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Black Maternal Health Crisis Prompts Politicians, Providers To Act

THE AFRO — One previous cesarean section, a five-page written plan outlining post-delivery care for her oldest child and around 12 weeks of natural childbirth classes still didn’t prove to be enough preparation for the arrival of Allyson Brown’s second child. Almost two months after turning 34, Brown was overdue delivering her baby. Rather than risk more than a day’s worth of induced labor, she opted to have another C-section. Brown, who is black, met the doctor who performed her impromptu cesarean that morning.

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(Photo by: dph.illinois.gov)

By Ambriah Underwood

WASHINGTON — One previous cesarean section, a five-page written plan outlining post-delivery care for her oldest child and around 12 weeks of natural childbirth classes still didn’t prove to be enough preparation for the arrival of Allyson Brown’s second child.

Almost two months after turning 34, Brown was overdue delivering her baby. Rather than risk more than a day’s worth of induced labor, she opted to have another C-section. Brown, who is black, met the doctor who performed her impromptu cesarean that morning.

In what marked the beginning of an unexpected and unsettling experience, Brown said the orderlies transferring her from her midwives patient program to the OB-GYN department ahead of delivery had an ill-timed conversation.

“They were talking like they were at happy hour and like I was a sack of potatoes, just like something else they had to check off for the day,” Brown said.

But Brown’s experience was anything but casual: she had complications after delivery that required three emergency surgeries.

Her case was considered a “maternal near-miss,” which the World Health Organization defines as a woman who almost dies due to issues during pregnancy, delivery or within 42 days after pregnancy.

Brown’s experience underscores a persistent discrepancy among black mothers, whose mortality rate is far higher than that for the general population. Several factors, including racism, are behind that disparity, according to health experts.

Some members of Congress last week launched an initiative to combat this long-standing yet recently-publicized issue.

House Majority Leader Steny Hoyer, D-Mechanicsville, and 57 other lawmakers formed the Black Maternal Health Caucus, which is aimed at encouraging culturally relevant, evidence-based policies to support black mothers.

Hoyer said he wanted “to make clear that the House ought to approach issues of healthcare access with a recognition of the unacceptable and tragic disparities for women of color and their children.”

Founded by Reps. Alma Adams, D-North Carolina, and Lauren Underwood, D-Illinois, the Black Maternal Health Caucus seeks to promote better black maternal health outcomes.

“The status quo is intolerable, we must come together to reverse current trends and achieve optimal birth outcomes for all families,” Underwood said in a statement.

As Brown’s sudden change in birth plan illustrates, a number of factors related to the birth process remain out of a patient’s control.

Thinking about the type of care a mother-to-be wants can help ensure appropriate measures are taken, said Noelene K. Jeffers, a certified nurse midwife and Ph.D. candidate at Johns Hopkins University.

“It’s really important to consider carefully the provider that you’re choosing to make sure that you choose either an OB-GYN or a midwife who you can have a comfortable, respectful, collaborative relationship with and who will help you to make informed decisions,” Jeffers said.

Despite an overall improvement in life expectancy in the United States, there are still noticeable disparities among racial minority groups, said Stephen B. Thomas, director of the Maryland Center for Health Equity.

On average, 36 women in the District of Columbia and 24 women in Maryland die for every 100,000 live births, while the overall national average recorded 20.7 maternal deaths, according to the United Health Foundation’s 2018 report on children and women’s health.

The black maternal mortality rate average is more than double the national average at 47.2. Maryland ranks lower, with an average of 40.5 black maternal deaths, while in the District the mortality rate among black mothers was a staggering 70.9 deaths per 100,000 live births, the analysis said.

In a country with the most expensive health care, more women die of complications from childbirth than in any other developed nation, according to the American College of Obstetricians and Gynecologists.

“We’re like the richest third-world country in the world and unfortunately, the burdens of race and history would be easy to ignore if they were not so well documented,” Thomas said of the death rate among black mothers.

