美国国家公共电台 NPR--In series 'From Birth To Death,' AP reporters examine health care and racism

In series 'From Birth To Death,' AP reporters examine health care and racism¹

Transcript²

At every stage of life, Black Americans grapple with health care challenges directly tied to racism. NPR's Michel Martin talks to Associated Press reporter Kat Stafford, about the year-long probe.

MICHEL MARTIN, HOST:

A large group of Americans is more likely than others to have complications and even die during childbirth, to struggle with asthma³ during childhood and high blood pressure during adulthood⁴, and to develop Alzheimer's as elders. What do these Americans have in common? They're Black.

Researchers have known about these disparities for some time. But reporters with the Associated Press wanted to know how wide these disparities are and why they persist. So they spent a year examining all this and just delivered their work in a new five-part series called "From Birth To Death." I recently spoke⁵ with one of the series' main reporters, Kat Stafford.

You start the series talking about something that's gotten a fair amount of attention in recent years, which is the very high rate of death that Black women and babies experience in childbirth in the U.S. compared to white people in the U.S. and, frankly⁶, compared to other parts of the world. But you go further. You say this is a pattern of health disparities that follows from birth to death. What made you take that expansive look?

KAT STAFFORD: So I did a lot of reporting for the AP amid the early months of the COVID-19 pandemic and really taking a deep look at the disparate toll⁷ that we saw on Black communities across the nation. And I felt like there's more to this. How do we get to this point where we saw these disparate outcomes? So that was kind of the genesis for this project where we really wanted to set out and show that the things that you encounter as a Black American, even before you take your first breath of life, can really set the stage for you to encounter and deal with these health inequities that impact Black Americans from birth, literally⁸ to their final moments of life.

MARTIN: And just even looking at maternal⁹ mortality, you point out that the differences exist regardless of income or education level for Black women. Why do you think it's so important to point that out?

STAFFORD: That is a crucial element of this project because this is true for the maternal mortality rates that we are seeing, but it's also true for many of these ailments¹⁰ that we reported on - that regardless of how much money you make, if you are a Black person in America, you have a higher chance of dying of these illnesses. And a lot of these deaths are preventable. If you are a Black woman, a Black person, you enter the medical system, you are likely to encounter a medical provider who might not listen to you. Your concerns aren't heard.

MARTIN: That was Angelica Lyons' experience in Alabama. When Stafford interviewed her for the series, Lyons told her that when she became pregnant in 2019, she started experiencing severe pain. But she says hospital staff did not take her seriously.

(SOUNDBITE OF ARCHIVED RECORDING)

ANGELICA LYONS: I got in the bed. I felt this strong pain from, like, my vaginal area all the way up to my chest. I screamed. That was literally the beginning of literally them constantly leaving me in pain.

MARTIN: Black Americans report similar experiences when they become caregivers to aging parents with Alzheimer's. African Americans are 40% more likely to develop Alzheimer's than white Americans, according to federal data. But all along the way, family members say they struggle to get adequate information, treatment and support from medical providers.

STAFFORD: What we found was that a lot of Black caregivers, they encounter the same things. You have providers who aren't listening to them. Even getting a simple diagnosis¹¹ is hard. So not only are Black people more likely to have Alzheimer's, they are also less likely to be receiving equitable¹² care that they need to take care of this disease.

MARTIN: How do we know that this is a systemic issue? Because as you certainly know that we live in a time when there are a lot of people who are just really reluctant to - and even hostile - about the idea that there is something called systemic racism. So what convinces you that this is something about the systems that people live in and under?

STAFFORD: The fact that there are decades worth of research, statistics, all of these things that have laid out clearly the role that structural¹³ racism plays in inequities. We also made an intentional¹⁴ effort to highlight the voices of doctors, historians, folks that have really been rooted in this work, to really lay clear why these disparities exist today. And one thing that they all were very keen on pointing out was this cannot be explained by genetics alone. There is nothing genetically¹⁵ wrong with Black people. But what we are seeing are the effects of socioeconomic conditions, social determinants and all of these things that manifest because of this legacy¹⁶ of structural racism.

MARTIN: That legacy plays out in the city of Hartford, Conn. More than 21% of kids in East Hartford have asthma. That's compared with 13% statewide. Black children are disproportionately affected¹⁷. Stafford spoke to a mom in Hartford named Catherine. Her 5-year-old son has asthma, and he suffered a frightening attack at a birthday party.

(SOUNDBITE OF ARCHIVED RECORDING)

CATHERINE MANSON: So I literally had to pick him up. And he just kept saying, I can't breathe, I can't breathe. He's crying. And I'm just like, OK, just breathe. Just breathe. Sorry. That was scary.

