[music playing]
WOMAN: People think, well,
we live in the 21st century.
We have all of these hospitals
and all of this equipment.
It's mind boggling.
I'm not trying to make this up.
I'm not looking for a sob story.
This is true.
It knows no boundaries because
this is a problem nationwide.
It's not just a problem
here in Colorado.
Rate of infant mortality,
that is the number of babies
who die before their first
birthday, in the United States,
that means that's
23,000 babies that die
before their first birthday.
What I want for our country
is to not tolerate the fact
that our children have
different rates of survival
to their first birthday based
on their race and ethnicity.
I would like one number, one
number for our whole country
would be fantastic.
WOMAN: Really, everybody
deserves a first birthday.
[music playing]
NARRATOR: As Arvian Harper
and her one year old daughter
Ellis are playing drums on
their living room floor,
her husband Marcus and
three year old son Porter
are practicing the alphabet.
His patience with--
I just-- I don't know.
Like, I feel you're
definitely an amazing husband
and a good friend too, but--
Did you get all that?
But you're just a
really great father.
NARRATOR: They're high school
sweethearts, married for eight
years, but together for 15.
And the joy their
family shares helps
them cope with the grief of
losing their first daughter.
Now that I know
what it is to have
a relationship with your kids
and, from a dad's perspective,
to be longing for
that, I appreciate what
I'm missing more even more now.
That's something I never
even told you before today.
You never forget that child.
They'll always be in your heart.
And don't try to forget them.
NARRATOR: Sheila Young
lives in Aurora, Colorado.
Her home is filled
with family photos.
That's my husband.
NARRATOR: Her husband died from
cancer nearly 10 years ago.
My husband was my best friend,
my very, very best friend.
She and her husband lost
their daughter Streisand
when Sheila was
38 weeks pregnant.
We had gone like the
week before to pick out
her furniture.
You know, everybody was just
really excited and looking
forward to her coming.
I have three living
children, but I have four.
I have an angel baby.
NARRATOR: Niesha Thorne
lost her first daughter
when she was in her early 20s.
Now she works with
kindergartners
in Commerce City.
She attends a breastfeeding
support group with her youngest
daughter Joelle.
She has two older
kids, a boy and a girl.
I've told my son about her
and he has a lot of questions.
Would Taylor babysit
us if she was here?
Would she be in high school?
So just different
things that come
to a 9, 10 year old
little boy's mind
about having an older
sibling they've never met.
NARRATOR: The Harpers,
Sheila, and Niesha never got
to bring their daughters home.
And while they were
all in different places
in their lives--
Sheila was married.
She and her husband
had bachelor's degrees,
steady jobs, and two healthy
children already at home.
Niesha was single, her
pregnancy a surprise.
And the Harpers were still
pursuing their education
and working in retail.
But despite these
differences, their stories
reflect what so many
black families face.
Black women are
more than twice as
likely to experience
a late term fetal loss
as a white or Asian woman,
and nearly two times
more likely than a
Latino woman, according
to the Centers for
Disease Control.
These same trends that show more
losses of unborn black babies
hold true for infant
deaths as well.
And the infant mortality rate
is much more closely monitored
than the fetal mortality rate.
It measures the
number of infants
born who die before
their first birthdays.
And it's considered one of
the most important indicators
of the health of a
community or even a nation.
In the US, black
infants die at a rate
three times higher
than white infants.
And this has been
true for decades.
Overall, the rates of int
mortality for the United Ss
have gone down over time,
which is a very good thin.
And we should celebrate that.
The crux of the real
remaining problem
is that there's such
significant disparities
in the-- our
different populations.
NARRATOR: Dr. Lauren Smith has
been a pediatrician in Boston
for 20 years.
She leads a national campaign
to reduce infant mortality
in communities of color.
So despite the fact we have
some of the best medical care
and health care in
the world, we have
one of the worst
infant mortality
rates in the world of
industrialized Western nations.
NARRATOR: In Colorado,
the infant mortality rate
is considered one of the
lowest in the nation.
But the disparity between blacks
and their white counterparts
is among the worst.
