As a Black mother, Hope Williams-Burt always felt as if she had to fight to get her doctors to listen to her. One health care worker even criticized the way she spoke, telling her that she needed to articulate better.
But when Williams-Burt first sat down with pediatrician Dr. Dayna Long, co-founder of the BLOOM: Black Baby Equity Clinic, to discuss her daughter Mykylah’s breathing issues, her usual anxiety in health care settings immediately dissolved.
“I was talking to her, and she just looked at me and asked, ‘How are you?’ ” Williams-Burt said. “She just had a conversation with me.”
BLOOM, for Black Love Opportunity & Outcome Improvement in Medicine Primary Care, is based at UCSF Benioff Children’s Hospital in Oakland. It is the first clinic in the Bay Area to provide Black families with baby and toddler care from a team of health care workers who share their racial identities and understand the social, cultural and racial challenges that Black families such as Williams-Burt’s face.
“When I go into this clinic, I don’t have anxiety. I don’t have stress,” said Williams-Burt, “My baby girl is now 14 months old, and I’m still breastfeeding because I’m not stressed when I go into that space.”
Across the U.S., Black newborns are more than twice as likely as white newborns to die before they turn one year old. And in the Bay Area, the disparities are particularly concerning. According to a 2017 report from the San Francisco Department of Public Health, Black babies in the city were more than 4 times more likely to die before the age of three than those born into white or Asian families.
Long and co-founder Dr. Javay Ross, a primary care doctor, opened BLOOM in July to improve these health outcomes. Research suggests that high rates of Black infant mortality are associated with racial inequity in employment and education, but the health care system can also be a hostile place for new Black mothers. In one survey, researchers found that women of color seeking pregnancy and childbirth care reported higher rates of being shouted at, scolded, threatened, ignored or receiving no response to requests for help.
A growing body of evidence indicates that health outcomes improve when Black patients are treated by Black health care providers. In a 2018 study among 1,300 Black men in Oakland, patients were more likely to seek preventative care and advice if they were seen by a Black physician. The researchers calculated that the increased screenings could lead to a 19% reduction in cardiovascular deaths among Black men.
Crucially for the BLOOM clinic, a study of 1.8 million hospital births in Florida from 1992 to 2015 found that when Black newborns were cared for by a Black doctor, their chance of dying in the first year of life — while still higher than for white babies — dropped by more than 50 percent.
“There’s something to be said about likeness in medicine that decreases a barrier to health equity,” said Ross.
But while about 5 percent of California’s population is Black, less than 3 percent of physicians identified as Black or African American, according to data from the California Health Care Foundation.
Long and Ross began thinking about how to improve health outcomes for Black babies during the global protests that erupted against racial injustice following the death of George Floyd in 2020.
“I had three school-aged children who were home. And the racial reckoning that we went through with George Floyd made me think, ‘How can we do more? How can we do better?’ ” said Long.
In 2021, plans accelerated after Ross came back from maternity leave with her second child. She realized how lucky she was to have a village and access to resources like a supportive partner, extended family, and lactation support. But she knew that many Black women were not getting the same help, leading to depression and anxiety.
“After I had my second child, I felt like I needed to do something to address this lack of support,” said Ross.
At first, Ross proposed providing Black mothers with a basket filled with breastfeeding supplies. But Long had the funding from grants to do more, and so plans for the BLOOM clinic took shape.
The clinic, which is open every Friday, currently has three physicians — Long, Ross and a recent UCSF pediatric residency graduate, Dr. Justin Williams — plus a wider team dedicated to meeting each family’s needs.
When the patients arrive for the first time at BLOOM, the clinic manager greets them and gives them a welcome bag with a water bottle and a stuffed animal. Then they’re met by various providers.
The clinic’s feeding specialist answers questions about breastfeeding, bottle feeding, moving to solid food and helping parents with picky toddlers make sure that their kids are eating nutritious meals.
Williams-Burt’s 20-year old daughter, Myrai Mills, has been going to BLOOM since it opened, with her 8-month-old son. When she was having trouble breastfeeding, she felt comfortable asking questions as they came to her head, without having to reframe them.
“When I’m at BLOOM, I feel ready to be empowered,” Mills said.
The clinic also has a health navigator who helps families struggling with housing, financial needs or job security find the support they need. Starting in December, the team will also have a social worker, who will check in with every family to address their behavioral or mental health needs.
“The most rewarding part for me is seeing families who look like me and providing families with that sense of security and safety so they know they have someone who they can talk about some of the struggles they have raising a Black child and a Black family in the Bay Area,” said Williams. “I have experienced some of those as a child, and I can help alleviate some of their stress, be there for them and give them resources.”
Long and Ross said they would like more Black families to experience these benefits, but they know that expanding the clinic’s approach to other sites will depend on convincing funders that it delivers better results.
So a team of UCSF researchers led by Nicole Bush, a professor who specializes in developmental behavioral health, and Dr. Kayla Karvonen, are now gearing up to track the impact of the care on the mental and physical health of Black parents and babies.
“I wish this could be launched nationwide, because every momma of color needs this,” said Mills.