Thomas, who is also a professor at the University of Maryland, said an understanding of the gap in life expectancy for black mothers can be broken down into three components: a broken healthcare system, patient preferences (that is, not wanting a midwife) and “what’s left is what we call a health disparity.”

Such a disparity is “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage,” according to Healthy People, a federal website managed by the Department of Health and Human Services.

“It’s when you look between the lines, when you disentangle those lines by race, ethnicity — everyone is not benefiting,” Thomas said.

Acclaimed tennis player Serena Williams last year shared with Vogue the intense medical journey she went on following the birth of her child.

Williams said she alerted a nurse that she needed medical attention and the attendant initially thought the medication was confusing her, but Williams persisted. Eventually, tests revealed small blood clots in her lungs.

While Williams had the ability to self-advocate through a complicated process, Thomas added, “think of those black women who didn’t have that kind of agency to speak to power, who are now not here.”

Brown, who works at an education nonprofit, relied heavily on her husband for support after doctors were alarmed by her significant blood loss after delivery, which led to the three subsequent emergency surgeries.

During one of the surgeries, hospital staff failed to alert Brown’s husband, who was with their newborn, that she had been put under anesthesia again.

“Nobody called him and told him I was in surgery,” Brown said. “He said someone came and told him, ‘Your wife’s almost out of surgery’ and he was like, ‘When did she go back into surgery?’”

Even with the steady support of a partner, Brown said she witnessed faulty hospital procedures and policies. She filed a complaint with the hospital’s administration.

“When you’re at the peak of crisis that’s not the time to be dealing with their internal issues on things,” Brown noted. “So, there was a whole added element on top of the actual medical emergency.”

The hospital responded to Brown’s complaint and she said she was pleased with the response, encouraging the administration to do a formal review of her case to see what could be done differently. According to her doctor, Brown said, they did.

Typically, poor health and healthcare are associated with a person’s socioeconomic standing. In the cases of Williams and Brown, regardless of being two black women in their thirties with active support systems and careers, they encountered life-threatening birth complications.

Understanding that factors such as class, education and marital status have not lowered the disconcerting rates of black maternal mortality has encouraged health experts to acknowledge the influence of racism as a cause.

“Specifically thinking about race-based maternal-infant health disparities, the prevailing theory is that racism is the major underlying factor that contributes to these disparities,” Jeffers said.

For instance, a woman’s perception of the daily racism she experiences in her interpersonal relationships, which can include encounters with coworkers or strangers, is associated with premature birth, Jeffers added.

Also, Jeffers said women living in areas known to have higher amounts of explicit or implicit racism are at-risk for having babies with low birth weights.

“So there is quite a bit of evidence that indicates that racism and stress that comes with … racism, sort of dealing with that on a chronic everyday basis, is impacting maternal-infant healthcare,” Jeffers said.

Jeffers cited an example of structural racism continuing to affect black people: redlining, an unjust method used to prevent minorities from acquiring home-ownership loans, stifle their ability to relocate out of impoverished areas and ultimately uphold local racial segregation.

“When you have large amounts of segregation and, for example, black individuals are segregated into specific areas, then that can subsequently affect the access to quality healthcare institutions,” Jeffers said.

Thomas likens this nonstop, multifaceted wear and tear from the daily pressures of racial prejudice to incessantly revving an engine to the point of damage.

“If you were to sit in your car, turn your car on and press the accelerator to the floor and just let the engine rev up, that’s what’s described as what’s happening to black people in America,” Thomas said. “The foot never comes off the pedal.”

That is to say, when you are living in a society where the presence of racial prejudice is never-ending, few ways exist to avoid the stress of racism and thus, overcome health issues leading to disparities.

The National Partnership for Women & Families suggests policymakers address the issues of structural racism and racial discrimination in healthcare as well as expand protections for pregnant workers and health coverage for low-income insurance services like Medicaid to combat the maternal health crisis.