Black babies die at
rates as high or higher
than those in about
100 foreign countries.
And that includes places
like China, Colombia,
and even war torn
Libya, according to data
from the CIA and World Bank.
Demetra Seriki is concerned
about these high rates.
She's a midwife and she
runs The Small Clinic
in Colorado Springs.
When I chose my
OBGYN, I couldn't
find an OBGYN that was like me.
There wasn't a
black female OBGYN.
NARRATOR: Now she
works with patients
who have limited
access to health care,
including those from rural
communities and minorities.
And they also need to
see a woman of color who
can relate to the
problems and struggles
that they go through every day.
NARRATOR: Seriki
wants her patients
to do everything they
can to give birth
to a healthy baby
who will survive.
Women never forget
their births.
They never ever forget.
Whether it's a loss
or a live birth,
they never forget their births.
It is a footprint in their heart
for the rest of their life.
NARRATOR: A
complicated pregnancy
made footprints in her heart.
She carried her baby to
11 weeks, but miscarried.
I felt like, you
know, this is a life.
I am excited.
I am happy, and looking forward
to all the stages of pregnancy,
and then feeling
like I was robbed.
When you're carrying a baby,
they're are piece of you,
they're a part of you.
An then when you deliver, like
what our son or our daughter,
you can-- they're still
with you, you know.
And so I know-- I know you
feel like she was robbed almost
of that.
ARVIAN: Yeah.
NARRATOR: Robbed
of their children.
And this happens far too
often for black families.
About 12 black babies die n
Colorado out of every 1,000
born before their
first birthday, meaning
black families are neary
two times more likely to e
their baby than a Latino
family, and three times moe
likely than a white famil.
This is Adora Loftis.
She lives in a
transitional housing
unit with her two children.
DJ and Darla.
They're ages 5 and 6.
She's expecting her third
child in the spring of 2016.
Adora recently lost her job.
I was working construction.
I was a prep worker.
It's good money.
It's good money.
But, unfortunately,
yes, I was laid off.
The stress, like I said, is on.
Who's going to
hire somebody who's
this far along pregnant for
the pay that I was getting,
that I'm used to.
NARRATOR: Adora has a
high risk pregnancy.
I've had preemie.
And I am at risk
for another one.
So the stress is
definitely real.
NARRATOR: And she rides the
bus for an hour each way
to get to Denver Health
for prenatal care.
Adora worries about
an early birth
and being able to support
her family without a job.
ADORA: What I going
to do if this happens
or if that happens.
And then not only
about the baby, about
my current situation, as
far as money goes or--
NARRATOR: Adora's
living situation
can affect her health and
what happens to her baby.
We know that black women
have higher rates of poverty,
experience much
more discrimination.
NARRATOR: Dr. Susan
Hwang has spent years
studying disparities
in infant mortality.
She says her research has
shown that stressful life
experiences, like being fired,
having a partner go to jail,
struggling to provide
meals for your family,
all of those kinds of things
can make people less healthy.
And this is especially
apparent with minorities.
What we typically consider
to be non-medical reasons
do cause biologic disruptions.
NARRATOR: A biologic
disruption, that
could endanger a fetus
or infant's life.
And while public health data
show a link between poverty
and infant loss for
most races, it's
not the same for black families.
Black families at
all income levels
are more likely to lose their
babies in the first year,
and the same is
true for education.
Neither a college education
nor a stable middle class job
decrease the gap between
blacks and all other races.
Kelly Teter manages the Denver
Health maternal child health
program and she's
part of a local effort
to tackle this national issue.
Unlike other differences
we see in health,
other health disparities,
mortality, infant mortalit,
is not explained by education
level or income level.
You see that economics
doesn't explain it all.
NARRATOR: Here's what the
state public health data
does explain.
A middle income black famiy
earning $50,000 to $75,000
a year is just as likely
to lose their baby
as a black family making
less than $15,000 a year.
And when compared to a
middle income white famil,
the black family
earning the same income
is three times more likely
to lose their baby.
To look at this another
way, in Colorado,
a middle class black
family is nearly two times
more likely to lose their baby
than a white family living
below the poverty line.