MARTIN: Stafford also interviewed the former director of Hartford's health department, Mark Mitchell. He sought to raise awareness¹⁸ of how industrial development clustered near Black neighborhoods contributes to high asthma rates.

(SOUNDBITE OF ARCHIVED RECORDING)

MARK MITCHELL: It's clear that there is systemic racism. I don't think that there is a racist¹⁹ on the steps of the Capitol saying, let's have all toxicants go to communities of color. But the rules and the processes that are in place tend to make that happen.

MARTIN: Would access to care fix this problem? I mean, if, for example, there were more health facilities in Black neighborhoods, would that address the problem? Or is it more than that also?

STAFFORD: Even if those places do exist, what a lot of advocates and experts have said is, that does not address the structural racism that might manifest in these institutions.

MARTIN: What do you think has been lost by the fact that the health of African Americans compares so poorly to that of other Americans, particularly white Americans? How would you kind of describe what the country has lost?

STAFFORD: When you think about all the people that we have lost across generations, we have lost people who we don't know what they could have become. And for me, I kept that throughout the course of the reporting. And I hope that is something that sticks with everyone. It's not just numbers we're losing here. These are real people.

MARTIN: That's Kat Stafford. She reported a series on the health disparities that African Americans experience from birth to death. Kat Stafford, thanks so much for talking to us.

STAFFORD: Thank you for having me.

(SOUNDBITE OF MUSIC)

1 racism   

n.民族主义；种族歧视(意识)

参考例句：

• He said that racism is endemic in this country.他说种族主义在该国很普遍。
• Racism causes political instability and violence.种族主义道致政治动荡和暴力事件。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 asthma   

n.气喘病，哮喘病

参考例句：

• I think he's having an asthma attack.我想他现在是哮喘病发作了。
• Its presence in allergic asthma is well known.它在过敏性气喘中的存在是大家很熟悉的。

4 adulthood   

n.成年，成人期

参考例句：

• Some infantile actions survive into adulthood.某些婴儿期的行为一直保持到成年期。
• Few people nowadays are able to maintain friendships into adulthood.如今很少有人能将友谊维持到成年。

5 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

6 frankly   

adv.坦白地，直率地；坦率地说

参考例句：

• To speak frankly, I don't like the idea at all.老实说，我一点也不赞成这个主意。
• Frankly speaking, I'm not opposed to reform.坦率地说，我不反对改革。

7 toll   

n.过路(桥)费；损失，伤亡人数；v.敲(钟)

参考例句：

• The hailstone took a heavy toll of the crops in our village last night.昨晚那场冰雹损坏了我们村的庄稼。
• The war took a heavy toll of human life.这次战争夺去了许多人的生命。

8 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

9 maternal   

adj.母亲的，母亲般的，母系的，母方的

参考例句：

• He is my maternal uncle.他是我舅舅。
• The sight of the hopeless little boy aroused her maternal instincts.那个绝望的小男孩的模样唤起了她的母性。

10 ailments   

疾病（尤指慢性病），不适( ailment的名词复数 )

参考例句：

• His ailments include a mild heart attack and arthritis. 他患有轻度心脏病和关节炎。
• He hospitalizes patients for minor ailments. 他把只有小病的患者也送进医院。

11 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

12 equitable   

adj.公平的；公正的

参考例句：

• This is an equitable solution to the dispute. 这是对该项争议的公正解决。
• Paying a person what he has earned is equitable. 酬其应得,乃公平之事。

13 structural   

adj.构造的，组织的，建筑（用）的

参考例句：

• The storm caused no structural damage.风暴没有造成建筑结构方面的破坏。
• The North American continent is made up of three great structural entities.北美大陆是由三个构造单元组成的。

14 intentional   

adj.故意的，有意（识）的

参考例句：

• Let me assure you that it was not intentional.我向你保证那不是故意的。
• His insult was intentional.他的侮辱是有意的。

15 genetically   

adv.遗传上

参考例句：

• All the bees in the colony are genetically related. 同一群体的蜜蜂都有亲缘关系。
• Genetically modified foods have already arrived on American dinner tables. 经基因改造加工过的食物已端上了美国人的餐桌。 来自英汉非文学 - 生命科学 - 基因与食物

16 legacy   

n.遗产，遗赠；先人(或过去)留下的东西

参考例句：

• They are the most precious cultural legacy our forefathers left.它们是我们祖先留下来的最宝贵的文化遗产。
• He thinks the legacy is a gift from the Gods.他认为这笔遗产是天赐之物。

17 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

18 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。

19 racist   

n.种族主义者，种族主义分子

参考例句：

• a series of racist attacks 一连串的种族袭击行为
• His speech presented racist ideas under the guise of nationalism. 他的讲话以民族主义为幌子宣扬种族主义思想。