The Sentinel

Facing inequities in maternal health care, Black mothers are more at risk to receive lower quality care

For Black women, one of the biggest issues is finding their voice when confronting health issues.

by Paul Arco
OSF Healthcare

As a practicing OB/GYN, Lisa Davis, MD, sees the maternal health challenges Black women deal with every day.

Lisa Davis, M.D.
OSF HealthCare Saint Anthony Medical

“Some of the issues that face black women when it comes to maternal health are issues with blood pressure,” says Dr. Davis, chief medical officer for OSF HealthCare Saint Anthony Medical Center in Rockford, Illinois. “So what we would call preeclampsia, a risk of preterm birth, which can result in low birth weight of the infant, postpartum hemorrhage, or hemorrhage that occurs right after delivery or during the latter stages of delivery.”

And it can lead to even more serious consequences. According to the Centers for Disease Control and Prevention (CDC), the pregnancy-related death rate for Black women is three times the rate for mothers of other racial and ethnic groups.

Nationally, April 11-17 is Black Maternal Health Week, a time to raise awareness and take action to improve the health of Black mothers.

Dr. Davis says for Black women, one of the biggest issues is finding their voice when confronting health issues, which include disparities such as getting quality healthcare, dealing with underlying chronic conditions and social drivers such as income, housing, transportation or child care.

Dr. Davis stresses to her patients the importance of making their own health a high priority.

“I think for black women in the maternal health space, it's being heard and too often, there is a misperception that sometimes is out there regarding their response to pain, their use of drugs and things that are all misconceptions,” she says. “That is a big challenge for us, and that includes me, to overcome. It doesn't matter what level of education or where you live. The research has shown that it is still an issue.”

Dr. Davis adds that the medical community can do better when it comes to listening and responding to their patients’ needs. “Every patient is special and different for us to slow down and really look at that person as the person, and understand and listen,” she says. “Sometimes patients, if they're not comfortable, won't disclose what's going on in the first few minutes, but as you get ready to leave, then you might start to get the real back story. And so, it's important for us to slow down and be in the moment.”

Another need is for more Black providers, according to Dr. Davis. She says studies have shown that Black patients tend to relate to someone their own color. “It's very important, I think, for that message to be out there and to encourage young people to look at health care as an option, especially young people of color, because in the future, that's what we're going to need.”

But there are things patients can do for themselves. Dr. Davis stresses to her patients the importance of making their own health a high priority. That includes maintaining a healthy diet, getting enough rest and exercise and attending prenatal appointments.

“If you're not at your best, how can you be good for anyone else?” she asks. “I think what moms suffer from is everyone's important, but sometimes they need to take that step back and focus on themselves, so they can be 100% for their kids, for their spouse, for their parents, for their siblings.”

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Lost for Words? Using the wrong words could be an indicator of Alzheimer’s onset

There are many lifestyle choices that hurt our cognitive reserve, or brain health. Most Alzheimer's dementia cases normally start showing up in people's 60s and 70s.

by Matt Sheehan
OSF Healthcare

PEORIA - The number of those with Alzheimer’s disease is expected to double in the next 35 years. New research is showing there may be a new key to catching the disease early: language.

Deepak Nair, M.D.

The Journal of the Alzheimer’s Association published its findings in Alzheimer’s & Dementia, stating speech patterns could indicate who is more at-risk for Alzheimer’s disease down the line.

Deepak Nair, MD, the vice president of the Neuroscience Service Line for OSF HealthCare, says there are things we can be looking out for, both in ourselves and our loved ones.

"Most of the time that people recognize that early cognitive impairment, the technical term is 'mild cognitive impairment,' is happening because we notice, either in ourselves or our loved one’s memory seems to be a problem," Dr. Nair says. "Difficulties finding common words. Especially to describe things we would manage every day. If you notice in yourself or your loved ones the loss of common words, you're really struggling to think of something really common."

Signs to look out for

Most Alzheimer's dementia cases normally start showing up in people's 60s and 70s. But have risk factors and lifestyle choices been hurting your vascular and brain health for years before that? That's the worry, Dr. Nair says.

Most dementias progress very slowly, Dr. Nair says. So, this could make it difficult to catch something day to day in a loved one. Think back to a year ago and think through how they were functioning then.

When talking with families, does the person have to hand off responsibilities like financial accounts? Did they shrink how far they will drive? Who manages the household? These are all questions to consider if you have concerns about a loved one’s brain health.

Paraphasic errors

Dr. Nair says paraphasic errors, or when someone means to say one thing but says another, could be an early sign of a major cognitive disorder.

"You might mean to say the word 'clock.' But you substitute it with something that rhymes like 'tock' or 'lock.' Or something that means the same thing, like watch," Dr. Nair says. "You have an intention to refer to a specific word, but you can't find that right word, so you substitute something that's similar."

Less speech overall is also a possible early sign of Alzheimer’s.

Masking symptoms with schedules

"When people experience impairments, it's very common that they're already building in regular habits and routines to mask their impairments," Dr. Nair says. "It's things like that we pay attention to."

Physical exercise and social connection

"Physical exercise, both aerobic and anaerobic, have the highest correlation with better cognitive function in later life," Dr. Nair says. "So, we try to promote that as much as we can. Mental activity, specifically social connection and activity, seems to also play a major role."

On the flip side, there are many lifestyle choices that hurt our cognitive reserve, or brain health, Dr. Nair says. Excessive alcohol intake, smoking, obesity, high blood pressure and diabetes are common cardiovascular risk factors. Not only that, but as we get older, socialization normally decreases.

Alzheimer’s is the most common of the dementias. “Dementia” is no longer the actual diagnostic term neurologists are using, Dr. Nair says. Dementia is defined as a clinical syndrome where patients experience impairments in at least two different cognitive domains, enough to hurt their ability to do everyday tasks (balancing your checkbook, driving a car, cooking, etc.).

Memory is one cognitive domain. Language is another. Dr. Nair says the brain has special centers and pathways that help our ability to communicate. They take time to develop, which is why it takes a while for babies to start talking.

The second most common form of dementia is vascular dementia. The better we do at maintaining overall vascular health, the less likely it is that you'll have vascular disease of the brain, which leads to later cognitive impairment.

For loved ones, Dr. Nair says you're not alone. Communicate with your care team, and they can get you connected with the right resources.