Racism in U.S. Healthcare Is a Life-or-Death Crisis For Black Pregnant Mothers!

Black History Month Presentation for the Jamaican Nurses Association of Florida (JNAF)

By Norris R. McDonald, DIJ, AARC, Respiratory Therapist
Health Vybz | https://healthvybz.blogspot.com/

Norris R. McDonald, DIJ, AARC

Across the United States, over 1,100 counties have closed hospital maternity units, creating what public health experts call maternity care deserts — areas where pregnant women must travel long distances for prenatal visits, labor, and emergency obstetric care. The consequences are not theoretical. They are measurable: delayed treatment, higher complication rates, and preventable maternal deaths. 

 

Maternity Care Deserts: When Distance Becomes Destiny

In these “maternity care deserts” poor Black women and families are forced into long travel times, delayed prenatal visits, and weaker continuity of care. In emergencies, distance becomes destiny.

In Florida alone, 13 counties lack maternity clinics, forcing families to cross county lines — sometimes for hours — to deliver babies safely.

Why This Matters

When maternity wards close:

• Emergency C-sections are delayed
• High-risk pregnancies go unmanaged
• Rural mothers travel 30–90 minutes or more
• Ambulances become delivery rooms
• Postpartum care collapses

Research shows longer travel times are directly associated with increased maternal and infant mortality. For Black women — already facing a maternal mortality rate significantly higher than white women — these closures compound structural inequities.

The National Pattern

Since 2018, approximately 300 maternity units have closed. More than 100 rural hospitals have stopped delivering babies since 2020. Financial losses, low Medicaid reimbursement rates, staffing shortages, and declining rural birth volumes are cited as causes.

But policy choices shape those financial realities.

When obstetric services disappear, what disappears with them is safety.

Black maternal and child health in the United States has therefore reached a breaking point. Despite medical advances, too many Black women still face avoidable danger in pregnancy and childbirth—driven not by biology, but by systemic racism, unequal access, and preventable failures in care.

What This Presentation Seeks to Achieve

This Black History Month presentation for JNAF is designed to outline current systemic maternal and child health issues affecting underserved Black communities, explain root causes through evidence-based medical knowledge, and strengthen the role of nurses as assertive change-agents in policy and bedside advocacy.

Racism Inside Healthcare Costs Lives

Racism in healthcare is not only personal prejudice; it can be embedded in systems and routines—dismissed symptoms, delayed care, undertreated pain, and neglectful attitudes that increase medical errors. When discrimination becomes predictable, patients may avoid care altogether. In the maternal health context, that avoidance and dismissal can turn treatable complications into emergencies.

Provider–patient relationships matter. Respect, listening, and timely response are not “soft skills.” They are clinical protections. A system that repeatedly fails Black mothers is a system that must be confronted.

Black Maternal Mortality Is a National Emergency

Many Black women die in childbirth from poor health care in American hospitals. Data consistently show that pregnancy-related deaths are dramatically higher among non-Hispanic Black women than among white women. This is a national emergency rooted in racial disparity—unequal treatment, unequal access, and unequal protection.

Core principle: Who you are or where you live should not decide whether you survive childbirth.

Mental Health Crisis: The Hidden Emergency Behind the Numbers

Poverty and racism shape health outcomes beyond the delivery room. Experiencing racism increases the risks of prenatal and postpartum depression and can raise parenting stress. Meanwhile, mental health resources remain scarce in many minority and rural communities—long wait times, shortages of professionals, and limited culturally competent services.

Mental health struggles do not emerge in a vacuum. They grow from material conditions—poverty, instability, discrimination, and chronic uncertainty. When those pressures are constant, the body keeps score.

How Parental Depression Affects Maternal & Child Health

Parental depression is linked to long-term harms: disrupted bonding, reduced responsiveness, inconsistent routines, and increased risk for children’s wellbeing. For nurses and clinicians, the lesson is clear: evidence-based care must also be socially intelligent—aware of the political, economic, cultural, and racial pressures shaping patient outcomes.

