Health Disparities and Mental Health in Chicagoland: Pregnancy-Related Black Maternal Mortality, COVID-19 and Mental Health

  

 

Health Disparities in Chicago

As an African American graduate student of social work, I'm aware that my community is at the intersection of two significant health disparities: COVID-19 infection and mortality rates and pregnancy-related maternal mortality. Chicagoland, my hometown, has long-standing issues with inequitable distribution of resources such as employment (primary access to private healthcare insurance) and access to healthcare providers and facilities. These are two of the many significant barriers to healthcare for African Americans in Chicago. 

 

In Chicago, social vulnerability and health risk factors were the focus of research by Kim and Bostwick (2020). The results indicated segregation, poverty, and discrimination affect a community's social vulnerability and risk exposure when faced with a public health crisis such as COVID-19. The researchers compared COVID-19 outcome differences between non-Hispanic African American and non-Hispanic White population in Chicago. There were 13,000 confirmed cases of COVID-19 resulting in 538 deaths in Chicago as of April 2020. Comparisons between the two groups are below: 

 

·     Non-Hispanic, African American: 

o  Confirmed Cases of COVID-19 - 45.6%

>  COVID-19 deaths – 56%

·     Non- Hispanic, White:

o  Confirmed Cases of COVID-19 - 20.4%

> COVID-19 deaths – 15.8%

 

This data is alarming! Kim et al., (2020) reported that the African American population is only 30% of Chicago’s overall population but 70% of the COVID-related deaths, as of April 2020.  The mortality rates differ between the two studies cited (56% and 70%). However, both studies demonstrate health disparities exist between the African American and White populations of Chicago.

 

African American Pregnancy-related Maternal Mortality in Chicago 

Illinois is fifthin the nation for all births, and data shows that African American mothers' outcomes are alarming. The Illinois Department of Public Health’s 2018 Maternal Morbidity and Mortality Reportstated non-Hispanic, Black women were six times more likelyto die from the pregnancy-related condition than Non-Hispanic White women. 

 

The landscape for birthing options continues to change for Chicago’s South Side. Pregnant women are experiencing fewer options for hospital deliveries. Due to COVID-19, St. Bernard Hospital is diverting resources to manage the illness and have suspended deliveries. Advocate Trinity Hospital’s Birthing Center website states it has temporarily relocated its birthing center to a nearby Advocate facility. University of Chicago, Roseland Community Hospital, and Mercy Hospital are the options for birthing facilities on the South Side. Mercy is scheduled to close in early 2021, further reducing birthing options for a predominantly African American population and presenting transportation barriers to access care (Schorsch, 2020). 

As a graduate student of social work with interest in women's health, I am concerned about the overall well-being of pregnant African American women in Chicago. Positioned in the center of a global pandemic, healthcare racial disparities, and high pregnancy-related mortality rates, pregnant African American women's mental health needs to be a priority. Recommended COVID-19 safety measures include frequent hand washing, mask-wearing, and social distancing. The global pandemic and isolation resulting from social distancing practices have been linked to increased maternal stress and increased risk of intimate partner violence (Jago et al., 2020).  Researchers Durankus and Aksu (2020) reviewed the results of an anonymous survey to assess depression and anxiety in pregnant women. The results indicate an "urgent need to provide psychosocial support" during the pandemic. Depression and anxiety are linked to adverse outcomes for both mother and baby.

 

 

It Takes a Village

The global pandemic and social justice protests have dominated all streams of media since this past spring. Many Chicagoland communities, agencies, and organizations are strategizing to provide services and care to vulnerable populations.

Metropolitan Family Services(https://www.metrofamily.org/) offers various programs and services throughout Chicagoland, including individual counseling and domestic violence education and support. 

While access to mental health providers is critical for mental health support, Chicago’s communities are ready to provide psychosocial support to pregnant African American mothers during the global pandemic. Community Doula organizations are providing education and support to pregnant African American women in the Chicagoland area. Chicago Birthworks Collective(https://www.chicagobirthworks.com/) and Chicago Volunteer Doulas(https://www.chicagovolunteerdoulas.org/) are two birthing support organizations who are stepping in to provide support to mothers to be and their families. 

