Why Black American Women Literally Cannot Breathe

The U.S. Supreme Court decision on Monday to strike down a restrictive Louisiana abortion law in June Medical Services v. Russo is a major win for reproductive rights in the United States. If the law had been upheld, it would have severely diminished access to abortion services in Louisiana and potentially other states. It’s a welcome victory for reproductive health and equitable access to reproductive services, but the battle is far from over, and many other threats remain, especially for women of color.

The definition of reproductive justice includes the right to raise families in healthy communities. But the U.S. is the most dangerous industrialized nation in which to give birth. American women are more likely to die from pregnancy-related complications (such as heart attacks and excessive bleeding) than women in 45 other countries. Black women in the U.S. face medical racism, lack of access to health care, higher rates of poverty, and intergenerational trauma and stress. This makes them three to four times more likely to die during pregnancy than their white counterparts, and twice as likely to die from complications.

Since pregnancy outcomes are already far worse for black women, added health risks associated with environmental damage and climate change are especially worrisome. A comprehensive review of scientific studies dating back to 2007, just published in JAMA, concluded that pregnant women exposed to high temperatures or air pollution in the U.S. are more likely to give birth to premature, underweight, or stillborn children. The populations at highest risk were persons with asthma and minority groups, especially black mothers.

In his testimony for the House Energy and Commerce Committee, Mustafa Santiago Ali, the Vice President for Environmental Justice at the National Wildlife Conservation, testified that more people die from the effects of air pollution than from gun violence. He made the powerful point that Black Americans “literally cannot breathe.”

Higher temperatures and greater frequency of heat waves generated by climate change harm pregnant women and their infants. As temperatures rise, so do the risks of premature birth and low birth weight. Exposure to increased heat can increase the lifelong risk of cardiac disease, respiratory disease, and infectious diseases. For asthmatic mothers, the risk of premature birth increases 52 percent with exposure to air pollution. During the third trimester, high exposure to air pollution increases risk of stillbirth by 42 percent.

Black women and babies are at higher risk, since they are more likely to live in “heat islands” and fence line communities where industrial polluters are located. They are less likely to have air conditioning in their homes or live in neighborhoods with green spaces that keep temperatures down.

The combination of these social and environmental determinants of health places black women and their children at greater risk than other groups for negative health outcomes. Many women who are pregnant do not have the resources to move, so they have no choice but to live in environmentally damaged areas and endure these negative health impacts. That’s why the National Women’s Law Center has declared that reproductive justice is an environmental justice issue.

Continued reliance on fossil fuel accelerates climate change and worsens air quality, impacting communities of color disproportionately. None of that has stopped the Trump administration from assaulting existing environmental and climate protections as relentlessly as it has assaulted reproductive health and rights. As of May, the administration had reversed 66 environmental regulations, including lifting the ban on the use of ethanol-gasoline blends during the summer and weakening a program that protects communities of color from power plant pollution. These regulatory rollbacks make it easier for polluters to profit at the expense of public health, and in particular, the reproductive health of women of color.

The U.S. Supreme Court’s decision in June Medical Services was a victory for reproductive health and rights. But meanwhile, the Trump administration’s assault on the environmental regulations continues, undermining reproductive health, especially of black women. Environmental injustice is structural racism in action, disproportionately threatening black lives. It, too, must be stopped.

This op-ed by Zadaiah Roye is a Duke Stanback Fellow at the Population Institute originally ran on June 30, 2020 in Thomsom Reuters