This meta-analysis, composed for the Women and Gender class, meets several of the categories for SLOs. It is composed with a clear awareness of purpose, audience, and medium, showing communication skills. The gathering and analysis of data demonstrates critical thinking, and the content and presentation show civic engagement.
Meta-Analysis: Socioeconomic and Ethnic Effects on Reproductive Health Outcomes
Women and infants of color are far more likely than their Caucasian counterparts to experience maternal and fetal morbidity and mortality. This is not in question. They are more likely to face “significant maternal morbidities (severe postpartum hemorrhage, peripartum infection, and severe perineal laceration)”( “Committee Opinion No. 575: Exposure to Toxic Environmental Agents.”), low infant birthweight, and other complications. The fault, however, is not innate. The reproductive ramifications of “race” are not caused by ethnicity or heritage, but by a culture of racism and neglect. Pollution and life-long stress are contributing factors, magnified by the effects of poverty (Lu and Halfon). Pollution is not just a problem among women of reproductive age and their newborns. Lauren N. Lessare in “Pollution, Poverty, and Potentially Preventable Childhood Morbidity in Central California” states that children who are admitted to hospital for all potentially preventable diseases are disproportionately likely to be low income and under four years old. They are also more likely than their more affluent peers who are exposed to lower rates of pollution to live in primary care shortage and more racially diverse areas. Evidence overwhelmingly points to the fact that ethnicity and socioeconomic status are determining factors in mortality and morbidity of all causes, particularly maternal and fetal mortality and morbidity, especially among communities suffering from environmental racism.
Neighborhoods of color are more likely to be exposed to much higher rates of pollution of all kinds (Perlin). Though it is not explicitly stated in the study, Perlin asserts, “there are many potentially negative consequences besides elevated exposures that are likely to be associated with living next to industrial emission sources, including odors, noise, traffic, contaminated soil e.g., brown fields , inferior housing…” (46). Exposure to pollution increases risk of preterm delivery, birth defects, and other morbidities including mortality (“Committee Opinion No. 575: Exposure to Toxic Environmental Agents.”). These stresses all add to the allopathic load that, in turn, decreases positive medical outcomes across the board (Lu and Halfon). It is unsurprising, though no less horrifying, that Black women (sic) are three times more likely to face maternal mortality, two times more likely to face infertility, more than two times more likely to die of cancer after diagnosis, and are less likely to receive necessary interventions in all fields than their White counterparts (Eichelberger).
All of the studies cited by this meta-analysis share the conclusion that women, children, and all members of impoverished communities of color, be they African American, Latino, or Native American, bear the overwhelming burden of environmental abuse that manifests itself in reproductive and other medical disorders. As shown above, their communities are more likely to be located in areas of industrial, pesticide, and other pollution. Not only this, they are statistically more likely to be underserved by the medical community than their Caucasian neighbors. According to Lessare, “With every unit increase in pollution burden, preventable disease hospitalizations rates increase between 21% and 32%… Children living in primary care shortage areas are at increased risk of preventable hospitalizations. Preventable disease hospitalizations increase for all subgroups… as neighborhoods became more racially diverse.”(198) Women and children are not the only affected populations, as well. Elevated exposure to pesticides in adult males is linked to “altered semen quality, sterility and prostate cancer” according to Obstetrics and Gynecology in their “Committee Opinion No. 575: Exposure to Toxic Environmental Agents.”
In Allison Bryant et al’s “Review: Racial/Ethnic Disparities in Obstetric Outcomes and Care: Prevalence and Determinants” hypothesizes that “population health status, as measured by premature mortality, is contributed to by five domains, either individually or in conjunction with one another.” The domains include patterns of behavior, genetic predispositions, social circumstance, environmental exposure, and a dearth of medical care, by which they propose that disparities in health status may also be considered. The data is presented in tables, multiple citations per paragraph, and qualitative description. Sources include government reports including: vital statistics reporting, DHHS reporting, and other scholarly papers published in peer reviewed journals such as, but not limited to, Journal of the American Medical Association, Pediatrics, and the American Journal of Clinical Nutrition. The method used in this statement of the problem was a “review of relevant literature”.
“Black Lives Matter: Claiming a Space for Evidence-Based Outrage in Obstetrics and Gynecology.” by K.Y. Eichelberger, et al proposes that Black women (sic) face significant disparities in reproductive care and outcomes and that these disparities are significant, not only statistically, but morally, and are “fundamentally unjust.” To support their hypothesis, they used statistical models using adjusted odds ratios with confidence intervals of less than .9 and a great deal of qualitative description. Their source materials included peer reviewed journals such as the New England Journal of Medicine, the American Journal of Public Health, and the AMA Journal of Ethics. They also used data and language from the BlackLivesMatter website. In this statement of the problem article, they summarize their methods thus, “As subspecialist obstetricians–gynecologists, we use data from our field to demonstrate the significant disparities Black women face across their reproductive lives.”
Lauren Lessare, in her study titled, “Pollution, Poverty, and Potentially Preventable Childhood Morbidity in Central California” uses maps, data tables, and qualitative description to measure ecological relationships between a neighborhood’s rate of poverty, its amount of pollution, its ethnicity, and the rate at which pediatric patients were hospitalized with preventable disease. Its stated objective is, “To measure ecological relationships between neighborhood pollution burden, poverty, race/ethnicity, and pediatric preventable disease hospitalization rates.” The study is an analysis of the data. Said data was drawn from the 2012 California Office of Statewide Health Planning and Development database, the US Census, and the California Office of Environmental Health Hazard Assessment.
The available data are grim, indeed. The potent combination of poverty, pollution, and life-long stress has been devastating to populations of color since before data were being collected. As it stands, the only way forward is to seek a finer understanding of the impact of these factors on individuals and communities in specific geographic areas (Lessare) and to act upon that understanding. Future research on this topic must include risk factors and stressors over the entire course of the lives of the affected populations, not just during pregnancy and immediate pre- and post- natal periods (Lu and Halfon). As a society, not just as medical and social scientists, we must “challenge obstetricians–gynecologists to consider how accepting that Black women (sic) do worse in your research study, worse in your quality improvement project, or are absent from your clinical trial as the status quo directly reinforces the lesser value our society has assigned to Black women’s lives (Eichelberger). For the foreseeable future, studies of the effects of pollution must include their impact on communities of color and poverty or be denied peer review. Environmental impact studies must include long term reproductive data on surrounding communities. Research, however, is not enough. Policy must be established to prevent the prevalent practice of placing polluters in impoverished communities. Creating a framework for environmental reparations before damage is done is a start. Communities of color, most especially women and children are the people most affected by industry and pollution and can no longer be left out of the economic and environmental equation.
Desk Study Presentation
This desk study is a video presentation of the above paper. This is a further example of my communication skills in that it steps outside the traditional medium of print into video.