Furthermore, the organization calls for policies funding reliable community-based providers such as Planned Parenthood that provide basic yet critical reproductive health services.

“(Racial discrimination) can actually get under your skin and kill you. And that’s what we believe is happening with African Americans,” Thomas said.

This article originally appeared in The Afro.

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California Black Media

Stakeholders Warn Lawmakers of Expanding Aging Population; Older Black Californians Included

The California Commission on Aging (CCoA) hosted its second annual forum focused on challenges facing Californians over 65 years old. Titled “Aging and Disability Issues: What Legislative Staff Need to Know for 2024,” the virtual event was organized to bring awareness to lawmakers that California’s aging adults are living longer and to emphasize the importance of developing policy to support this growing population, according to organizers.

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The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.
The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.

By Antonio Ray Harvey, California Black Media 

The California Commission on Aging (CCoA) hosted its second annual forum focused on challenges facing Californians over 65 years old.

Titled “Aging and Disability Issues: What Legislative Staff Need to Know for 2024,” the virtual event was organized to bring awareness to lawmakers that California’s aging adults are living longer and to emphasize the importance of developing policy to support this growing population, according to organizers.

This year’s meeting included the perspectives of gerontologists and other subject-matter experts who provided data and insights critical to informing policy.

Former Assemblymember Cheryl Brown (D-San Bernardino), who chairs the CCoA’s Executive Committee, began the discussion.

“The landscape of California is changing. Aging is changing and it’s changing California,” Brown said. “Older adults are living longer, and the cohort is becoming more ethnically diverse, underscoring the need to develop culturally, appropriate services.”

The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.

The CCoA acts as the principal advocate for older Californians and as a catalyst for change that supports and celebrates Californians as they advance in age. The CCoA advises the Governor and Legislature, along with state, federal, and local agencies on programs and services that affect senior adults.

Statewide organizations that participated in the event included LeadingAge California, Disability Rights California, California Foundation for Independent Living Centers, and California Collaborative for Long-Term Services and Supports.

In addition, representatives and staff members of Choice In Aging, Age Watch Newsletter, California Elder Justice Coalition, California Association of Area Agencies on Aging, and the California Long-Term Care Ombudsman Association were presenters during the 90-minute discussion.

“In California, we know that older adults are underserved and unserved relative to their needs,” CCoA Executive Director Karol Swartzlander said. “In stark terms, we know that 4% of older adults who need service actually receive services.”

According to the California Department of Aging (CDA), California’s aging population is expected to reach an estimated 4.5 million individuals ages 60 to 69 and 4.2 million senior adults ages 70- to 79 by the year 2040, based on information from CDA’s Master Plan for Aging. 

Recognizing that the state’s 65-plus population is projected to grow to 8.6 million by 2030, Gov. Gavin Newsom issued an executive order calling for the development of the MPA.

Debbie Toth, from ChoiceInAging, said the MPA is a model of “how we can do better” to service the needs of older adults. ChoiceInAging, Toth said, “is going to be shopping accessible transportation and rate increases for adult day healthcare.

“But we need to have legislation to do it,” Toth told legislative staff members.

A 2016 California Health Report (CHR) revealed that by 2030, 18% of the state will be 65 or older. Projections in that study also indicated that 52% of these older adults would be from diverse minority groups but “no population is expected to be harder hit than African Americans,” the report stated.

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California Black Media

Asm. Akilah Weber Introduces Bill to Protect Terminally Ill Californians

On Feb. 7, Assemblymember Akilah Weber (D-La Mesa) introduced legislation, Assembly Bill (AB) 2180, designed to ensure that terminally or chronically ill people living in California can afford their life-saving medications.
If passed, the law would require California health plan providers, insurers and pharmacy benefit managers (PBMs) to count the value of financial assistance provided by subsidy programs towards a terminally ill patient’s deductible and out-of-pocket expenses.

