When it comes to health, race and ethnicity are not risk factors – systemic oppression is. That’s why I, a midwife and reproductive health activist, get frustrated when I come across “African American” and “Latina” listed as risks for pregnancy and reproductive complications. This puts the blame on marginalized people for their illnesses, when, in reality, it’s the conditions they live under — racism, poverty as well as xenophobia — that have a direct impact on health and well-being.
Our lives don’t occur in a vacuum. What happens to us throughout our existence, as well as our parents’ experiences, remains connected to us even in our present — and all of this plays a role in our health.
I learned this while studying to be a doula. At the time, I came across “Closing the Black-White Gap in Birth Outcomes: A Life-course Approach,” a study in which researcher Michael C. Lu succinctly explains why connection to our past is important to understanding why Black and Latinx pregnant individuals experience more complications than their white counterparts.
While the article focuses on African-American women and communities in particular, it made me reflect on Latinx, immigrant, trans, gender non-conforming and other marginalized individuals’ lives in this oppressive system. In a nutshell, being under stress from a young age, even as early as in utero, can impact the function of the immune system and lead to someone being vulnerable to infectious and inflammatory diseases later in life. Even more, this chronic stress can cause wear and tear on a person’s body and affect their health and body’s function over time.
Being a first-generation Black Dominican has exposed me to stress from an early age because of the environments I had to live and interact with. But this is not a result of any shortcoming of my parents. Rather, it’s explicit bias on the part of institutions.
Before immigrating to this country, we must consider the reasons groups of people leave their homelands to begin with. For Latinxs, who experience political and economic strife in South and Central America as well as the Caribbean, it is common to hear that families migrated to the U.S. in hopes of creating a better life for themselves and their children. For others, violence pushes them away from their native lands.
This combination of experiences often means that women had little to no access to quality reproductive health services, such as annual exams, mammograms, contraception, family planning information and maternity care, in their countries of origin. For those with health care services, the facilities that serve them are often inadequate. With a high volume of patients and not enough medical staff, the clinics that care for impoverished individuals lack supplies and up-to-date equipment, and the medications needed may sometimes be unavailable. This is all compounded by the mere stress of living in impoverished communities.
Under this type of suffering, many times accompanied by gender-based violence, a person has to put their health and well-being on the back burner to pursue stability for themselves and their families.
Upon immigrating to the United States, the stress does not go away. It may look different, and many may even experience some reprieve with a source of income, a more stable home as well as access to public assistance for their food and health care, but discrimination continues to persist and affects women’s reproductive and maternal health services.
For decades, anti-immigrant sentiment has permeated into health care. Xenophobia doesn’t stop at difficult paths to citizenship, deportation risks, low-paying jobs and lack of insurance. For those who have access to health care, there’s also risk of receiving inadequate education and information due to not speaking English, receiving and/or witnessing condescending tones from medical staff because of economic status, skin tone, language or immigration status, as well as having procedures done during birth without one’s consent.
For example, the Office of Minority Health research reports that Latina mothers are almost twice as likely to begin prenatal care in the third trimester or not receive prenatal care at all, as compared to non-Latina white mothers. At first glance, it seems like Latinas are irresponsible or “non-compliant;” however, for many, this care is simply unavailable or inaccessible.
This issue is further compounded by the intersection of race within the Latinx community. Though Latinxs tend to be healthier in a few areas than most in what some call the “Latino paradox,” Black Latinxs end up facing much of the same problems and outcomes that African Americans do, such as maternal mortality and morbidity as well as higher rates of hypertension.
These everyday stressors, which don’t include intimate partner violence, sexual trauma, labor abuse and many of the other ills that impact our community, can cause insomnia, anxiety and depression. And it is difficult to be well and make healthy decisions when one is constantly assaulted by stress they cannot escape.
Racism and xenophobia take a damaging toll on our bodies. We are not “crazy” for feeling overwhelmed by the oppressive circumstances we live in that are largely dictated by how the United States treats our racialized bodies. Understanding the context of why we feel ill and experience barriers to wellness gives us the opportunity to build community with each other to create networks of health providers and resources to promote better health. The trauma and pain we have endured must be understood so that we can create a better reality for ourselves and tools to be well.