Applying Racial Equity to U.S. Federal Nutrition Assistance Programs - Flipbook - Page 58
This exploitation of black motherhood and the bodies of black women caused many women of later generations to associate
breastfeeding with being an enslaved wet nurse. In some African American communities, rejecting breastfeeding was seen
as women asserting control over their own bodies and expressing their freedom.250 This view was reinforced by corporations’
aggressive marketing of formula to African American mothers in the early 1900s to mid-1900s. Formula was promoted as a
modern alternative to breastfeeding.251
The history of indigenous people has also contributed to today’s lower breastfeeding rates. Indigenous women from many
groups had a strong tradition of breastfeeding their children.252 It was considered a first food for infants. However, the United
States has a long history of violence against Indigenous people—including even genocide, as well as forced migration and
cultural erasure253—that disconnected many from their histories.
Later, for two generations, many Indigenous children were forcibly separated from their families and sent to boarding
schools, where they were required to learn English and adopt the customs of white people.254 Some children could not travel
home for the summer and therefore went as long as six years without seeing their parents.255 This disruption of family life
meant that many traditions, including home languages and cultural norms such as breastfeeding, were lost rather than passed
down from grandparents and parents to children. Compounding the problem, the family separation era coincided with
the arrival of WIC offices on or near tribal lands. Many Indigenous people recall the WIC office as a “formula center” that
promoted formula over breastmilk256 and further reduced breastfeeding rates.
Appendix 2: Everyday Occurrences of Racism
In addition to historical trauma from racism, racism remains embedded in the structures under which women of color live.
Structurally racist policies such as redlining have segregated the neighborhood where she lives257 and stripped wealth from her
neighborhood258 or reservation. She is very often a low-wage worker, due in large part to job segregation by race and gender.259
The environment she lives in260 is at higher risk of air and water pollution because of racially unjust environmental policies and
practices, such as disproportionately establishing hazardous waste disposal sites near neighborhoods of color. Other important
areas of life have also been shaped by racism. Women of color experience such “ordinary” racism and trauma on a daily basis.
Refer to figure 2 on page 11 for additional context on the impact of racism on communities of color.
Appendix 3: Racism Impacts Maternal Mortality
Research shows that structural racism directly contributes to maternal mortality through factors such as limited access
to quality prenatal care, lack of equitable access to a nutritious diet, and preexisting conditions. Women who do not receive
prenatal care are three to four times as likely to die as a result of pregnancy and childbirth.261 Data indicate that African
American and Indigenous women are between 2.2 and 2.5 times as likely to receive late or no prenatal care as white women.262
263
Native Hawaiian women are twice as likely not to begin prenatal care until the third trimester of pregnancy.264 According to
the Centers for Disease Control, African American women are three times as likely as white women to die from complications
during pregnancy or childbirth.265 Researchers now know that this is true regardless of a woman’s income or level of education,
leading to a theory that living in a racist society is an independent risk factor.
The fact that many low-income communities of color are “food deserts,” meaning that they are far from the nearest fullservice grocery store, is partly a reflection of racism in neighborhood design.266 Pregnancy is riskier in a food desert since there
are higher rates of nutrition-related health problems such as iron-deficiency anemia, which is a significant factor in maternal
mortality.267
Lastly, racism leads to lower-quality care during pregnancy and childbirth—part of generally high levels of racial
discrimination in medical care. Providers are more likely to underestimate the pain of African American patients,268 ignore
symptoms, and dismiss complaints. Studies such as one published in the Proceedings of the National Academy of Sciences
have quantified racial bias in the medical treatment of African Americans.269 A study from Emory University found that among
patients with similar bone fractures, a hospital in Atlanta prescribed painkillers for 74 percent of the white patients and only 50
percent of the African American patients.270 A third study found that physicians were more likely to underestimate the pain of
black patients than of other patients.271 Women of color have reported instances of discrimination during prenatal visits, labor
and delivery, and postpartum care, all of which contribute to higher maternal mortality rates.
Understanding the devastating consequences of racism in healthcare settings reinforces the importance of applying a racial
equity lens and practicing cultural humility.
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APPLYING RACIAL EQUITY TO U.S. FEDERAL NUTRITION ASSISTANCE PROGRAMS: SNAP, WIC AND CHILD NUTRITION