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Dr. Akilah Weber (File Photo)
Dr. Akilah Weber (File Photo)

By California Black Media

 On Feb. 7, Assemblymember Akilah Weber (D-La Mesa) introduced legislation, Assembly Bill (AB) 2180, designed to ensure that terminally or chronically ill people living in California can afford their life-saving medications.

If passed, the law would require California health plan providers, insurers and pharmacy benefit managers (PBMs) to count the value of financial assistance provided by subsidy programs towards a terminally ill patient’s deductible and out-of-pocket expenses.

“When insurers and PBMs do onto count the value of copay assistance toward cost-sharing requirements, patients often experience “a copay surprise” at the pharmacy counter and may be forced to walk away without their needed medication because they cannot afford it,” wrote Weber in a statement.

Over 80 patient advocacy organizations, medical foundations and other groups applauded Weber for introducing the legislation.

“The All Copays Count in California Coalition commends Dr. Weber for championing legislation that will improve patient access to medications and protect the most vulnerable Californians from harmful and deceptive insurance schemes that raise patient costs,” said Lynne Kinst, Executive Director of Hemophilia Council of California (HCC), which is a cosponsor of the bill.

According to the HCC, an estimated 70% of patients “abandon their prescription medications when their out-of-pocket costs reach $250 or more.

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Bay Area

Who Are the Top Donors in the Alameda County District 5 Supervisor’s Race?

District 5 covers West and North Oakland and includes Emeryville, Berkeley, Piedmont and Albany. The five-member Board of Supervisors sets the county’s budget, governs its unincorporated areas, oversees the sheriff, Alameda Health System, and the mental health system. Voting in this election has already begun. Most of those living in the district will have been mailed paper ballots. Residents can also vote in person on March 5, the last day voting is open. If no candidate gets more than half of the votes, the top two candidates will face off in the general election in November.

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A ballot drop box sits in West Oakland. Feb. 12. Photo by Zack Haber 
A ballot drop box sits in WesA ballot drop box sits in West Oakland. Feb. 12. Photo by Zack Haber t Oakland. Feb. 12. Photo by Zack Haber 

About $342,500, a little less than half of the approximately $705,000 raised in the race so far, has come from just 30 sources.

By Zack Haber

Nine candidates are running to represent District 5 on the Alameda County’s Board of Supervisors.

District 5 covers West and North Oakland and includes Emeryville, Berkeley, Piedmont and Albany.

The five-member Board of Supervisors sets the county’s budget, governs its unincorporated areas, oversees the sheriff, Alameda Health System, and the mental health system.

Voting in this election has already begun. Most of those living in the district will have been mailed paper ballots. Residents can also vote in person on March 5, the last day voting is open. If no candidate gets more than half of the votes, the top two candidates will face off in the general election in November.

Candidates in Alameda County are required to report all of their campaign donations. The public can search these filings through an online portal.

Looking through the county’s campaign finance reports, we found that residents, businesses and other organizations, such as unions, have donated around $705,000 in total to all candidates as of Feb. 13. In three cases, candidates donated to their own campaigns, but we excluded these figures.

Of the nine candidates, John Bauters, the former Emeryville Mayor and current City Councilmember, has raised the most, about $167,500. Alameda County Board of Education Trustee Ken Berrick has raised about $157,500. Piedmont resident and East Bay Rental Housing Association board member Chris Moore has raised about $129,000. Oakland City Councilmember Nikki Fortunato Bas has raised about $130,000; and Berkeley City Councilmember Ben Bartlett raised about $103,500.

The other candidates, Omar Farmer, Gregory Hodge, Gerald Pechenuk and Lorrel Plimier have all raised much less than the other candidates. So far, Hodge has raised about 11,500 and Plimier has raised about $5,500. Farmer and Pechenuk haven’t reported receiving any campaign donations.

