The large and persistent gap in the infant mortality rate between blacks and whites was the topic of a speech Assistant Professor of Health and Society Rongal Nikora gave last week at his alma mater, the University of New Mexico. In his talk, he made the theoretical claim that the gap is due to three stages of embodiment.
In "Let's Talk About Embodiment: Considering Internalized Trauma in US Health Disparities," Nikora discussed how the gap in the infant mortality rate between the two racial groups has worsened even though the rates have lowered. Currently, the infant mortality rate (the number of infants who die before their first birthday per 1,000 births) for blacks is 2.3 times the rate for whites compared to about 1.7 times in 1920.
Factors including the education, income, marital status, and age of a mother can affect the infant mortality rate for white women much more than black women, and one of the most striking facts to Nikora is that the infant mortality rates for the most educated black woman are never lower than for the least educated white woman.
“This defies everything we think we know about socioeconomic status and what we think we know about health,” Nikora said. “We have to begin to consider a variety of traumas are probably at work.”
He asserts that the gap could be due to a variety of traumas caused by fundamental differences between the lives of white and black women from birth to reproduction. Some of these differences include where they live and environmental exposures--including to racism--and they are all part of the process of embodiment.
Harvard professor and epidemiologist Nancy Krieger has conducted well-known research on embodiment, which Nikora defines as the physical incorporation of injurious events that over time can lead to semi-permanent changes that could potentially be passed onto successive generations.
In his talk, he took the concept of embodiment and applied it to the infant mortality rate, making the claim that there are the following three stages to embodiment:
- Proximal: Physical or psychological health problems caused by acute stress. Examples include being involved in a car accident or living in a violent household.
- Life course embodiment: Physical or psychological health problems caused by long-term negativities such as experiencing low-grade insults to health from living near a dump or in poverty from childhood.
- Trans-generational embodiment: The notion that the physical or psychological problems that a mother embodies can affect her offspring’s health.
Nikora’s lecture was part of a Robert Wood Johnson Foundation-UNM Center for Health Policy lecture series on embodiment.