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Focusing on Children’s Health: Community Approaches to Addressing Health Disparities - Workshop Summary D Special Presentation: Unnatural Causes In addition to the presentations and panel discussions described in the report, Mildred Thompson of PolicyLink, co-chair of the Roundtable, provided the workshop participants with an opportunity to preview a segment of a forthcoming PBS documentary series entitled “Unnatural Causes: Is Inequality Making Us Sick?,” which explores socioeconomic and racial inequities in health. The purpose of the preview was to educate Roundtable members and the audience about the root of causes of health disparities but more importantly to foster discussion about how the documentary can be used as a tool to stimulate action in communities and organizations. The first segment in the series aired on March 27, 2008, on PBS stations.1 The segment screened at the workshop, entitled “When the Bough Breaks,” addressed the disproportionate infant mortality rates of babies born to African American women. One striking conclusion from this segment that Thompson highlighted was that African American women with college degrees have worse birth outcomes than non-Hispanic white women who are high school dropouts (mortality rates of 10.2 per 1,000 versus 9.9 per 1,000, respectively). Thompson also drew attention to the role of stress in poor health outcomes, citing the example of the married African American lawyer that was featured in the segment shown. The video dis- 1 The documentary and associated toolkit, produced by California Newsreel in association with Vital Pictures, and presented by the National Minority Consortia of public television, can be found at http://www.unnaturalcauses.org.
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Focusing on Children’s Health: Community Approaches to Addressing Health Disparities - Workshop Summary cussed the stress and racism that may have contributed to the premature birth of her infant. After viewing the segment, a member of the audience commented that while the segment focused on African American women, similar outcomes are observed with Hispanic women, most dramatically among Puerto Rican women, and opined that this affects all women of color. Disparities within ethnic groups were also discussed, as some subgroups within Latino and Asian ethnic groups suffer from higher rates of illness and disease than other subgroups within the same ethnic group. For example, recent Mexican immigrants, despite being poorer, have better health than other Latinos already living in the United States. Another participant commented that while direct implications of racism in health care are easy to see, there are also indirect effects of institutional racism, specifically neglect. She highlighted the increasing prevalence of HIV among African Americans and Latinos and the associated lack of money for programs to address HIV in these populations as an example of such neglect. One example of a successful community initiative in Flint, Michigan, part of the REACH program, was cited by another participant. Workshops conducted in the community bring people together to discuss what is needed in terms of undoing racism. They are having productive conversations, and change is occurring, the participant noted. For example, over the last 6 years, a 25 percent reduction in infant mortality among African American women has been observed. Another participant noted, however, that it is only the REACH program in Flint that has seen such a reduction in infant mortality. Although overall infant mortality rates have decreased over the years, they are still disproportionately high among African American and other women of color. Thompson urged participants to continue the dialogue in their communities and organizations to address disparities especially across races, sectors, and genders.