While there were over 525 donations to candidates in total, of these, about $342,500 or a little less than half of the about $705,000 in total donations, came from just 30 sources. For the purposes of this article, we’ve defined these 30 donations as large donations—$5,000 or more. Bartlett, Bas, Bauters, Berrick, and Moore have received large donations, while Farmer, Hodge, Pechenuk and Plimier have not.

Below is a listing of each reported large donation, and information we could find about its source. We ordered the list in alphabetically by candidate name.

Large donations to Ben Bartlett:

Mukemmel ‘Mike’ Sarimsakci of Millbrae donated $10,000. Sarimsakci is a real estate developer and the CEO of Alterra Worldwide, a commercial real estate company. Man Hao Chen of San Francisco, CEO and founder of crop farming company Sunbber, inc., donated 5,000. Bao Le of Fremont, CEO of medical marijuana company Hemp.co, donated $5,000. Retired Berkeley resident Frank Brown donated $5,000.

Large donations to Nikki Fortunado Bas: 

Alameda Labor Council AFL-CIO Unitywhich represents about 135,000 healthcare, construction, service, education, and manufacturing workers, donated $20,000. Building and Construction Trades Council of Alameda County donated $20,000. Quinn Delaney of Piedmont, founder and the board chair of Akonadi Foundation, donated $20,000. Wayne Jordan of Piedmont, husband to Delaney, Akonadi Foundation board member, landlord and founder and president of Jordan Real Estate Investments, donated $20,000. California Working Families Party, a “grassroots party for the multiracial working class,” donated $10,000. Bas also received a $5,000 donation from the San Francisco crop farming company, Sunbber, inc. Man Hao Chen, who donated to Ben Bartlett’s campaign, is the CEO of Sunbber. IBEW Local 595, a union representing about 2,000 electric workers in Alameda and San Joaquin/Calaveras counties, donated $5,000. UA Local 342, a union representing around 4,000 workers in the pipe trades industries in Contra Costa and Alameda counties, donated $5,000.

Large donations to John Bauters:

Maryam Asefinejad of Orangevale, board member of Teranomic Software, donated $20,000. Fred J Bauters of Lisle, IL, relative of John Bauters, donated $20,000. The International Association of Firefighters Local 55 donated $11,000. State Assemblymember Buffy Wicks donated $10,000 from her reelection campaign. Nick Josefowitz of San Francisco, commissioner with the Metropolitan Transportation Commissionand co-founder of the nonprofit Permit Power, donated $10,000. Daniel Golden of Santa Monica, who works in sales at the pharmaceutical company Bausch Healthcare, donated $5,000. Marc Hedlund of Berkeley, founder of the investment company Tenuki Moves LLC and board treasurer of the nonprofits Bike East Bay and Code 2040, donated 5,000. The California YIMBY Victory Fund donated $5,000. Steven Berger of Berkeley, president of the company NYF Properties, inc. donated $5,000.

Large donations to Ken Berrick:

Megan Salazar of Richmond, director of advocacy for the Bay Area based nonprofit, Just Advocates which Ken Berrick founded, donated $13,520. Christopher Ciauri of London, England, CEO of the software company Unily, donated $17,500. Betsy Maushardt, unemployed resident of Santa Cruz, donated $10,500. Christopher Seiwald of Alameda, member of the University of San Francisco’s Board of Trustees and investor with the Berkeley Angel Network, donated 5,000.

Large donations to Chris Moore:

Quintin Anderson of Redwood City, Chief Operating Officer with Granite River Labs, donated $20,000. Madeline Moore, retired resident of Walnut Creek and relative of Chris Moore, donated $20,000.  Philip Dreyfuss of Oakland, partner with Farallon Capital Management, a San Francisco based hedge fund, donated $20,000.  Fred Morse of Piedmont, landlord with Morse Management, donated $15,000 through individual and company donations.

Justin Wallway of Oakland, landlord with JDW Enterprises, donated $10,000.

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