That is absolutely
consistent with national a
as well, that even if you take
the wealthiest black woman,
her rate of pre-term birth is
still higher than the poorest
white woman.
LAUREN SMITH: A black
woman who's been to college
could have the same likelihood
of having a bad outcome
in terms of her pregnancy
as, say, a white woman who
hasn't finished high schoo.
So the benefits that accruo
education and increased ine
aren't felt equally by
all groups in our country.
And we have to understand
some of why that is.
So why is it that
women who are otherwise
achieving in the
culture-- well-paying job,
climbing the career ladder,
otherwise seeming to do well
in a society, would have such
high infant mortality rates.
NARRATOR: At Denver Health.
Dr. Camille Hoffman
thinks she can
find the answer in
clippings of hair
from patients like Adora Loftis.
Our assumption is that
African American moms have
higher levels of
stress and that may
be part of the relationship
with pre-term births
in that population.
NARRATOR: The stress hormone
Dr. Hoffman and her team
are measuring is
called cortisol.
Cortisol is released
by your adrenal glands
when you're confronted
with stressful events.
It's your flight
or fight hormone.
Studies have proven that too
much cortisol can be toxic.
At high levels, it can
alter your blood vessels,
increasing your risk for
heart attack or stroke.
Cortisol is also a marker
for anxiety, heart disease,
and diabetes.
Long-term exposure to
heightened levels of cortisol
can reduce your life expectancy.
In pregnant women,
the hormone is
linked to complications
and premature birth.
Using a hair cortisol
versus the other measures
that I mentioned out
of blood or saliva also
gives us kind of a chronic or
overall picture of a stress
status.
So when we measure
cortisol or other stress
hormones in blood
and saliva, that
can be influenced by a
bad morning, an event that
happened five minutes before
you saw that mom in clinic.
With hair, you won't capture
those same kind of spikes
and highs and lows, so
you just kind of get
an overall baseline cortisol
status or stress status.
But that gives you
more of a reflection
of someone's overall life
accumulation of stress.
NARRATOR: Here's how that works.
Every month, our hair grows
about 1 centimeter longer,
giving researchers
like Dr. Hoffman
an opportunity to, in
effect, look back in time.
So as she measures
a strand of hair,
she can test months of
stress building up, sometimes
even before her patient
became pregnant.
Here's what Dr.
Hoffman is finding.
African American moms have
higher stress hormone levels
in both hair and
in blood and saliva
than white non-Hispanic
moms and Hispanic moms.
NARRATOR: Stress could
help explain the disparity.
I wrote this paper about the
effects of stress on pregnancy.
I remember it being
like how can you
not be stressed, like if ye
a working pregnant woma,
like how can you
not be stressed.
But then trying to teach
like that connection of,
like, what are the
effects on your baby.
It's the stresses of,
you know, am I going
to be able to provide
for my family, you know,
all those things.
Am I going to be safe?
You know, if I live in
this certain community,
I might be able to afford
it, but are my kids
going to be safe when
they go to school?
Or are we going to
be safe in our house?
Is somebody going to
try to break in on us?
You know, stuff like that.
NARRATOR: Are my children
going to the right schools?
Are they safe?
Am I secure in my job?
All of those very stressful
things build up day after day.
But what makes it unique
for black families
as opposed to any other
race, even those who
are not experiencing poverty?
Back then, I was probably
upper middle class.
My kids went to private school.
They did all the
things that, you
know, well-to-do kids
are supposed to do,
like did ballet.
They did music lessons,
and they went to camp.
They had a very, very
nice childhood, I think.
NARRATOR: But still,
Sheila felt stress
associated with her race.
Well, you know, there are
diseases that African Americans
have because of, you
know, their race,
like I have high blood
pressure and I have diabetes.
And, you know, you
wonder why-- why
is this only prevalent in the
African American community.
I think it's the same issue.
It's the stresses of racism.
Studies have demonstrated
that maternal report of racism
is associated with higher
reported rates of stress,
inflammation, infection,
and pre-term birth.
And so there's
enough literature out
there that demonstrates that.
