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In spring 2020, COVID-19 quickly and disproportionately swept across the United States' unequal and racially segmented social landscape, claiming the lives of many Black Americans. Amid this deepening public health crisis, the brutal murder of George Floyd by police sparked widespread protests and increased support for the Black Lives Matter movement (BLM). BLM calls our attention to structural racism and its many devastating effects, including the high numbers of U.S. maternal and infant deaths disproportionately affecting African American and Black1 families. While recent discussions related to racial justice have primarily focused on urgent issues related to policing, the need for racial health equity, too, is dire. The first step toward health equity is a fundamental shift in how we think about health.
Ours is a story of three university faculty members, two graduate students, and three community partners who connected over a common goal: to improve maternal-child health (MCH) outcomes in a predominantly Black neighborhood in Pittsburgh, Pennsylvania. Faculty came from the disciplines of sociology, history, and nursing. The project was initiated by our primary community partner, with whom we were working on a separate MCH project in the same area (Devido, Appelt, and Szalla 2020).2 She is well known in her community for finding innovative and culturally relevant solutions to challenges and for creating opportunities for women. At the time, she was working for a local nonprofit organization focused on primary and secondary education. As the faculty members developed a research proposal to support the project, her supervisor at that organization joined the effort, followed by another of her close contacts who works in education. The two graduate students conducted background research for our partners' proposal to initiate an MCH-related vocational training program to provide doula certification for adolescent girls in their neighborhood.
The community partners' vision for improved MCH outcomes links education and career development to culturally grounded reproductive knowledge. Moreover, it places health outcomes within a social structural context, scaffolded by institutional racism, and it reflects BLM's call for broad structural changes and a redistribution of funding. Their holistic approach broadened our own views on the origins of MCH inequality and illuminated some blind spots in the academic literature on this topic-particularly the common belief that MCH inequality can be largely solved...