Equitable Thriving: A Lifecourse Approach to Maternal and Child Health Justice
Black women are at least three times more likely to die due to a pregnancy-related cause than White women. Grave racial disparities also abound in severe maternal morbidity, or significant unexpected health consequences of labor and delivery. The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, eliminating the constitutional right to abortion, has only further restricted reproductive healthcare options and raised concerns that these disparities will grow even starker. Black, Indigenous, and Latine infants and children also experience unjust—and avoidable—health inequities. As a general matter, people of color are sicker across their lifespans and die younger in the United States.
A robust body of legal scholarship has surfaced significant problems with healthcare access and delivery, including racism within the healthcare system, that impact pregnancy, labor, and delivery and drive disparities in maternal and infant mortality and morbidity. Research shows that these inequities also have structural causes outside of healthcare and in many facets of life over a person’s lifespan. Indeed, myriad social conditions, such as housing insecurity, employment discrimination, and barriers to early childhood education, drive poor health and have an outsized impact on racial health disparities, including maternal and child health inequity. Laws in all these areas drive inequity in these conditions.
The health justice framework and movement aim to eliminate health disparities caused by laws and systems of subordination. This Article argues for urgent attention to maternal and child health injustice and proposes “equitable thriving” as a new approach—a lifecourse approach—to law and policy. Under-explored in legal scholarship, Lifecourse Health Development is a body of scientific theory and research that examines mechanisms of maternal and child health to promote human flourishing beyond the doctor’s office and the hospital room—and across the lifespan.
Building on ongoing efforts to attack barriers to maternal healthcare and the discrimination and bias within it, equitable thriving widens the analytical lens to examine maternal and child health justice across the broad range of sectors that impact health and across a wider time frame, long before and after pregnancy and across the lifespan and generations. The core thesis of this Article is simple: Legal action, informed by life-course science, is needed to preempt and mitigate grave racial disparities in maternal and child health—and to create the conditions necessary for children and parents from racially minoritized communities to not only survive but thrive.
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