Infants could be born at a disadvantage just by virtue of living close to gun violence. That’s the upshot of new research from Princeton economist Janet Currie and her colleagues.
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"We found that there was a significant increase in the risk that the baby was very premature," Currie said, "... and also that there was a risk that the baby was more likely to be very low birth weight."
In fact, infants exposed to gun violence while still in the womb were as much as 25% more likely than peers to be premature or low birth weight. Local experts say this research should have special resonance in Northwest Florida, where communities have been grappling with the twin crises of surging gun violence and high infant mortality rates.
Claire Kircharr is associate director of Healthy Start Coalition of Escambia County, which conducts an annual audit of all infant deaths in the region. She said the local area ranked poorly for maternal and infant health outcomes, in general, but that the situation was especially stark among black mothers and infants.
"Our infant mortality rate and our general maternal and child health outcomes are worse amongst people of color," she said, "And that's something you see nationwide. But unfortunately ... we have a larger gap than most communities in Florida."
Currie said her research could provide a clue as to why these disparities were so persistent.
"Black women are more likely to live in neighborhoods where there is this kind of violence," she noted. "... They're more likely to know somebody who's subject to gun violence, and they may just have higher levels of stress because of that."
Stress, Currie said, could be the key mechanism connecting gun violence with poor health outcomes.
Angela West-Robinson knows this fact all too well. As a local doula, she sees it every day. During the pandemic, she started a peer support group called “Melanin Motherhood” to give black and brown women a forum to discuss issues like stress and mental health.
West-Robinson pointed to a 2019 study from the Centers for Disease Control and Preventionthat examined more than a thousand pregnancy-related deaths in 36 states.
"Over 23% of those deaths were related to mental health conditions," she said, noting that the impact extended beyond mothers to their babies, both while in the womb and during the postpartum period. "... Gun violence, trauma, these things scientifically have (been) shown (to) affect babies."
While it’s impossible to put a dollar figure on one person’s trauma, Currie and her colleagues were able to place a value on many of the downstream effects to society. When a baby is born prematurely, they incur direct costs for things like NICU care. Then, there is the cascade of second and third-order costs. They are at greater risk for conditions like asthma or ADHD, which might put them at a disadvantage in school and then work. This means fewer earnings, less tax revenue. The list goes on and on.
"We add up all of those things," Currie said, "and we get a number of about $15.5 billion."
That’s billion with a “b.” And that’s each and every year. Experts say figures like these, if not simple empathy, should be enough to convince policymakers to do more to help mothers affected by gun violence.
"Our home visitors are not licensed mental health counselors," Kircharr said. "They will work with parents, and they will work to do depression screenings. (But) we do see an incredible wait list for mental health services around here, and I think that is an intervention that needs a lot more attention: How are we addressing the mental health of our mamas?"
West-Robinson agreed.
"We really need people who are talking to women directly," she said. "... As a doula, I watch women go through the motions of being pregnant and they're absent-minded. They go into an examination room, they're out. And the whole time they're not connected with self. They're not connected with what's going on at home. I have fed women, have you eaten today? What's going on in your home? Is there domestic violence? Is there gun issues? Or have you experienced some sort of trauma? Those moments are really very rare unless someone does have a doula or they have someone who's really talking to them about their experiences."
Until then, Kircharr said, the steepest costs won’t be tallied in dollars or cents, but in death and sadness.
"We want every child to be able to make it to their fifth birthday," she said. "You know, here in Escambia County, we have enough infant deaths every year to equate to about an entire kindergarten classroom."
Currie said she hopes her research can make space for more pragmatic, proactive policymaking.
"Basically being killed by a gun is a major cause of death among U.S. children," she noted, "which is just not the case in other parts of the world. So, you know, we have these innocents who are bearing the cost of all of this gun violence. Maybe focusing on that could help people come together and put aside their differences about strategy and maybe be a little bit more flexible on finding something that works."