erase that conservative image and win those Woke voters. It is not a liberal rag but certainly is not the conservative (and usually informative) voice it was. Thank goodness it still carries George Will, Hansen, a few other commentators I seek out regularly. I’m sure the pressure is on, as the goal of the extremists on both sides is to own every platform.

  8. Hadn’t heard of the Betsy Ross flag but did a quick read.

    Here’s my take on race.

    Black folks do NOT agree that we live in a post-racial era where the color of your skin plays no role in things.

    And it does not help when one set of folksl calls Jim Crow era symbols of white supremacy – “history”l and the other side says that the fact that these sympols still exist and are still held in high esteem by white folks proves that we are no where near “post racial”. KAEPERNICK NFL and Nike is more than what white folks think of him – he represents a LOT of black folks thinking and that’s why Nike changed course.

    The point here is to not debate all the specifics but to simply realize that black folks in this country – not all – but a lot – are more and more reactive to what they feel are racist connotations and policies – and yes the liberals – who usually can depend on their vote – are going to do what they think will continue to bring black votes to the Dem party.

    Voter suppression, criminal justice, average householdl wealth, school-to-prison, schools and public buildings still named for Confederates, etc, etc.

    All of these things are now promoted as “proof” that blacks are still discriminated against – and yes some of it is spaghetti on the wall stuff but a lot of it is still true.

    Was there not really a racial divide and it got created by partisan zealots or is it real and those who argue that it’s just trumped up stuff and it’s false – basically just convinces blacks that racism is still with us.

    So, for instance, if a white guy wants to address what he feels is misleading stats about harm to blacks – he cannot do it without also acknowledging where it is true – a hard but balanced look. If he does it just from one angle – it is interpreted as a defense of all of it and justification for doing nothing about any of it.

    That’s the difference in my mind between how a moderate would react to some of this – if white folks just summarily reject it – it just convinces black folks that racism is still being defended as “we’ve done enough and now it’s getting ridiculous and we’re not going to put up with it any more”

    It boils down in my mind if one still thinks there are inequities in our system AND wants them addressed. If we do that at the same time we also identify things that are bogus – then the other side will listen – if we reject it out of hand – the “divide” continues.

    • And Catholics, most especially Irish Catholics, were repressed by Protestants, most especially Episcopalians and Baptists. The English prevented the distribution of food during the Potato Famine and the Americans made many Irish go to Canada. Despite being around 1/4 of the American population, there’s only been one Catholic president in the history of the United States. Go back the 1928 Hoover-Smith race for president. Can I insist that all Episcopal and Baptist churches remove all their signage? If not, why not?

  9. My grandmother, with real resentment in her voice, told of seeing “No Irish Need Apply” signs. Her husband, my grandfather, dealt with the anti-German hysteria by denying his heritage and trying to pass for Dutch. Uh, no, Deutsche….(originally Hahner.)

    Disrespect the flag in front of either of them and expect a fight. Both their sons put it all on the line 1942-45 and then again in Korea. Just heard a very cogent CNBC discussion on the Nike/Flag flap and the point was made it was probably a calculated PR stunt from the beginning. Makes perfect sense in this Twitter-driven world. COMMERCIAL exploitation of this charged racial environment – manipulating both sides. That’s worse!

    • I agree. Plus I suggest that:

      Jim Bacon’s post is devastating. Racism and race baiting are evil enough when they infect a mere thoroughly corrupt and depraved Governor, but when these twin evils infect not only the Virginia Governor but also the director of the Virginia Department of Medical Assistance Services, the Commonwealth is rotting down into its core and its citizens are in deep trouble.

  10. First – either we “believe” the blacks when they say there have been and continue to be race issues that affect OR we summarily reject it as “grievances” of the past and that liberals are exploiting it all.

    My view is that if black folks are saying it’s a problem – it’s mandatory that we accept that as a STARTING point in further discussions about it. If Conservatives/GOP/etc reject it out of hand – where does that leave them in ever having blacks in their ranks and building more so that we actually do have “two sides” even on black/race issues?

    • “We ‘believe’ the blacks when they say…”
      “If black folks are saying it’s a problem..”

      Larry, do you think of “black folks” as a monolithic entity in which everyone believes the same thing? Isn’t that kind of racist?

  11. When we think/talk about blacks and the idea that slavery set back multiple entire generations and then we look at things like education test scores and access to medical care/maternity care, and the litany of other issues and we wonder why Asians and Hispanics who are “poor” don’t have the same issues, I have a suggestion: look at Native Americans – and the Canadian version called First Nation. If you think the situation with blacks in the USA is bad – you ain’t seen nothing until you take a look at the state of Native Americans when it comes to similar issues, poverty, education, health care, etc and so I would ask – WHY is that?

    My answer is that they were a totally different culture than White Colonial folks – who actually were more advanced in education and technology and essentially colonized much of the world and subjugated the people they colonized from India to Africa to Asia, in fact. In some of those places, the subjugated populations rose up and defeated the Colonists and in other places they did not until late in the 20th century they “gave” “independence” to them but still have a presence at some of them.

    Anytime an entire race of people is subjugated over generations, it’s not going to be fixed so easily. We’ve made a good start in the USA – better than most other places, but we still have a ways to go – and if we just summarily reject the complaints as “grievance mongering” , i.e. “enough is enough” – we’re not going to fix it. We are in Cheyenne Wy this morning – where a LOT of the place names are native american and when we came through St. Louis – a LOT of place names there were French!

  12. Larry, sounds pretty selective to me. Yes, Europeans colonized other nations. The U.S. did as well after the Spanish American War. But if you go back into world history, you will find that all sorts of nations, tribes and people colonized and/or enslaved other nations, tribes and peoples. If being colonized in the past drives a right to some type of recompense today, it should apply to every nation, tribe or people that were colonized. And if engagement in colonization requires a nation, tribe or people to pay recompense, it should apply to every nation, tribe or people who colonized others during human history. Ditto for slavery.

    Thus, we may have a situation where the same nation, tribe or people receive recompense but also must pay recompense. Otherwise, line-drawing becomes very arbitrary.

    • My goodness, the story of human history, going as far back as the human record allows, that is for hundreds of thousands of years, is a tale of unrelenting efforts by one family group, band, tribe, nation, or endless alliances of these aggregations, to dominate, exploit, enslave, annihilate, or otherwise render extinct, all other groups they come up against, in a never ending series of conflicts, skirmishes, raids, battles, invasions, and wars. ‘Praise the Lord and pass the ammunition’ is the constant song of the human species. Apes, monkey, hyena, wolves and wild dogs don’t approach the rapacious and wanton need and complusion of men to dominate all within, and without, their own species, and territories of origin.

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