To achieve systemic change, we must go beyond the numbers to look at the stories and people who are contributing to a more equitable Orange County.
Last month, Orange County Grantmakers brought together experts to address our collective responsibility to address Black maternal and infant mortality. The Beyond Equity Learning Series presentation shed light on a critical challenge that Black pregnant women face here in Orange County.
While our regional wealth and access to healthcare should be a shield against poor birth outcomes, we’re experiencing a 10-year high for infant mortality, low birth weight, and preterm births. Black women, in particular, are three to four times more likely to die from pregnancy-related complications compared to white women. Structural racism and other social determinants are the key contributors to these disparities.
The lived experiences shared during the Dec. 3 session, “Our Sisters’ Keeper: A Collective Responsibility to Address Maternal and Infant Mortality in Orange County,” served as a powerful call for urgent, collective action. Hear from our panelists to learn more about how every sector, from community leaders and nonprofits to businesses, philanthropists, and public agencies, can help reverse these alarming trends and ensure every family in Orange County is valued, heard, and supported throughout their birthing journey.
Meet Our Speakers
Chantrell Lewis, MFA, CTE, Executive Director and Founder, Jar of Sunshine, Inc.: A Black mother with lived experience of the disparities in healthcare, Chantrell wants to support others in acquiring the knowledge and tools to have joyous, healthy pregnancies and birthing experiences.
Anaiah Brown, MPH, Program Officer, First 5 Orange County: Descended from a long line of strong Black women, Anaiah believes her advocacy of Black maternal and infant health equity is much bigger than her own experience — it is for her ancestors and for the generations yet to come.
Antoinette Andrews-Bush, Ph.D., Founder/Principal Consultant, Andrews Bush & Associates, LLC: In addition to serving as a strategic advisor, consultant, and partner to organizations including First 5 Orange County, OC Health Care Agency, BreastfeedLA, University of California, Irvine, Los Angeles County Department of Public Health, and First 5 LA, among others, Antoinette is a mother who recalls interactions within healthcare and social service systems that made her feel like she was not worthy of care and support. In 2025, Andrews, Bush & Associates, First 5 OC, and UCI will conduct community listening sessions and form a Community Advisory Board to co-create solutions for improving maternal and infant health outcomes.
Candice Taylor Lucas, MD, MPH, FAAP, Pediatrician and Health Sciences Associate Clinical Professor, University of California Irvine, School of Medicine: Candice is an academic general pediatrician who serves as a co-director for the UCI School of Medicine, Program in Medical Education, Leadership Education to Advance Diversity – African, Black and Caribbean (PRIME LEAD-ABC), and associate program director for the UCI / CHOC pediatric residency program. She works clinically in the cities of Santa Ana and Irvine and is also the principal investigator on a grant funded by the Department of Health and Human Services’ Office of Minority Health to implement the Black PEARL (Promoting Equity, Anti-Racism and Love) model for systemic integration of community maternal support services in perinatal care, in partnership with an interdisciplinary team of physicians, nurses, students, researchers, and advocates from UCI and First 5 Orange County. The team is working to strengthen health system partnerships with BIPOC community-based doulas and realize birthing equity.
Taking Action
What does the statistic that Black women are more likely to die from pregnancy-related complications reveal about systemic health inequities and what role does structural racism play?
Anaiah Brown (AB): We cannot solve a problem without first addressing its root cause. Racism lies at the heart of the health disparities we see today, particularly in maternal and infant health outcomes. When we confront racism directly as the root cause, we can begin to make meaningful progress.
Antoinette Andrews-Bush (AAB): The statistic reveals gaps and biases within the healthcare system that are reinforcing poor and deadly birth outcomes for mothers and their babies regardless of their education and socio-economic status. There are mutually-reinforcing biases and racism within economic, political and social structures that perpetuates mistreatment, induces toxic stress within the body even before pregnancy, and blames families for the trauma they experience.
Candice Taylor Lucas (CTL): Statistics like this one magnify the fact regional, state, and federal policy makers, in addition to health systems, need to prioritize optimizing access and quality of perinatal care for Black women and infants. Health systems are downstream magnifiers of systemic health inequities and interdisciplinary solutions are needed to prevent current and intergenerational health implications.
What changes do you envision in healthcare systems to ensure better maternal and infant health outcomes for Black families?
Chantrell Lewis (CL): Consistent and timely access to affordable, quality healthcare. Additionally, providers giving clear insight and information regarding health while sharing statistics and data with patients. This will support patients in really having the opportunity to look at the numbers and make well-informed decisions about their (our) health. This will shrink the health literacy gap.
AB: To truly address these inequities, we must examine and dismantle racism across every aspect of the healthcare system—from insurance policies and administrative practices, to the attitudes and biases within nursing and clinical staff, to the accessibility of care in different neighborhoods. Every intersectionality plays a role in perpetuating these inequitable systems, and only by addressing them holistically can we create real, lasting change.
