Today (February 1), the Center for American Progress released a new report, authored by Cristina Novoa and Jamila Taylor, which explores the existing research on the high incidence of maternal mortality and infant mortality among Black women. This crisis has seen more attention in recent months, as a number of high profile stories, including Serena Williams‘ and Erica Garner’s, have brought attention to Black women’s maternal health into the headlines.

The authors outline the stark statistics:

Erica Garner’s death illuminates a devastating problem in the United States: African American mothers are dying at three to four times the rate of non-Hispanic white mothers, and infants born to African American mothers are dying at twice the rate as infants born to non-Hispanic white mothers. These two trends hold true across education levels and socioeconomic status.

They then lay out how the research examining the risk factors of socioeconomic status, physical health, prenatal care and maternal health aren’t able to explain the high incidence of these problems. In response, researchers have begun to investigate how racism itself could be to blame, specifically how ongoing repetitive stress contributes to maternal health problems. The report continues:

Given the United States’ climate of racial inequality, African American women are more likely to experience stress during sensitive periods in early life and to be chronically exposed to stress. One would therefore expect women spared the stresses of American racial inequality during sensitive early developmental periods to have better outcomes. This seems to be the case, as black immigrant women—mostly from African and Caribbean countries—who arrived in the United States as adults enjoy better birth outcomes than native-born African American women. Similarly, one would also expect better birth outcomes for younger African American women, as they have spent less time exposed to the cumulative stresses of being a person of color in the United States. Indeed, studies show that African American teen mothers have lower infant mortality rates than African American mothers in their twenties. Since the births of young mothers are generally associated with poor health outcomes, this is a surprising finding and has been taken as strong evidence for the weathering hypothesis—the idea that cumulative stress negatively affects African American women’s health.

The authors also synthesize research showing that the situation is worsened by health care institutions who give lower quality care to Black women and babies. In order to address these health disparities, the authors conclude, broader social inequities caused by racism must be addressed:

The impacts of institutional racism and sexism compromise women’s health across time, leading to poorer outcomes for African American women and infants. A fractured and unequal health care system and gaps in health workforce training further aggravate these racial disparities. It is racism, not race itself, that threatens the lives of African American women and infants.

Read the full report here.