Each year, in February, the United States celebrates Black History Month, commemorating the achievements of African Americans and recognizing their central role in the history of our country. While some advocate for yearlong awareness of issues that are often highlighted during Black History Month — such as voting rights and access to health care — I personally find that setting aside a specific time to reflect, as a nation, on these important matters can help prevent them from getting lost in the everyday conversation.
As I think about how NLM can better serve African Americans, I know we must take into account the fact that their health care experiences, which include issues of access and outcomes, frequently differ from those of other Americans. I find two initiatives at the National Institutes of Health (NIH), addressing the greater risk of maternal mortality among women of color and the health challenges related to heart disease and stroke experienced specifically by African Americans, particularly inspiring.
As I prepared this blog, a surprising insight, at least to me, was the connection between cardiovascular risk and maternal mortality. African American women in the United States have a pregnancy-related mortality ratio (number of pregnancy-related deaths for every 100,000 live births) of 42.8, which is more than three times the rate of white women. Furthermore, the high ratio of maternal mortality among African American women cuts across all socioeconomic levels. While there appear to be various factors that influence pregnancy-related deaths, cardiovascular disease, particularly risk factors such as high blood pressure, is implicated in many cases.
What can NLM do to foster health equity among African Americans, particularly African American women?
We can support research and open access to the literature that provides the foundation for developing clinical guidelines and informing clinical care. Key NLM health disparities and minority health information can be found on our MEDLINE®/PubMed® Search and Health Disparities & Minority Health Information Resources page. We developed this page in collaboration with the National Institute on Minority Health and Health Disparities and maintain the content to ensure we’re providing the most up-to-date resources available. While accessible to anyone, this page is primarily for health care professionals and researchers and provides the following:
- A link to a comprehensive PubMed search on minority health and health disparities
- The complete details of the search, so users can see the strategy used and can add specific terms, such as maternal mortality and hypertension
- A list of links to additional NLM resources, NIH resources, and other federal resources on this subject, as well as to associations, foundations, and research centers
The Library also has information for patients and their families. Our world-famous MedlinePlus® online resource provides, in plain language, direct-to-consumer information (in English and Spanish) about diseases, conditions, and wellness issues. For example, a search using the terms pregnancy, African American, and high blood pressure returns almost 100 short articles and fact sheets that discuss how to recognize and manage high blood pressure during pregnancy. Sometimes a MedlinePlus search provides a pathway to unanticipated, but related, health information, such as the link between heart disease, stroke, and diabetes.
The goal of reducing maternal mortality related to cardiovascular problems among African American women requires a concerted effort linking basic science, clinical care, and patient self-management. It’s also critical to develop strategies across the full spectrum of prevention, including primary prevention of cardiovascular problems among African American women; secondary prevention that supports the early diagnosis of women at high risk for pregnancy-related cardiovascular complications; and tertiary prevention that includes aggressive care interventions before, during, and immediately after childbirth to better manage the problems of women who experience cardiovascular-related complications during pregnancy.
The effectiveness of NLM is centered around our development and distribution of scientific literature that leads to biological discoveries and supports clinical care strategies; our curation of massive genomic and molecular databases that support scientists trying to isolate genetic precursors of disease and identify promising targets for pharmacological intervention; and our outreach to clinicians, patients, and family members about the vast professional and consumer-focused resources available to promote health and self-management.
Let me know what else we can do to better serve the health needs of all African Americans and improve pregnancy-related health outcomes for African American women. Together, we can make the health of African Americans a year-round focus.