AAB: I envision a time when every clinic, doctor’s office, and hospital is intentional about cultivating a sense of belonging and trust in their interactions with families, among healthcare providers, and within their physical spaces. That birthing patients can expect, and will in fact experience, a clean, comfortable, welcoming place with doctors, nurses, and staff who value them, listen to them, care for them with dignity and respect. That healthcare providers and community-based resources are integrated into a seamless system of care that holds itself accountable for the health and wellbeing of every family.
CTL: In my ideal world, to ensure better maternal and infant health outcomes for Black families, communities and health systems would truly foster health, well-being, and joy for Black patients and families across the lifespan. Health systems would also partner with communities to develop birthing centers that provide culturally responsive care to birthing patients, offer streamlined support to referrals for patients with high-risk diagnoses in need of additional care, and connect mothers and babies to comprehensive postpartum care for clinical needs, lactation services, and connection to social supports.
What are some of the systemic barriers that prevent equitable access to quality healthcare and how can they be dismantled?
CL: Socio- economic barriers are a big one. People simply can’t afford healthcare. This is detrimental to low-income individuals. Due to discriminatory practices in education, housing, and food access, low-income and low-resourced individuals are in great need of healthcare access.
AAB: Lack of a diversified, culturally responsive workforce. Workloads and health plan payment structures that affect provider decision-making. Complicated or nonexistent referral pathways among providers and between healthcare providers and community-based services. Lack of community trust in the healthcare system rooted in historical trauma and racism. There are no easy solutions to how these can be dismantled. But programs like Black Infant Health and Black PEARL (Promoting Equity, Anti-Racism and Love) [with First 5 Orange County and UCI] are seeking to address these system barriers. Over the next year, we will learn a lot about what it will take to mitigate the effects of racism within the perinatal system to promote healthy and joyous births for Black families in Orange County.
How can the next generation of healthcare professionals be equipped to address these challenges?
AAB: It is critical for medical schools and hospitals to regularly reflect on data, policies, and practices with their students and residents highlighting health inequities, the systemic issues that contribute to them, and ways to mitigate the factors that are contributing to poor birth outcomes. Training medical students and residents in this way promotes sustainable change within the healthcare system.
CTL: Health inequities are reflective of individual and community needs, socio-political and environmental climate, and access to care, and it is imperative that the next generation of healthcare professionals are engaged as thought-partners in the creation of solution-oriented and innovative health programs, research, and models for clinical care, which address these challenges. Active engagement of pre-health professionals through service-learning experiences, paid and volunteer opportunities, and facilitated education and reflection sessions can also support the creation of a pipeline of skilled future birth equity advocates, clinicians, nurses, and public health practitioners with the ability to eliminate maternal and infant health inequities.
What is an actionable step you recommend leaders in the community take to support Black maternal health equity?
CL: An actionable step would be teamwork. I would urge community leaders to collaborate and fund organizations and programs working to resolve this issue. Working together amplifies impact.
AAB: Conduct their own reflective practice to uncover what may be inhibiting their ability to engage Black families and discern how they can transform their leadership, operations and strategies to be an authentic partner and contributor to Black maternal and infant health. Invest in and partner with Orange County’s Black community, supporting our work in education, the arts, health and social services, community gatherings, cultural expression and faith-based programming. These are important resources for Black families that act as a buffer against the racism and bias we experience, and therefore, are essential community supports that are significant contributors to maternal and infant health.
What is one thing you want our audience and community to know?
CL: I want the community to understand that Black maternal and infant health inequities are not distant or isolated issues — they are community challenges that require collective action to address and resolve.
AB: When we work to dismantle health disparities within specific communities, we create a more equitable healthcare system for everyone. True progress comes from supporting one another, collaborating across sectors, and actively addressing these disparities. By doing so, we not only uplift the most marginalized, but we also strengthen and improve the health of our entire community.
AAB: Your voice and active partnership are needed. Your engagement and investment in Black maternal and infant health is an investment in the health and wellbeing of all families. It will take commitment from all of us to transform systems and create the conditions that enable every family to thrive in Orange County.
CTL: At times, we each may look at challenges that have existed for decades, centuries or more, and think change is not possible, or believe what we do will not make a difference. If this is you at this moment, please stay encouraged. Know that change is possible. We can improve maternal and infant health outcomes. Take time to learn about birth inequities impacting your local community, partner with organizations that prioritize addressing the health and well-being of Black patients and marginalized communities and be an agent of change.
Join OCG at an upcoming Beyond Equity Learning Series session, where subject matter experts are drawn from academics, community leaders, and practitioners with an orientation to social and racial justice, including people with lived experience. Click here for upcoming dates!
