Race factoring

I try to be an equal opportunity excoriator. The "gotcha" headline at several liberal blogs today was very similar. But was it fair?

Supposedly, according to Louisiana Senator Bill Cassidy, maternal mortality rates in the Pelican State aren't too bad if you factor out the black people.

Cassidy is one of four doctors in the Senate and the words sound very harsh if not completely racist. I am diametrically opposed to the man on practically every issue. But is that really what he said and what he was intimating? I am not so sure. In fact, I don't think so.

Here is the original story at Politico.

“About a third of our population is African American; African Americans have a higher incidence of maternal mortality. So, if you correct our population for race, we’re not as much of an outlier as it’d otherwise appear,” Sen. Bill Cassidy said in an interview with POLITICO for the Harvard Chan School of Public Health series Public Health on the Brink. “Now, I say that not to minimize the issue but to focus the issue as to where it would be. For whatever reason, people of color have a higher incidence of maternal mortality.”

The United States has the worst maternal mortality rate among developed nations. Each year, approximately 17 mothers die for every 100,000 pregnancies in the country, with rates much more common among Black women than other racial groups, according to Centers for Disease Control and Prevention figures. Against that backdrop, Louisiana’s health department says it outpaces other states: Four Black mothers die for every white mother, compared to a three-to-one ratio nationally. The state ranks 47th out of 48 states officials assessed.

Cassidy then goes into the possible reasons for the chasm.

Cassidy, one of four physicians serving in the Senate, acknowledged during the interview that several reported reasons for high maternal mortality rates in his state, including racial bias in care, higher rates of preeclampsia among American Black women — a serious high blood pressure condition that is the leading cause of maternal deaths worldwide — and the difficulty for women especially in rural areas to easily and quickly get to medical care.

His proposed Connected MOM Act, S. 801 (117), co-sponsored by Sen. Maggie Hassan (D-N.H.), would tackle some of the access issues by requiring Medicare and Medicaid recommendations for mothers to remotely monitor their blood pressure, glucose and other health metrics. Cassidy also co-sponsored a bill named after late Rep. John Lewis, S. 320 (117), signed into law this March, to study racial health disparities.

Cassidy also argued that the state’s definition of maternal deaths plays a factor in its persistently high rates.

“Sometimes maternal mortality includes up to a year after birth and would include someone being killed by her boyfriend,” Cassidy said. “In my mind, it’s better to restrict your definition to that which is the perinatal, if you will — the time just before and in the subsequent period after she has delivered.”

Now his initial statement of "correcting his population for race" shows remarkable tone deafness. He is going to rightly get raked over the coals for that one.

But I do think he is being mischaracterized. Is it not a fair question to wonder if it is proper to factor homicide and crime into these statistics? I tend to agree with the Senator that it would be more academically sound to stick with medical metrics  and pregnancy and leave the pre and post criminal data out of the calculus here.

Louisiana employs a wide-ranging definition of maternal mortality that states have gradually adopted in recent years as the CDC broadened its own analysis through the Pregnancy Mortality Surveillance System. States, the federal government and the World Health Organization had traditionally defined maternal mortality as any deaths caused or linked to pregnancy or childbirth up to 42 days after the end of pregnancy. Louisiana has extended that to one year out from pregnancy or childbirth and includes what it calls “pregnancy-associated deaths” that are not actually caused by or linked to pregnancy.

Now there are still a lot of horrid things to say about Louisiana on this issue. Maternal mortality is second worse in the nation, I think only Mississippi Georgia is worse and even taking the crimes and homicides out, it looks like a large segment of the maternal population is not being served adequately. It is clearly a racist state. But that is not the issue at hand, at least in regards to the Senator in this discussion.

Black pregnant women continue to face disproportionately high pregnancy-related deaths, with data from the Centers for Disease Control and Prevention indicating a 26 percent increase in the maternal mortality rate for Black women since the start of the pandemic. 

Though researchers do not have an explanation for the disparities, the research suggests it's a culmination of institutional racism and other health factors, such as the increased risk of obesity and hypertension in Black women. ... also added that stress and a lack of access to quality prenatal care further exacerbates this issue. 

I think he gets at least a partial pass here.