Today, FXB Health and Human Rights Fellow Dr. Brittney Butler testified before the Massachusetts Legislature’s Racial Inequities in Maternal Health Commission. The hearing was a listening session on maternal health efforts and experiences in the Metro West and Central Massachusetts regions.
In her testimony, Dr. Butler shared her expertise and research on maternal mortality and morbidity. Read her remarks as prepared for delivery:
Dear Members of the Racial Inequities in Maternal Health Commission,
Thank you to the Racial Inequities in Maternal Health Commission for this opportunity to testify, and especially the Co-Chairs, Senator Comerford and Representative Decker. My name is Dr. Brittney Butler. I am a social epidemiologist and a current research fellow at the FXB Center for Health and Human Rights at Harvard University, speaking today about my research and technical expertise in this area, not on behalf of the institution.
My research focuses on how racially segregated, under-resourced neighborhoods where many Black families have been forced to live are targeted for inequitable policy implementation stemming from decades of legalized racist housing policies. My research has found that living in these segregated neighborhoods impacts preeclampsia risk for Black women, a leading cause of maternal mortality and morbidity and a large driver of the racial disparities we see.
My research has found that neighborhoods impact health before, during and after pregnancy. Before pregnancy, neighborhoods increase early exposure to environmental toxins during sensitive developmental periods; under resourced and overcrowded schools limit future educational and professional opportunities; and limited access to fresh and nutritious foods increases risk of obesity—all widely-accepted social determinants of health related to pregnancy outcomes.
During pregnancy, mothers are often unjustly judged for not “complying” with common recommendations to reduce the progression of preeclampsia through individual choices related to diet and physical activity. While we blame mothers for their individual choices, we rarely question whether fresh food or accessible sidewalks are available in their neighborhoods.
After pregnancy, women return to the same neighborhoods and are met with the same barriers to accessing health when their bodies are in critical need of recovery.
Addressing inequitable clinical care and practices alone, without addressing neighborhood level factors, can further the blame placed on mothers for their individual choices. We need holistic policy solutions, such as increased access to fresh and nutritious foods, fewer fast-food restaurants, safe and affordable housing, fewer environmental pollutants, fewer police, and safer infrastructure and green spaces. These policies must be understood as public health measures for eliminating anti-Black racism in maternal health that are just as urgently needed as improvements in clinical settings.
For more information on the FXB Center’s racial justice program, click here.