Despite overall declines in infant mortality, the rate for black infants is more than double that of white infants—13.5 deaths per 1,000 births for blacks compared to 5.7 deaths per 1,000 births for whites. Moreover, black women are twice as likely to give birth prematurely and nearly four times as likely to die during pregnancy.

The Institute of Medicine in a 2006 report on preterm birth concluded that differences in socioeconomic condition, maternal behaviors, stress, infection, and genetics cannot fully account for the racial/ethnic disparities.

More recently the Joint Center for Political and Economic Studies, with funding from the W.K. Kellogg Foundation, the UCLA School of Public Affairs, and the University of Michigan’s National Institute of Health Roadmap Disparities Center, formed a 19-member Commission—Courage to Love: Infant Mortality Commission charged with examining basic assumptions, redefining the problem, and formulating recommendations for policy, research, and practice.

“The root causes of persistent racial/ethnic disparities in infant mortality are not thoroughly understood. Many theories have been proposed. The high incidence of infant deaths among black women and children has been attributed to high teen pregnancy rates, single motherhood, lower education levels, poverty, and—most recently suggested—genetic causes. These theories fade in the light of robust research; however; alarmingly high levels of infant mortality persist, even when most factors are controlled,” said Ralph Everett, Joint Center President and CEO.

The findings of the Commission are published in a series of landmark reports:

• Race, Stress and Social Support: Addressing the Crisis in Black Infant Mortality
• Maternal Nutrition and Infant Mortality in the Context of Relationality
• Inequality Matters: Infant Mortality in the Global Village
• African American Women and Breastfeeding

In an effort to reframe the debate, California Newsreel and Vital Pictures, Inc. in association with the Joint Center Health Policy Institute has produced a documentary—Unnatural Causes: Is Inequality Making Us Sick?

Unnatural Causes: Is Inequality Making Us Sick? aims to reframe the debate by stimulating a national dialogue about what we as a society can—and should—do to address health inequities. The 4-hour documentary sifts through the evidence to discover there is more to our health than bad habits, health care, or unlucky genes.

The 7-part series will air on PBS (Public Broadcasting System) Winter/Spring 2008 as part of a Public Impact Campaign that has grown to include more than 80 outreach partners.

Part One: Sick of It?
Why do some of us get sicker and die sooner? What are the connections between healthy bodies, healthy bank acounts, and skin color? We travel to Louisville, Kentucky to discover how social policy, growing economic inequality and racism affects our health.

Part Two: Place Matters
Our street address can be a powerful predictor of our health. In Richmond, California we witness how one neighborhood exposes its residents to health threats while in Seattle, Washington, another neighborhood is being created that promotes health. What public policies and community actions make the difference?

Part Three: Becoming American
On average, poor immigrants of color actually arrive in the U.S. healthier than the average American. But the longer they are here, the less healthy they become. We follow Mexican immigrants laboring on the mushroom farms of Pennsylvania to find out why they are healthier, what’s grinding down their health over time (and even more so, that of their children), and what they are doing to reverse this trend.

Part Four: When the Bough Breaks
African American pre-term births and infant mortality rates remain more than twice the national average. The babies of African American women with professional degress face as much risk as being born early and low-birthweight than white high school drop-outs. Might the cumulative impact of racism over the life-course be the culprit?

Part Five: Bad Sugar
Diabetes is a growing American epidemic and Native Americans were the first to suffer its profound effects. We travel to the O’odham Indian reservations of southern Arizona to see how history and powerlessness can drive the disease, while Native efforts to regain control of their communties’ economic destiny and re-connect to their culture offer hope for the future.

Part Six: Not Just a Paycheck
Unemployment and job insecurity isn’t just bad for your pocketbook – it’s bad for your health. Must it be this way? Workers in Michigan and Sweden were both thrown out of work by the same corporate giant. One town struggles against depression, spousal abuse and an uptick in heart disease and diabetes while the other seems to be doing just fine.

Part Seven: No Man Is an Island
Pacific Islanders, even native Hawaiians, have poor health outcomes. In the Marshall Islands and in the unlikely spot of Springdale, Arkansas we can see how U.S. occupation, foreign policy and globalization impact peoples’ health—often in unanticipated ways.