Healthcare Without Justice Is Structural Violence

As Dr. Paul Farmer argued, healthcare without justice becomes structural violence: unjust social, economic, and political arrangements that produce preventable illness and premature death among marginalized communities. This lens clarifies what too many families already know—these outcomes are not random. They are patterned.

“Weathering”—the long-term psychological and physiological deterioration from chronic racism—helps explain why repeated exposure to stress and discrimination produces real, measurable harm. Racism behaves like an exposure. It accumulates. It injures. It kills.

Nurses as Change-Agents: From Ethics to Action

Historically, nurses have led transformative change. Mary Seacole, a Jamaican-born nurse and healer, challenged racial and gender barriers, integrated traditional medicine into treatment of cholera and yellow fever, and modeled holistic care long before it became mainstream.

Nurses and healthcare professionals, clearly have a moral and legal duty to speak out against unsafe and unethical practices. Doing no harm ameans refusing to become a silent partner to racial injustice. History offers models of courageous care, including Mary Seacole, who challenged racial and gender barriers and practiced holistic healing grounded in mind, body, and spirit.

Conclusion: The Reforms We Must Demand

We must: end racism in healthcare, fund Black maternal health, protect access in maternity care deserts, strengthen mental health supports, and hold institutions accountable for preventable harm. Saving Black mothers’ lives is not optional. It is the baseline of a moral healthcare system.

Today’s nurses can follow that legacy by:

• Advocating for Black maternal health funding
• Reporting unsafe practices
• Supporting policy reform
• Educating communities

The American Nurses Association affirms nurses’ responsibility to dismantle racism within the profession and healthcare systems.

What Must Be Done

• End racism in healthcare
• Fund Black maternal health programs
• Hold hospitals accountable
• Expand mental health services
• Protect maternity units
• Save Black mothers’ lives

These are not radical demands. They are moral obligations.

Justice in healthcare is not abstract. Justice is oxygen. Justice is survival. Justice is life!

READINGS 

American Nurses Association. (2022). ANA position statement on dismantling racism in nursing. American Nurses Association.

Farmer, P. (2004). Pathologies of power: Health, human rights, and the new war on the poor. University of California Press.

McDonald, N. R. (2026). Systemic racism worsens women’s and children’s health: How hospital closures and structural inequality are fueling a national maternal and child health emergency. Health Vybz.
https://healthvybz.blogspot.com/2026/02/systemic-racism-worsens-womens-and.html

Race Forward. (2024). Understanding systemic racism & the wealth gap [Video series].
https://www.raceforward.org/resources/video-series/what-systemic-racism

University of Minnesota School of Public Health. (2025, October 22). Reproductive justice denied: The structural violence of recent federal health care cuts.
https://www.sph.umn.edu/event/reproductive-justice-denied-the-structural-violence-of-recent-federal-health-care-cuts

Yale Medicine. (n.d.). How parental depression affects children.
https://www.yalemedicine.org/conditions/how-parental-depression-affects-child

Finichealth. (n.d.). Nurses’ growing impact on healthcare policy: Advocacy for patient-centered reforms.
https://www.finichealth.com/articles/nurses-growing-impact-on-healthcare-policy-advocacy-for-patient-centered-reforms

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About the Author

Norris R. McDonald is an author, respiratory therapist, and economic journalist whose work focuses on political economy, public health, healthcare systems, and global public policy. He is a regular contributor of public commentary and analysis for the Jamaica Gleaner, where he examines the intersection of economics, governance, social justice, and development in Jamaica, the Caribbean, and the Global South.

With professional training in respiratory care and decades of frontline healthcare experience, McDonald brings a clinical and evidence-based perspective to issues such as maternal mortality, health inequities, pharmaceutical policy, and healthcare access. His journalism blends data-driven analysis with historical and cultural context, particularly around Black communities, post-colonial development, and structural inequality.

McDonald is also the publisher of Sulfabittas Newsmagazine on Substack, where he produces investigative features, long-form essays, and geopolitical commentary on global power dynamics, economic sovereignty, and emerging multipolar realities.

