Cash for expectant moms could bridge racial gap
San Francisco is launching a program that aims to improve health outcomes for new Black and Pacific Islander mothers and their babies by providing nostringsattached funding that can help eliminate the manifold stresses of financial insecurity.
Mayor London Breed announced the “first of its kind” pilot program Monday that aims to address racial maternal health disparities and prevent premature births by increasing economic and community support for Black and Pacific Islander women in San Francisco.
The Abundant Birth Project, a collaboration with the Expecting Justice initiative at the San Francisco Department of Public Health, will provide $1,000 a month to 150 Black and Pacific Islander expectant mothers in San Francisco. Mothers will receive unconditional aid throughout pregnancy and for six months after their babies are born. Participants will be selected over the next two years.
The project is funded by a patchwork of philanthropic donations and city funding, including $1.1 million from Jack Dorsey’s #startsmall campaign. Donations also came from the Hellman Foundation, Genentech and the city’s health department.
“Black and Pacific Islander people are not having increased adverse birth outcomes because of something that’s inherently wrong with them or because of their race,” said Dr. Zea Malawa, a physician with Expecting Justice.
Underlying stress — often rooted in financial insecurity— may contribute to high rates of premature births, Malawa said.
Black families make up half of all maternal deaths and more than 15% of infant deaths in San Francisco, despite accounting for only 4% of all births, according to city data. Pacific Islander babies have the second highest premature birth rate in the city at 10.4%.
Researchers will also study the social factors that can weigh on health and are often based more on ZIP code than genetic code, said Dr. Larry Rand, the principal investigator of the Preterm Birth Initiative at UC San Francisco. Housing and food security, employment conditions, and racist treatment in public institutions are sometimes more likely to cause adverse birth outcomes than a woman’s biology.
“Communities often can solve the problem if we would just give them the resources, the space and the platform,” Rand said.
Officials believe maternal health disparities are exacerbated by the increasing wealth gap in San Francisco, where the average annual income for Black families is $30,000, and the average household income for Pacific Islander families is $67,000. The overall average household income in the city, by comparison, is more than $104,000.
“Providing guaranteed income support to mothers during pregnancy is an innovative and equitable approach that will ease some of the financial stress that all too often keeps women from being able to put their health first,” Breed said in a statement. “The Abundant Birth Project is rooted in racial justice and recognizes that Black and Pacific Islander mothers suffer disparate health impacts, in part because of the persistent wealth and income gap.”
Solaire Spellen, associate director of the Preterm Birth Initiative, said it is critical that mothers be unhampered by restrictions on how to use the money because it is important to dismantle the “welfare queen” stereotype that prevents many women from seeking aid.
“We felt strongly that this should be an unconditional cash supplement,” Spellen said. “We wanted people to have the freedom, liberty and dignity to receive the funds and do what they need to do with them, because they know what’s best for them.”
If the pilot program is successful, Malawa hopes to establish longterm funding through policy and expand the program to reach marginalized groups across California — including the Bay Area mothers priced out of San Francisco.
And after a summer defined in part by nationwide civil unrest, “a lot of us are recognizing that racism itself needs to be addressed. Many people have no idea what that would look like, but this project is a really exciting starting place.”