I’m still processing the conclusions of some research on Black maternal health by Dr. Arline Geronimus:
A multitude of figures illustrate the stark health differences between African Americans and whites. Black residents of high-poverty areas, for instance, are as likely to die by the age of 45 as American whites are to die by 65. The disability rates of black 55-year-olds approach the rates of 75-year-old whites. Traditional theories, which blame the phenomenon on factors like genetics or income differences, fail to fully explain these huge disparities. Geronimus has devoted her career to finding the real reasons. Her own complex explanation for what’s happening — the weathering framework — rests on two unexpected, controversial causes: racism and stress, in the broadest senses of both terms. American minorities face a bevy of chronic obstacles that whites and the socioeconomically advantaged cope with far less often: environmental pollution, high crime, poor health care, overt racism, concentrated poverty. Over the course of a person’s life, the psychological and physiological response to this kind of stress leads to dire health problems, advanced aging and early death.
I don’t think that hypothesis comes as a surprise to many Black Americans. In fact, it’s commonplace knowledge. What was striking was her findings about teen pregnancy and maternal health in Black Americans:
Geronimus would sit in on the professors’ meetings, listening to them discuss how young girls, ignorant of family planning, were ruining their lives with accidental pregnancies. Bearing children at an early age would rewrite these mothers’ life scripts, with terrible consequences. The funders behind the academic studies — including those in charge of Planned Parenthood’s own research arm — supported the consensus opinion that teen pregnancy was a crucial cause of ghetto poverty and ill health among America’s urban blacks. The only question was how to get these girls to stop having babies before they’d come of age.
The girls Geronimus met at Planned Parenthood’s alternative school for expectant teens, however, seemed to know exactly what they were doing. When she tried to teach them about contraception — something they supposedly knew nothing about — they laughed at her. The girls in the program told Geronimus they were overjoyed to have children. Far from blundering into motherhood, many were experienced with child rearing, having helped raise siblings or cousins. Some talked about how long they’d been trying to have a baby.
As the months wore on, the professors’ belief — that poor childhood health and ghetto joblessness would disappear, if only these girls would stop getting themselves pregnant — started to seem absurd. “What I was hearing in the halls of Princeton was inaccurate,” she remembers. “It just didn’t fit in, in any way, with what I was seeing.”
Though Geronimus didn’t understand the discrepancy, she noticed that these girls, even at 15 or 16, had been worn down by tough lives. Compared with her classmates in Princeton’s dorms — many of them hailing from America’s WASP elite — the poor black girls at the clinic seemed to lack the energy and health of youth. Geronimus couldn’t quite put her finger on it, except to say these girls seemed older — and not in a good way.
Somebody, Geronimus thought, had to put the facts together and change things for the better for these girls and others like them. In a fit of youthful arrogance, she took it upon herself to become that person. Now a professor at the University of Michigan, Geronimus has spent the last 30 years challenging the received wisdom of researchers about a pressing social question: Why are some racial minority groups less healthy than others?
. . .Geronimus hypothesized that the black infants’ poor health wasn’t because their mothers were too young; it was due to their mothers’ social disadvantages. If she could take into account factors like income and race, she might show that teen mothers were no worse off than moms in their 20s. Unlike most studies, which separated mothers into the broad categories of teen and not-teen, Geronimus broke down maternal ages by year. The results among white women were expected: higher infant mortality rates among teen mothers. Yet the numbers for blacks astounded even Geronimus. Black teenage mothers had lower infant death rates than black mothers in their 20s. Because infant health is a decent predictor of maternal health, Geronimus’ data meant the average black woman might be less healthy at 25 than she was at 15. Perhaps the population of pregnant teens in Trenton was onto something. Consciously or not, the black teen mothers might be doing what was best for their infants’ health.
The reaction to her hypotheses and findings was telling:
Geronimus was in the middle of a talk at the 1990 meeting of the American Association for the Advancement of Science when her 1-year-old daughter, overjoyed at recently having learned to walk, wandered toward the podium. Her husband pulled the girl away to the hallway, only to discover another panelist, Karen Pittman, surrounded by reporters and attacking his wife’s research. It seemed odd that this representative from the Children’s Defense Fund, one of the most prominent nonprofit organizations in America, was disparaging conclusions based on data Geronimus hadn’t yet circulated.
After 15 years, the people whose careers depended on the scientific status quo had finally taken notice of Geronimus’ work. They were angry.
Together with earlier studies, Geronimus was presenting new data showing that teen mothers’ socioeconomic outcomes were as good as or better than those of older moms. In many cases, pregnancy made the teens eligible for social programs like Medicaid, or they formed alliances with the families of the fathers of their children, improving their economic positions. Geronimus hoped to explain why these girls were making these choices and to show that efforts to prevent teen pregnancy wouldn’t solve anything. Her goal was to convince people to focus on larger underlying causes of poverty and poor health. After all, even the young mothers who were slightly better off still had it very rough.
Amid a climate of culture-war controversies over family planning and abortion rights, many didn’t hear the nuanced version of Geronimus’ work. It didn’t help that her conclusions undercut the mission of a major Children’s Defense Fund campaign against teen pregnancy, along with the work of prominent researchers nationwide.
“Her facts are misrepresentative, her premise is wrong and the policy implications of her arguments are perverse,” Pittman told The New York Times. Many news stories published in subsequent months were horrendously critical, with liberals painting Geronimus as racist and conservatives dismissing her as dangerous. One nationally syndicated columnist accused her of “prescribing pregnancy for poor teenage girls.”
Geronimus now blames the anger on a lack of empathy. “Most of us can take for granted that we could have healthy babies any time between 18 and 40. The concept that if you’re 25, you’re not going to have healthy kids? That just doesn’t compute,” she says.
What does it mean if a community’s health profile is so poor, that infants stand a better chance of surviving if they’re born to a teen mother? Do the messages we give our children about marriage, sexuality and family life mean anything when we consistently fail to meet their basic survival needs?
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(with a nod to sister 
Lately, I’ve been thinking and reading about the strengthening of Black America’s institutional capacity, and my thoughts keep returning to the one institution that all Black Americans are a member of and have a stake in: the Black family. And I wonder what I can do to strengthen my own family institution and help others, especially Black men, to strengthen theirs. My thoughts keep returning to the Baha’i Black Men’s Gatherings that I’ve attended, and the spiritual and emotional support that I experienced there, and the question of how to extend and deepen that experience in my local community and personal life. So, I’d like to try an experiment, if you will. I want to try to create a “virtual” space where Black men can give each other spiritual, emotional, and to the extent that this virtual space creates opportunities for networking and mentoring, material support. To that end, I’ve created a forum on this site called “