How one reporter made an old statistic about Black infant mortality new and urgent

Black babies in the United States are twice as likely to die as white babies in their first year of life. In the summer of 2017, I heard this decades-old statistic for the first time. It hit me like a slap to the face.

When I learned that this gap remains despite a black woman’s prenatal care, education and socioeconomic status, and that prematurity is the leading cause of the deaths, I realized that my own family is caught up in this statistic. One of my sisters lost two babies who were born very premature. My other sister had my now-12-year-old nephew two months early and he could easily have been one of those lost babies.

Around the same time I learned about this issue, I also learned that the new leadership at the L.A. County Department of Public Health was preparing to launch an action plan aimed at addressing these infant mortality disparities. Though the overall infant mortality rate in California is lower than the national average, in Los Angeles County and many other local communities, the black-white gap in birth outcomes is wider. Black babies in Los Angeles County die at a rate three times higher than their white counterparts.

With the support of the USC Annenberg Center for Health Journalism, I produced a series of radio and digital stories that linked those statistics to personal narratives and the solutions that communities around the country are adopting to change the trends. I published the stories in the summer of 2018, appeared on various radio stations and podcasts discussing the issue and held a community event in January. Here are some of my takeaways:

1) GO TO THE LIBRARY

When I’m doing any type of solutions reporting, I like to do some historical research to understand what policies and campaigns have already been tried.

In the third lower level of Los Angeles’ Central Public Library, I found the transcript of a 1984 Congressional hearing on the very same issue that communities across the country are still working to address more than 30 years later.

While I was researching & reporting, this document from 1984 became my best friend.

I could not believe that there were such similar conversations taking place at the federal level more than 30 years ago. (Shoutout to central @LAPublicLibrary where I first found it!) pic.twitter.com/0ThOvsXtHU

— Priska Neely (@priskaneely) June 28, 2018

The language was eerily similar and I was able to use quotes throughout the mainbar web piece to reinforce how past policy approaches had failed.

I also saw a powerful quote describing the government’s lack of action around addressing the issues as “genocide through neglect perpetuated by the U.S. government.” Dr. Vicki Alexander made that statement and is still working to address infant mortality disparities. The interview I did with her was one of my most valuable.

2) OVERCOMING FEARS OF TWITTER

Before this project, I would do a tweet or retweet here on there. I would hesitantly share my own stories with something like, “Check out my latest.”

But with this project, my editors challenged me to focus on social media during the reporting process. It wasn’t like I was breaking news exploring this decades-old statistic, so why not share what I’m working on and see what types of responses I get.

So, before I’d published anything on the topic, when I was going on my first travel reporting trip to Oakland, I started a Twitter thread. It got 143 likes, which was very exciting for me at the time. It also got some pushback, with one user writing: 
Now, will your conclusion be a vague "the racist system" or are you actually going to delve into that and possibly find that it may be many things, one of them ... dare I say ... the parents? Perhaps ... oh lord here we go ... whites aren’t really to blame? Good luck.

This was helpful to get upfront because it helped me in framing the series to get ahead of some of that criticism and communicate in a concrete way about the role of racism. I ended up doing one radio story narrowly focused on this.

Not only did putting myself out there on social media prepare me for potential trolling, it helped me develop a following of people who were waiting for the stories to come out. And when they did, I got a larger Twitter audience than I ever imagined, with a thread that got 2,700 retweets and more than 4,000 likes.

Black babies in the US are twice as likely to die before their first birthday as white babies.

Since I learned this ugly statistic, and realized it touched my own family, I’ve been wondering:

How has this been true for so long? How do we fix it?

Here's what I found

— Priska Neely (@priskaneely) June 28, 2018

This Twitter thread was like a story in itself and took hours to put together. I learned to get over the idea of being self-promotional and really frame tweets in a way that emphasized the story itself. I put in a lot of effort to get it to grow — sending it to lots of friends, and even strangers, asking them to share. As I watched the thread grow and grow, I also realized that it was important to interact with people and nurture the thread.

3) IT’S ALL CONNECTED

In writing about disparity issues, it’s important to note how public health officials are framing the issue. Are the fixes only focused on changing individual behaviors, like smoking or drinking? Or do they look at larger, systemic issues, like housing or even how educational campaigns about things like safe sleep for in missed certain communities.

I have Google alerts set for “black infant mortality” and read so many stories that could really use a line noting that this is a decades-old problem, and that race and individual behavior does not explain the gap. Here are some studies to familiarize yourself with if you’re writing on this topic:

• Bad outcomes in black babies: race or racism?

• Differing Birth Weight among Infants of U.S.-Born Blacks, African-Born Blacks, and U.S.-Born Whites

• "Weathering" and age patterns of allostatic load scores among blacks and whites in the United States

• “It's The Skin You're In”: African-American Women Talk About Their Experiences of Racism.

• Infant mortality rates : failure to close the black-white gap

4) ASK RESEARCHERS HOW THEY CAME TO STUDY WHAT THEY STUDY

There’s a small cadre of folks who have dedicated their lives to studying these disparities and I started making it a habit to ask how they came to the work. Almost every single one of the black women had a personal connection — either they’d been born premature themselves or had complications during childbirth. I rarely mentioned their personal experiences in my stories, but I did end up writing a post highlighting some of these people and their experiences. I also asked these researchers if there were things that seemed to be missing from past coverage of these issues and those were also helpful insights when it came to framing.

5) KEEP IN TOUCH WITH SOURCES

I made it a habit to take down contact information for anyone I talked to over the course of my months reporting. I ended up with a spreadsheet with dozens of names. When the stories came out, I took a deep breath and sent every single one to every person on that list. This really helped to amplify the reach.

6) ENGAGING IN NEW WAYS

I also received an engagement grant for this series. I regularly work with KPCC’s In-Person team to put on community events linked to my reporting, but from the beginning Michelle Levander, the director of the Center for Health Journalism, challenged me to go beyond just a one-off event. When the series came out, I heard from a black woman who’d just found out that she was pregnant. She told me she was glad to know about the issue, the history, the policy. But she wanted to know, What should she do to protect herself and her baby? And that was part of the inspiration for this event. To raise awareness, but to also tackle that question. The panelists — a midwife, OB-GYN and a maternal-child health advocate featured in my stories — would share their personal experiences and advice for advocating for yourself inside and outside of the doctors’ office. I wanted to get a young, preconception audience of mostly black women — an audience that is, for the most part, outside of our listeners and readership.

In trying something to new, we decided to go old school by sending out postcards to the ZIP codes that had large black populations and higher infant mortality rates that were also near the venue. The postcards promoted the event but also directed people to the series. In the months ahead of the event, we identified black student union groups at nearby colleges and other medical student conferences where I could attend and share my work. (You can read more about those outreach efforts here.)

The result was an event in West Adams that was standing-room only with more than 200 people in attendance and the vast majority were black women. At the end of a 90-minute discussion and Q&A on a very heavy topic, there was an incredible sense of energy in the room.