"They make you feel less of a human being": Understanding and responding to Milwaukee's racial disparity in infant mortality


Background: Black infants die three times as often as white and Hispanic infants before their first birthday in Milwaukee, WI. Prematurity is the major cause of infant mortality, and social determinants of health contribute to this disparity.

Objectives: To understand how socioeconomic factors and racism create barriers to healthy pregnancies and birth outcomes for Black women, and identify practices necessary for overcoming these barriers.

Methods: Thirteen collaborators (four women, four support group leaders, and five health professionals) were recruited from church support groups, a family medicine residency clinic, and the health department. Data were collected through field observations, six one-on-one interviews, one small group interview, and one focus group.

Results: Thematic analysis identified six key themes related to socioeconomic factors and racism in women's and infant health: Public Apathy; Violence and Stress; Discrimination; Mistrust; Spiritual and Social Support; Reproductive Justice.

Conclusions for practice: These themes point out failures in health care, social services, and policy initiatives that do not meet women's and infant needs, in addition to some opportunities to implement successful practices. Recommendations are made for policymakers, social services, health systems, and health professionals to implement systemic changes that support Black women and their families. Future applications of this work include implementing and measuring the impact of systems change to benefit Black women and families.

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