For future support, and in response to the limited birthing facilities on Chicago’s South Side, Karie Stewart and Jeanine Valrie Logan are two Chicago midwives who are planning and fundraising to open Chicago South Side Birth Center (http://chicagosouthsidebirthcenter.com/). 

Social Worker Response

In 2018, the Maternal Mortality Review Committee (MMRC) made recommendations to the Illinois Department of Public Health to increase access to substance use and mental health services statewide for pregnant and postpartum women. Social workers are uniquely positioned to develop and support community programs and provide clinical interventions to individuals, families, and groups. Well-developed resource and referral lists for the populations we serve are critical during these times. Should our communities include pregnant African American in the Chicagoland area, please refer to this blog, and offer compassionate service and care through a trauma-informed lens.

Resources to consider:

·     Referrals to mental health providerswho offer telehealth, accept various health insurance, including Medicaid, and provide a sliding scale for services. 

·     Birthing support such as doula agencies and postpartum care such as lactation specialists. Some medical centers offer lactation support after delivery. Organizations such as the La Leche League provide various information forums and online meetings for continued lactation support.

·     Food resources for delivery and pick up options. Vendors such as Jewel and Aldi have pick-up options at their stores, limiting contact for pregnant and postpartum women. Walmart offers pick-up order options at specific locations and accepts EBT cards as a payment option for qualified items. 

·     Help expectant and new mothers to explore group chat options to connect with friends and family while practicing social distancing. Google, Apple, and Microsoft are a few providers of virtual meeting software.

 

 

Online Resources:

Chicago Birthworks Collective: The Chicago Birthworks Collective was launched in 2018 by Toni and Tayo, a mom and daughter doula duo as the first collective of birth workers, healers, and wellness practitioners serving Black families across Chicago! https://www.chicagobirthworks.com/

 

Chicago Volunteer Doulas Mission: We are a birth justice organization providing comprehensive doula support with a focus on vulnerable communities in the Chicago-land area. A Chicago Volunteer Doula is a labor support professional who has chosen to commit time and energy to helping pregnant people and their families in Chicago. Our doulas come from a variety of backgrounds. They are social workers, childcare workers, cab drivers, community organizers, accountants, stay-at-home moms, midwifery students, artists, activists, nurses, lawyers, teachers, yoga instructors, and massage therapists.https://www.chicagovolunteerdoulas.org/

 

La Leche League International’s Mission:To help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.https://www.llli.org/la-leche-league-online-support-resources/#Groups

·     Online support groups

·     Online meetings

 

Psychology Today: Find a Therapist - https://www.psychologytoday.com/us/therapists

 

Mothering Magazine: Inclusive Family Living -

 https://www.mothering.com/

 ~ Joey Yerger

  

 

References

Durankuş, F., & Aksu, E. (2020). Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. The Journal of Maternal-Fetal & Neonatal Medicine, 1–7. https://doi.org/10.1080/14767058.2020.1763946 

Illinois Maternal Morbidity and Mortality Report. (2018, October). http://dph.illinois.gov/sites/default/files/publications/publicationsowhmaternalmorbiditymortalityreport112018.pdf.

Jago, C. A., Singh, S. S., & Moretti, F. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: Combating isolation to improve outcomes. Obstetrics & Gynecology, Publish Ahead of Print. https://doi.org/10.1097/aog.0000000000003946 

Kim, E. J., Marrast, L., & Conigliaro, J. (2020). COVID-19: Magnifying the effect of health disparities. Journal of General Internal Medicine, 35(8), 2441–2442. https://doi.org/10.1007/s11606-020-05881-4 

Kim, S. J., & Bostwick, W. (2020). Social vulnerability and racial inequality in COVID-19 deaths in Chicago. Health Education & Behavior, 47(4), 509–513. https://doi.org/10.1177/1090198120929677 

Schorsch, K. (2020, September 1). Women have few options for giving birth on the south side. 2 midwives want to change that.WBEZ Chicago. https://www.wbez.org/stories/women-have-few-options-for-giving-birth-on-the-south-side-two-midwives-want-to-change-that/e2f2a774-5cf9-4f41-a53f-4261aede5ec3.