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 Student Discussion Questions

1. How does structural racism differ from individual prejudice, and why is this distinction important in healthcare?
2. Why are Black women three times more likely to die in childbirth than white women? Discuss system-level causes.
3. What are maternity care deserts, and how do they contribute to preventable maternal and infant deaths?
4. How does chronic exposure to racism create biological harm (weathering)?
5. In what ways does poverty intersect with racism to worsen mental health outcomes?
6. Why does Paul Farmer describe healthcare without justice as structural violence?
7. What ethical responsibilities do nurses have when they witness discriminatory practices?
8. How can nurses function as policy advocates beyond bedside care?
9. Should maternal healthcare be treated as essential public infrastructure? Why or why not?
10. What reforms would you prioritize to reduce Black maternal mortality?

 Quiz / Exam Questions

Multiple Choice

1. Structural racism refers to:
   A. Individual prejudice only
   B. Genetic differences between races
   C. Systems and institutions producing unequal outcomes
   D. Cultural misunderstandings

Correct Answer: C

1. A maternity care desert is best defined as:
   A. A hospital with limited staff
   B. A county without adequate maternity services
   C. A clinic serving only high-risk pregnancies
   D. A temporary emergency unit

Correct Answer: B

1. Weathering describes:
   A. Aging from genetics
   B. Stress from daily life only
   C. Biological deterioration from chronic racism
   D. Acute trauma events

Correct Answer: C

1. Which group has the highest pregnancy-related mortality in the U.S.?
   A. White women
   B. Hispanic women
   C. Asian women
   D. Black women

Correct Answer: D

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BRIEF LEARNING NOTE

1. Name two consequences of maternity unit closures.
2. Explain how implicit bias affects clinical decision-making.
3. Describe one way nurses can act as change agents.

Essay Questions

1. Analyze how structural racism shapes maternal and child health outcomes in the United States.
2. Discuss Paul Farmer’s concept of structural violence and apply it to maternity care deserts.
3. Propose a policy framework to reduce Black maternal mortality.

Sickle Cell Disease Crisis in Children Shouldn't Be Ignored!

What Every Black Household Needs to Know What If Living  With Sickle Cell Disease!

By Norris R. McDonald,  DIJ, AARC, Author & Respiratory Therapist, 

Health Vybz | healthvybz.blogspot.com

 Sickle Cell education for Black families.

Sickle Cell Disease (SCD) is a lifelong inherited blood disorder that affects millions of people worldwide and disproportionately impacts people of African, Caribbean, Afro-Latino, Middle Eastern, and South Asian descent. For Black families in particular, sickle cell is not just a medical condition—it is a community health issue that requires education, early detection, and strong support systems.

At Health Vybz, we believe that knowledge saves lives. Understanding how sickle cell disease works, recognizing early warning signs, and learning practical strategies for daily living can greatly improve quality of life for those living with SCD and the families who care for them.

What Is Sickle Cell Disease?

Sickle Cell Disease is a genetic blood disorder that affects hemoglobin, the protein in red blood cells that carries oxygen throughout the body. Instead of being round and flexible, red blood cells become hard, sticky, and shaped like a crescent or “sickle.”

These sickle-shaped cells can:

• Break down faster than normal red blood cells
• Block blood flow in small vessels
• Reduce oxygen delivery to tissues

This can lead to pain crises, infections, organ damage, anemia, and other serious complications.

SCD is inherited. A child must receive one sickle cell gene from each parent to have the disease. People with only one sickle cell gene have sickle cell trait, which usually causes no symptoms but can be passed on to children.

Why Sickle Cell Matters in Black Communities

Sickle cell disease is most common among people with African ancestry. Across the Caribbean and parts of Africa, prevalence is high and many families live with limited access to specialized care. Despite this burden, sickle cell disease has historically been underfunded, under-researched, and misunderstood.

Health equity requires:

• Accurate information
• Early screening and diagnosis
• Specialized medical care
• Social and emotional support

Common Signs and Symptoms

Symptoms vary, but common signs include:

• Episodes of severe pain (pain crises)
• Chronic anemia and fatigue
• Swelling of hands and feet
• Frequent infections
• Shortness of breath
• Vision problems

If you or a loved one has these symptoms, talk to a healthcare provider promptly.