And given that
prematurity is the leading
cause of infant
mortality, it just
naturally leads into a
higher risk of infant death
if mothers are perceiving higher
rates of racism in their life.
DR. NITA MOSBY HENRY:
I think about the fact
that we have schools
right here in Colorado
that are offering substand
education to typically
kids of color and
under-served communities.
And we know that
the schools are poor
and we know that the
education is substandard.
And we allow it to be so.
That's what
institutionalized racism
looks like in a
system where it's just
married in the tradition.
It doesn't mean that
people are ill-willed.
It just means it's a part of
an institutionalized system.
NARRATOR: Nita Mosby Henry
works to improve health outcomes
for patients of color at
Children's Hospital Colorado.
She says that includes
understanding a patient's
whole life circumstances.
What happens when you
live in a community
where education is poor?
What happens when
you're in a food desert
or there's no good access
to public transportation?
What happens when there's
safety issues when
you live in high crime
areas or where there
are no sidewalks or parks?
All of those things will
either positively or negatively
impact the health of an
individual in a community.
NARRATOR: If you're black,
studies around the country
show that your name
may turn employers away
from your resume.
Or lenders might refuse
to finance your home.
We can't even go into an
interview with our hair na.
Like, seriously, who's
going to hire me?
And being behind the desk
of somebody's business,
I'm not good enough.
I always feel like
I'm being watched.
Racism is in the
Colorado Springs area.
It's definitely here.
And it's very
profound when you're
trying to establish
yourself as a professional.
I know racism is taught.
But how do you get
one generation not
to pass that down to
the next generation
so that everybody's
life can be better?
NARRATOR: And now, in
Dr. Hoffman's study,
we're better able to measure
the build up of stress in hair.
And it's consistently
higher in black mothers.
And it could be a significant
factor for parents who
experience losses like these.
Christmas Eve she had
noticed that the baby wasn't
moving as much as normal.
So finally, on
Christmas day, I'm
like I really-- I feel
like something is wrong.
Marcus' mom told me, you
know, it's fine to go in.
It's best to just
go get checked.
The day after
Christmas, like we
went in the first thing
in the morning, right?
Mhm.
Like early in the
morning, like 7:00.
ARVIAN: Mhm.
And my doctor wasn't there.
And so then the doctor
on call came in.
And--
Dr. Williams.
Un-huh, Dr.
William, and she said
that my oxygen was really low,
my blood pressure was really
high, and she was concerned.
She's like you're
very, very sick.
Drove myself to the hospital,
and they did the sonogram
and the ultrasound.
And they told me that's where
your baby's heart should
be beating.
He wasn't hearing anything.
So he thought, well, maybe she's
hiding or something, you know,
whatever.
So then he took me into another
room and did a sonogram,
I believe it was.
He just said, you know,
I'm sorry Mrs. Young,
but your baby is dead.
He tells me this and I'm like--
I'm shocked because I'm like,
well, I've been healthy.
I've been going to my
doctor;s appointments.
You know, I've been
taking care of myself.
You know, I didn't
understand what had happened.
And I don't know, maybe
I led a sheltered life,
but I had never heard of
anybody losing a baby.
So it was just very
shocking to me.
And very, very painful
because I felt like I
had let my husband
down and I felt like I
had let my kids down too.
Dr. Williams came
in and said that we
were going to get
ready for delivery
and that she would
need to a c-section.
So we-- they rush
us into the surgery.
I remember they
were specifically
monitoring the baby's vitals
throughout the procedure.
And I was looking
at it as like, oh,
we're going to get through this.
Because I can hear
them, you know,
I was making myself aware
of what they were saying.
You know, they were saying,
yeah, the vitals look good,
they're still strong.
And they went in and I expected
to, you know, here the baby,
but then it was
like-- I remember
like the-- felt like
the weight of the world
just suddenly got thrown
on to me, like how am I
going to tell you that
the baby didn't make it.
SHEILA: She is buried.
They have a whole section called
baby land, which blew my mind.
But, yeah, they have a whole
section in the cemetery
just for babies.
Me, personally, I want to
be buried, not cremated.
