CRESHELLE R. NASH: Address disparity

There is arguably nothing more exciting than finding out you’re pregnant and welcoming the birth of your baby. We have an idyllic image of how it will all transpire.

From the beginning, you imagine what your baby will look like. You visit the doctor monthly to hear the whooshing sound of the heartbeat. You pick out the perfect name and items for the nursery. And after months of excited anticipation, you will bring your baby home from the hospital cuddled in their tiny car seat.

In reality, for many, the experience is much different. And the reason is often Mom’s skin color.

In this day and age, we like to think racial disparities are a thing of the past, but unfortunately, that is far from the case concerning health care for expectant moms. Arkansas not only has the third-highest maternal death rate in the nation, 71 percent of those moms are Black women. These are women who will die before the car ride home from the hospital; these are moms whose health complications will jeopardize themselves and their babies.

What is causing this disparity and how do we fix it? It’s not something we’re going to be able to fix before April ends, Minority Health Month. The cause of the disparity in health care has been studied for years, and answers pondered.

As hard as it might be to admit, the issue stems from structural and systemic discrimination that can operate with or without intent, as well as numerous barriers to care–issues that disproportionately impact Black women in Arkansas. We are not only more likely to have health conditions, like diabetes and heart disease, that put Black women at risk during pregnancy, but there are also issues some encounter in the stress of their everyday lives.

Can I afford to see a doctor? Is there a doctor near me? What if I don’t have transportation to the doctor, who is nearly an hour away? Will my doctor take my health concerns seriously? Will I be judged? Does my doctor look like me? Am I comfortable? Am I getting the best care? The list goes on.

With so many factors, solving the problem undoubtedly will not be done with a single symposium or new policy. But together, we can all do our part.

Health-care organizations can expand their services to underserved areas and increase the diversity of the health-care workforce. As doctors, we can listen to our patients and advocate for all aspects of their care. We can improve public transportation in rural parts of the state. We can make low-cost wellness care more available to prevent women from entering pregnancy with pre-existing conditions. We can make healthy foods more readily available and affordable.

And moms, demand better care. Listen to your body. Speak up. Advocate for others too. Know that you aren’t alone. All women, regardless of race or ethnicity, deserve to enjoy the sound of their baby’s heartbeat, ponder the perfect name and welcome home the next generation of their family.

Creshelle R. Nash, M.D., M.P.H., CHIE, is the medical director for Health Equity and Public Programs at Arkansas Blue Cross and Blue Shield. In this role, Dr. Nash provides leadership for developing, implementing and evaluating health equity initiatives to help create a more inclusive and non-discriminatory health-care system throughout Arkansas.