Everyday Health Tips for Living With Sickle Cell

People with sickle cell disease can live full, meaningful lives with the right care and daily habits.

1) Stay Hydrated

Drink plenty of water throughout the day. Dehydration increases the risk of pain crises.

2) Eat a Balanced Diet

Focus on fruits, vegetables, whole grains, and lean proteins. Ask your clinician about supplements (like folate) if appropriate.

3) Get Enough Rest

Aim for 7–8 hours of sleep each night to support immune function and energy levels.

4) Stay Active (But Don’t Overexert)

Light to moderate activity can help circulation; extreme exertion may trigger symptoms for some people.

5) Prevent Infections

Wash hands often, stay current on vaccinations, and seek care quickly for fever or illness.

6) Keep Regular Medical Appointments

A hematologist and care team can help prevent complications and manage symptoms.

Medical Treatments and Management

Treatment plans vary and may include pain management, disease-modifying medication, transfusions, vaccinations/antibiotics, and other therapies. Discuss options with your clinician to find what fits your needs.

Emotional and Mental Health Matters

Living with chronic illness can be stressful. Support can include counseling, peer groups, family education, and community networks. Emotional support improves both mental and physical health.

When to Seek Emergency Care

Seek urgent medical help right away for:

• Fever above 101°F
• Difficulty breathing
• Chest pain
• Severe headache
• Sudden weakness or numbness
• Seizure
• Vision problems
• Pain that does not improve with home treatment

Having an emergency plan and access to medical records can save critical time.

Empowering Black Families Through Education

Sickle cell disease does not define a person—but informed care can shape outcomes. By learning the facts, advocating for proper treatment, and supporting one another, Black families can build healthier futures.

Health Vybz is committed to culturally relevant, evidence-based health education that uplifts our communities.

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ABOUT THE AUTHOR:

Norris R McDonald, is an Author, Respiratory Therapist and Economic Journalist who writes public commentary features for the Jamaica Gleaner. He writes on critical issues regarding Political Economics, Health Care & Public Policies, Black Culture and, World Affair. He also Publishes SULFABITTAS NEWSMAGAZINE on SUBSTACK].

Systemic Racism Worsens Women’s and Children’s Health ....How Hospital Closures and Structural Inequality Are Fueling a National Maternal and Child Health Emergency

By Norris R. McDonald, DIJ, CRT

@sulfabittasnews

Race in America is not only a social identity. It is increasingly a medical risk factor.

New national data from the United Health Foundation and the America’s Health Rankings project confirm what Black, Indigenous, and poor communities have warned for generations: systemic racism remains deeply embedded in U.S. healthcare and continues to shape who receives quality care, who struggles, and who dies prematurely.

The 2025 Health of Women and Children Report finds that race can be a stronger predictor of health outcomes than income or education. That reality is reflected in rising maternal mortality, worsening infant and child death rates, and growing mental health distress among women and children. Behind these trends lies a dangerous convergence of structural racism, economic inequality, and collapsing healthcare infrastructure.

This is not a temporary setback. It is a slow-moving national emergency.

Racism as a Public Health Threat

Black women in the United States are roughly three times more likely to die from pregnancy-related causes than white women. Black infants face significantly higher mortality rates. These disparities persist even when controlling for income, insurance status, and educational attainment.

Public health researchers describe a “weathering effect,” in which chronic exposure to discrimination, economic insecurity, and social stress accelerates biological aging and weakens immune and cardiovascular systems. Over time, this cumulative burden increases the risk of pregnancy complications, hypertension, diabetes, and maternal death.

The fight for healthcare justice is a moral imperative!

Structural racism also determines where people live—and therefore what healthcare they can access.

Residential segregation has concentrated many communities of color in areas with fewer hospitals, fewer prenatal clinics, and limited specialty care. Geography, shaped by decades of policy choices, becomes destiny.

