Co-written by Linda Goler Blount and Nicole Austin-Hillery
The summer of 2020 will (as in recent years) be hotter than average and with more periods of extremely hot weather. Like the pandemic, extreme heat exposure disproportionately harms Black women and communities of color, who are already hit the hardest by a number of health inequities.
Pregnancy reduces the body’s ability to regulate temperature and also makes pregnant people more vulnerable to heat exhaustion, and potentially fatal heat stroke. The connection between exposure to elevated temperatures during pregnancy and adverse birth outcomes, like preterm birth and low birth weight, is increasingly supported by studies. According to one study, “the hotter the temperature or the longer the heat wave, the greater the risk.” Two California studies have found a higher risk of preterm birth linked to heat exposure for Black mothers than white mothers.
Pregnant women receive little attention as an at-risk group. In emergency plans or government extreme heat warnings for Washington D.C., New York City, Philadelphia, Chicago, Austin, Nashville, Boston, Phoenix and Baltimore, only Phoenix mentions pregnancy — while older people, for example, are mentioned by all nine cities. The Centers for Disease Control and Prevention and the American Red Cross issue more temperature safeguards for pets than for pregnant women.
Urban neighborhoods are often hotter with fewer trees and more concrete. Marginalized areas, often home to communities of color, are where there are more multi-story, densely populated buildings less likely to have air conditioning (costly to run) and access to clean water to keep hydrated. A recent study examined the long-term impact in 108 U.S. cities of “redlining” — a racially discriminatory practice in the 1930s by which companies refused or limited loans, mortgages and other investments within specific geographic areas, especially Black inner-city neighborhoods. The study found temperatures in formerly redlined areas, still usually home to communities of color, are often as much as 13°F warmer than in non-redlined areas.
Imagine the pregnant woman who must stand on the hot pavement this summer waiting for public transportation to take her home where she must walk up three stories to no air conditioning hoping to cool off in front of a box fan?
What’s more, hotter temperatures exacerbate already existing maternal health disparities. Black women are three to four times more likely to die from pregnancy-related causes than white women for a number of reasons, including giving birth in poorly resourced hospitals and not receiving adequate care during an obstetric emergency. Similarly, preterm birth rates are much worse for Black women and they are two times more likely to deliver low birth weight babies as their white counterparts, even when socioeconomic class is considered. Several studies have found a singular cause: racism.
Because of the intersecting impact of increasing heat, barriers due to racism and maternal health disparities, our climate crisis is a Reproductive Justice issue. The climate crisis undermines a woman’s ability to have a healthy pregnancy and deliver a healthy baby.
The COVID-19 pandemic promises to make the heat of this summer season even more difficult for vulnerable communities. AC may be an impossible cost for low income families, especially after job cuts and wage loss. Social distancing makes going to a relative’s house, mall or library to cool off harder or impossible.
We will not address any of our crises — the pandemic or the climate crisis’ health impacts — without centering and addressing these health inequities and their cause: racism. Local governments need to wake up to the dangers of pregnancy and heat, and work with pregnant people and Reproductive Justice organizations to address this assault on the health of Black mothers and babies.
Marcela Howell is the president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda.
Linda Goler Blount is the president and CEO of Black Women’s Health Imperative.
Nicole Austin-Hillery is the U.S. Program executive director at Human Rights Watch.