And that's one of the things
I regret because I feel like I
couldn't--
I feel like I couldn't
provide that for my daughter,
like I had to settle for--
That's OK.
I mean, it's all right.
So we-- so we had her cremated
and I-- yeah, and I just
kept her ashes with my mom.
I have an angel baby.
I named her Taylor Jean, and she
was born on August 21st, 2001.
I miss her.
I struggle as a single mom,
but she's a part of me, so.
We have very important
disparities to tackle
and we need to be thinking
about it creatively
and collectively
to be able to have
the kind of impact we need.
Intervention strategies
are trying to target it.
And so the largest
national initiative
aimed at infant mortality right
now is the CoIIN Initiative.
So it's the Collaborative
Innovation Improvement Network
to reduce infant mortality.
You know, over 40
states are now involved.
NARRATOR: Dr. Lauren
Smith is the leader
of that national initiative.
I think any time you
face a complex problem,
you do run the risk
of potentially being
so overwhelmed by
the scale of it
that you just throw up your
hands and say this is too hard,
I can't possibly tackle it.
So I think just taking a
deep breath and saying,
you know, I'm going to
work with the partners is
one of the first things to do.
NARRATOR: At the local level,
the Community Action Network.
So at the center for our
work is the families--
NARRATOR: Which includes
Kelly Teter from Denver Health
and representatives from
state and local government,
work together to
reach this goal.
The goal is not to just reduce
disparities in infant mortality
and pre-term birth, but
actually to eliminate it.
Our baby's matter, just
like your own children.
We all matter.
So what are we going to
do to support each other?
NARRATOR: Other groups include
the Nurse Family Partnership,
which sends nurses into
the homes of low income
first time mothers to
improve health care.
And the March of Dimes offers
online parenting support.
These groups say eliminating
disparities in infant mortality
starts with education on
prenatal and postpartum care,
but also being healthy before
ever becoming pregnant.
They educate mothers
on safe sleep,
breastfeeding, and midwifery as
part of this national movement.
And these organizations want to
help address racism on a larger
scale, but also help individual
women to cope with stress
and limit social isolation.
Others just want to
share their stories.
There's something very
freeing about telling
your story instead of keeping
it a secret, you know.
NARRATOR: And help
support each other.
I actually have a friend
who had a son pass from SIDS
last year.
I tell her don't give
up and that nobody
understands your pain like
you understand your pain.
NARRATOR: And to
just keep living.
Because she had a c-section
and it wasn't a natural birth,
the amount of time we
had to stay in there.
Yeah, there and in the home.
I needed to recover, but--
MARCUS: The pain being
a constant reminder.
Yeah, and you're
recovering from giving birth
and you don't have a baby.
So it was-- it was difficult,
and then realizing,
like, you have to go
on with your life.
Go back to work, keep going
with-- without your baby.
And then I got to the
point where I didn't want.
And I'm like there's no
way I can experience, like,
this loss again.
I'd rather not--
we not have kids
than to have to go
through this again.
I realize, like, I
wanted to be a teacher
and that was what I
was going to pursue.
And when I went
through my schooling
and got to my student
teaching, there
was a little boy in
my class, and I hadn't
seen Dr. Williams in years.
And Dr. Williams was his mom.
And so she-- we were
so happy to see her
and she said, like,
when you're ready,
you know, you let me know when
you're ready to have a baby,
and I'm here, and I'll help
you, and it'll be fine.
And a week later, you know,
I found out I was pregnant.
Then I was like so, Dr.
Williams, remember--
I do.
ARVIAN: You do, too?
Yeah.
ARVIAN: It was
another c-section.
I would always have to do that.
And so that whole
process was hard
and I felt like I
had such high, like,
anxiety, like what's
going to happen.
What's going to happen?
But like hearing him cry
was like the most amazing
in the whole world.
It's me or the baby?
[laughter]
Order.
And hearing him cry and
seeing all his fingers and all
of his toes, him looking at me.
Gonna play your drum.
I'm taking some pictures.
We color together.
I couldn't ask for
anything better.
[baby noises]
[music playing]
