Racial disparities in maternal and infant health persist across the United States, significantly affecting minority communities.
While disparities among Black, Indigenous, and Hispanic populations have received attention, Arab-Americans—particularly in Dearborn, Michigan—are often overlooked.
This oversight is partly due to Arab-Americans being classified as “white” in many health data systems, which can hide the specific challenges they face.
Many individuals from the Middle East and North Africa (MENA) region consider themselves a distinct ethnicity but are classified as “white” in health data systems.
This outdated labeling obscures their specific health data and hinders the provision of targeted maternal and infant health services.
This article explores these disparities in maternal and infant health, focusing on the challenges within the Arab-American community in Dearborn and highlighting LAHC’s free Mom Care Connect program.
Overview of national maternal and infant health disparities
Leading health policy organization in the U.S., KFF’s statistics highlight the significant challenges that minorities and underrepresented communities face, including higher risks during pregnancy and increased infant mortality rates:
- Pregnancy-related mortality rates: American Indian and Alaska Native (AIAN) and Black women experience pregnancy-related deaths over three times higher than White women (63.4 and 55.9 vs. 18.1 per 100,000 live births).
- Birth risks and outcomes: Black, AIAN, and Native Hawaiian or Pacific Islander (NHPI) women have higher shares of preterm births and low birthweight infants. NHPI women are four times more likely than White women to receive late or no prenatal care (22% vs. 5%).
- Infant mortality rates: Infants born to Black women are over twice as likely to die compared to those born to White women (10.9 vs. 4.5 per 1,000 live births). The mortality rates for infants born to AIAN and NHPI women are nearly twice as high as those for White women.
These disparities result from a complex interplay of factors, including limited access to healthcare, socioeconomic challenges, and systemic racism.
However, the Arab-American community’s specific challenges often go unrecognized due to inadequate data collection practices.
Disparities in maternal and infant health among Arab Americans
The 2013 Arab Behavioral Risk Factor Survey (BRFS) provides valuable insights into health behaviors and conditions among Arab-American adults in Michigan.
However, the state has yet to conduct another survey since then, indicating a lack of updated data for this community.
Several factors identified in the survey may contribute to potential disparities in maternal and infant health within the American Arab community:
Limited healthcare access and insurance coverage
- High uninsured rates: In 2013, 25.4% of Arab adults aged 18–64 reported having no health care coverage, significantly higher than the 17.4% among all Michigan adults. Lack of insurance can lead to delayed or inadequate prenatal care.
- Cost barriers: Approximately 25.3% of Arab adults did not see a doctor in the past 12 months due to cost, compared to 15.5% of all Michigan adults. Financial barriers may prevent pregnant women from accessing necessary prenatal services.
Language barriers
- Limited English proficiency: Almost a quarter (24.1%) of Arab adults reported not speaking English well or not at all. Language difficulties can hinder effective communication between patients and healthcare providers, affecting the quality of prenatal care and maternal education on infant health.
- Preference for native language in health care: A significant portion of Arab-identifying adults (44.8%) reported speaking Arabic or Chaldean with their doctor. While culturally sensitive care is beneficial, limited availability of bilingual providers may restrict access to care.
Cultural factors affecting healthcare utilization
- Modesty and privacy concerns: The survey notes that Arab women face barriers related to embarrassment, discomfort, and modesty, particularly concerning reproductive health services. These cultural factors may lead to delays in seeking prenatal care.
- Fear of detection and stigma: Fear related to health diagnoses can prevent women from accessing necessary screenings and prenatal services.
Socioeconomic challenges
- Low household income: Nearly half (48.0%) of Arab adults reported a household income of less than $25,000. Financial instability can limit access to nutritious food, safe housing, and health care services.
- Financial stress: Over half (53.7%) worried about paying rent or mortgage, and 31.5% were concerned about affording nutritious meals. Chronic stress during pregnancy is associated with adverse outcomes like preterm birth and low birth weight.
Mental health concerns
- Higher rates of poor mental health: About 21.3% of Arab adults reported poor mental health, significantly higher than the 12.0% among all Michigan adults. Maternal mental health issues such as depression and anxiety can negatively affect both the mother and infant, potentially leading to complications during pregnancy and after birth.
Underutilization of preventive health services
- Low rates of cancer screenings: Only 59.8% of Arab women had a Pap test in the past three years, significantly lower than 79.4% among all Michigan women. This underutilization may reflect a broader pattern of limited engagement with preventive health services, including prenatal care.
- Delayed health care seeking: Approximately 23.2% of Arab adults delayed health care for reasons other than cost, including cultural preferences, lack of trust, or limited awareness of available services.
Lifestyle factors
- Physical inactivity and obesity: A significant proportion of Arab adults reported no leisure-time physical activity (31.2%), and 28.0% were classified as obese. Maternal obesity is a known risk factor for complications such as gestational diabetes, hypertension, and increased risk for cesarean delivery.
- Nutritional challenges: Financial constraints affecting the ability to purchase nutritious meals can lead to poor maternal nutrition, impact fetal development, and increase the risk of low birth weight.
Learn more about LAHC’s community kitchen, which supports Dearborn families.
Impact of discrimination and social determinants of health
- Experience of discrimination: While not quantified extensively in the survey, experiences of discrimination and the need for race consciousness can contribute to stress and negatively impact health behaviors and outcomes.
- Social isolation: Language barriers and cultural differences may lead to social isolation, reducing access to beneficial community support systems during pregnancy.
Implications for maternal and infant health for Arab-Americans
The interplay of these factors suggests that Arab-American women may be at increased risk for adverse maternal and infant health outcomes due to:
- Delayed initiation of prenatal care: Cultural and language barriers and lack of insurance may lead to fewer prenatal visits or starting care later in pregnancy.
- Inadequate prenatal care: Financial constraints and lack of awareness may limit access to comprehensive prenatal services, screenings, and education.
- Higher stress levels: Financial insecurity and discrimination can increase stress hormones, affecting fetal growth and development.
- Poor maternal nutrition: Economic challenges may result in inadequate nutrition during pregnancy, which is essential for healthy fetal development.
- Untreated mental health issues: A higher prevalence of poor mental health may lead to depression or anxiety during pregnancy and postpartum, affecting bonding and infant care.
Mom Care Connect: Supporting mothers in our community
Leaders Advancing and Helping Communities (LAHC) invites all moms and moms-to-be to join our free Mom Care Connect program, a support group for moms and moms-to-be to meet and learn about the best ways to care for themselves and their children before, during, and after birth.
Working in collaboration with other community partners, this program is hosted in our building (Lennon Pregnancy Center) on Fridays every other week.
LAHC will continue both in-person and virtual support groups in the new year. Additionally, we invite local moms to register for our WhatsApp group to receive tips, resources, event updates, and general support.
Call 313-846-8480 to learn how we support you before, during, and after birth.
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