Expecting Justice is a Collective Impact effort working on innovative approaches to eliminate health inequities for birthing people. These programs include anti-racism training for medical and social service providers, doula support for Black and Pacific Islander parents, and other initiatives focused on supporting women and other pregnant people who are experiencing racial disparities.
In San Francisco, nearly 16% of Black infants are born too early, as compared to just 7.3% of White infants. Pacific Islander infants have the second highest rate of preterm birth (10.4%). Preterm births (those occurring prior to the 37th week of pregnancy) carry the highest risk of infant mortality and also potential long-lasting health and developmental impacts for the baby.
Many factors are at the root of this crisis, perhaps none more so than structural racism. Historically racist policies (such as redlining and urban renewal) as well as modern-day discrimination underscore the wealth gap among Black and Pacific Islander communities and other racial or ethnic groups in San Francisco. Furthermore, Black and Pacific Islander families face unique social and environmental factors, including substandard and/or unstable housing, police violence, limited access to healthy foods and adequate nutrition, unequal educational opportunity, and poorer-quality employment opportunity. We, as a society, are long overdue in addressing these inequities.
However, there is something that can be done right now to change the circumstances for Black and Pacific Islander families in San Francisco: make life in the City more affordable.
With support from the Hellman Foundation, Expecting Justice is piloting unconditional income supplementation during pregnancy, targeting 100 low-income Black and Pacific Islander pregnant people in San Francisco. The first-of-its-kind study in the United States will distribute a monthly income supplement of $1,000 to $1,500 per month for the duration of pregnancy, plus several months postpartum. Providing direct, unconditional cash aid empowers the mother to meet her needs throughout her pregnancy.
“The reality is that if we want all kids to be born with a fair start, we have to be willing to address racism. When we do, the benefit will not just be to Black people and other communities of color, but to all of us. This pregnancy income supplement will make an important investment during a critical stage of life and the payoff will be felt well beyond the homes of the receiving families. What will the impact be on small businesses when more families have more liquidity, especially in the coming recession? How will our schools thrive when more parents are no longer living hand-to-mouth and can volunteer their time and important perspectives to PTAs? What will our city’s future look like when more families are stably housed and fed, and their children actually have the opportunity to reach their fullest potential? When we begin to acknowledge the harm our policies have caused to Black people and take major, healing steps towards repair, the benefits will be felt by us all.” Dr. Zea Malawa, Director of Expecting Justice
Read the “Racism as a Root Cause Approach” article written and published by Zea Malawa, Jenna Gaarde, and Solaire Spellen in Pediatrics, to learn about a new framework for developing strategies, policies, and mechanisms to address the root causes of health disparities.
Published Jan 2021
Learn more about their project:
For more information, contact:
Zea Malawa, MD, MPH
(415) 581-2571 | firstname.lastname@example.org