Black History Month Reflection: Truth, Trust, and Transformation

By Dr. Natashia L. Conner, Ph.D, M.Phil., MS, IBCLC

The BLACK Collaborative Inc. 

Founder & Executive Director | Health Equity & Racial Justice Expert

Black History Month is a time for celebration—but it is also a time for truth-telling grounded in evidence.

The Reality Behind Medical Mistrust

Medical mistrust among Black communities is not a cultural deficiency; it is a rational response to historical and ongoing harm. Decades of public health and clinical research document persistent racial inequities in maternal and infant outcomes, including differential treatment, implicit bias, and unequal access to quality care. These disparities are not due to individual choices or cultural differences but are linked to systemic issues such as:

• Implicit bias among healthcare providers

• Unequal access to quality prenatal and postpartum care

• Differential treatment during medical visits

Data from the Centers for Disease Control and Prevention consistently show that Black infants experience higher rates of infant mortality and morbidity than their White counterparts, and Black birthing people face disproportionately higher risks of pregnancy-related complications—regardless of income or education.

A serene and intimate portrait of a black pregnant mother embracing her growing belly, captured in soft lighting.

Local Impact: Cincinnati’s Neighborhood Disparities

Here in Cincinnati, these inequities are not abstract. Cradle Cincinnati and local partners have long documented stark neighborhood-level disparities in infant mortality, closely aligned with historic redlining, concentrated poverty, and structural racism. United States Census Bureau data further reinforce how residential segregation, housing instability, and income inequity shape access to prenatal care, breastfeeding support, and postpartum resources for Black families across the region. Neighborhoods with concentrated poverty and structural racism face:

• Limited access to prenatal care clinics

• Fewer breastfeeding support programs

• Higher rates of housing instability

Data from the United States Census Bureau confirms that residential segregation and income inequality shape the resources available to Black families. This environment creates barriers to healthy pregnancies and infant care.

Breastfeeding and Historical Barriers

Breastfeeding sits at the intersection of this history. Contrary to harmful stereotypes, Black families have always breastfed—often under coercive, violent, or unsupported conditions. What research shows today is not a lack of desire or commitment, but systemic barriers: limited access to culturally responsive lactation care, inconsistent clinical messaging, early return to work, and mistrust born from lived experience within healthcare institutions.

And yet, the data also tell a story of progress when communities lead.

Evidence from community-based initiatives—locally and nationally—demonstrates that Black-led, trust-centered models improve breastfeeding initiation and duration, strengthen maternal confidence, and contribute to reductions in infant mortality where they are adequately funded and sustained. Cradle Cincinnati’s collective-impact approach, paired with neighborhood-level engagement and accountability, has helped move outcomes in the right direction. These gains matter. They are lives saved. Families preserved.

Black History Month demands that we hold both truths:

• The harm caused by racism in medicine and public health

• The power of Black families, practitioners, and communities to create change

Medical mistrust is not something Black communities must “get over.” It is something systems must earn their way out of—through transparency, cultural humility, investment in Black-led solutions, and policies rooted in equity rather than optics.

A serene moment of maternal care as a mother breastfeeds her child while reclining on a patterned blanket.

Building Trust Through Evidence and Action

Addressing medical mistrust requires more than goodwill. It demands clear evidence-based actions that acknowledge past harms and work to dismantle ongoing barriers. Some practical steps include:

• Training healthcare providers to recognize and reduce implicit bias

• Expanding access to prenatal and postpartum care in underserved neighborhoods

• Offering culturally tailored breastfeeding support programs

• Engaging community leaders to build trust and improve health messaging

Moving Forward with Truth and Transformation

Black History Month is a moment to reflect on the past and commit to a better future. Recognizing medical mistrust as a rational response to historical and ongoing harm is a crucial step. By grounding efforts in evidence and community voices, we can work toward health equity and racial justice in maternal and infant care. Supporting Black families means addressing the systems that create barriers and building trust through transparency, respect, and culturally responsive care. This approach not only improves health outcomes but:

We honor our ancestors by protecting our babies today.

We honor data by listening to lived experience.

And we honor Black history by building a future where Black mothers and infants are not statistics—but thriving, supported, and safe.

#BlackHistoryMonth #HealthEquity #RacialJustice #BlackMaternalHealth #BreastfeedingEquity #InfantMortality #CincyLove #BlackLivesMatter

Dr. Natashia L. Conner, Ph.D, M.Phil., MS, IBCLC

The BLACK Collaborative Inc. 

Founder & Executive Director | Health Equity & Racial Justice Expert