America’s Vanishing Maternity Wards

One of the most alarming forces intensifying these disparities is the rapid disappearance of maternity wards across the United States. 

Since 2018, approximately 300 maternity units have closed nationwide. More than 100 rural hospitals have stopped delivering babies since 2020 alone. Today, fewer than half of rural hospitals still offer labor and delivery services.

Hospitals cite financial losses, chronically low Medicaid reimbursement rates, staffing shortages, and declining birth volumes as reasons for shuttering obstetric units. Maternity care is often treated as a money-losing service line rather than essential infrastructure.

The result is the expansion of what public health experts call “maternity care deserts”—regions where pregnant people must travel long distances for prenatal visits, delivery, and postpartum care.

In many rural counties, one in three residents now live without local access to an OB-GYN.

Closures are occurring nationwide, with heavy concentrations in the South and in rural regions. Even metropolitan areas are not immune. South Florida has seen maternity units close at facilities such as North Shore Medical Center, Jackson West, Holy Cross Health, and Hialeah Hospital, further straining already overcrowded systems.

For low-income families, the consequences are severe. Long travel times increase the risk of missed prenatal appointments, delayed emergency care, preterm births, and maternal death. Transportation costs, time off work, and childcare barriers compound the danger.

When maternity wards disappear, preventable deaths rise.

Rural Collapse, Racial Impact

Women in rural areas experience higher rates of chronic illness and face steeper access barriers than their metropolitan counterparts. When race and rurality intersect, the risks multiply.

Since 2018 over 300  units have been closed throughout America which worsens the plight of poor Black, Hispanic Native Americans and other minority women. 

Black and Indigenous women in rural communities are more likely to live far from hospitals, lack reliable transportation, and encounter providers unfamiliar with culturally responsive care. The disappearance of local obstetric services leaves them navigating pregnancy in isolation.

These conditions are not accidental. They reflect decades of underinvestment in rural hospitals, privatization of healthcare, and policy decisions that prioritize corporate profitability over community survival.

Children Paying the Price

Child mortality has worsened alongside maternal outcomes.

Rising housing costs, food insecurity, and medical debt force families into impossible trade-offs—rent versus groceries, utilities versus prescriptions. When pregnant people are undernourished and overstressed, infants face higher risks of low birth weight, developmental delays, and early death.

There have been modest gains in early childhood education enrollment and slight declines in smoking during pregnancy. But these improvements are fragile and easily overwhelmed by broader structural forces.

A nation cannot claim to value children while tolerating conditions that shorten their lives.

A Mental Health Emergency

America's poverty induced mental health crisis is worsening!

Depression and frequent mental distress among women continue to rise. Diagnosed anxiety among children is increasing at alarming rates, particularly in marginalized communities.

At the same time, fewer women report having a dedicated healthcare provider, weakening continuity of care and early intervention. Minority and rural communities face acute shortages of mental health professionals, long wait times, and limited culturally competent services.

Mental health struggles do not emerge in a vacuum. They grow from material conditions—poverty, instability, discrimination, and chronic uncertainty.

Policy Choices, Not Inevitable Outcomes

The report outlines clear, evidence-based priorities:

* Permanent Medicaid expansion in all states.
* Debt relief and financial incentives for providers who work in underserved areas.
* Sustained investment in rural hospitals and maternity units.
* Expanded support for Black and Indigenous midwives and doulas.

These solutions are feasible. What is lacking is political will.

The Bottom Line

America’s worsening outcomes for women and children are not mysterious. They are the predictable result of policy decisions that allow inequality to harden into infrastructure.

Systemic racism is not merely a social problem. It is a public health crisis measured in graves.

Health equity is not charity. It is justice!

ABOUT THE AUTHOR:

Norris R McDonald, is an Author, Respiratory Therapist and Economic Journalist who writes public commentary features for the Jamaica Gleaner. He writes on critical issues regarding Political Economics, Health Care & Public Policies, Black Culture and, World Affair. He also Publishes SULFABITTAS NEWSMAGAZINE on SUBSTACK].

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