Passenger manifest from the SS Ile de France, for my father when he immigrated on June 9, 1956
A friend of mine who works in improving prenatal care services in New York City posted this article about African-American infant mortality last week. Titled What’s Killing America’s Black Infants, and published in The Nation, it’s one of the best examples of what I’d call Guiding Principle thinking I’ve read in a long time.
What is Guiding Principle Thinking? It’s not just an attempt by me to ‘brain squirrel out’ on my readers by inventing a new term. I’ve been pondering for quite a while how to explain the difference between the more commonly used term Systems Thinking and encourage my readers to move up a couple of notches to really consider the larger picture . Peter Senge still gives the best start to Systems Thinking in his book, The Fifth Discipline. Yet we’ve talked about the commonly inferred structure of that kind of thinking, which says use data and algorithms to boot your brain out of guessing intuitive answers based loosely on your own arbitrary authority. Guiding Principle Thinking is structured around using all those lower data structures, like collected demographic data. But it adds on to the if-then algorithmic rule sets and categories, by coupling this with independent agency-driven heuristics and larger narratives that intentionally look at longer timelines and more insightful stories. The piece above does this beautifully.
The subtitle on the piece, however, does not. If you don’t read past that (the subhead is “Racism is fueling a national health crisis”) you’re not going to get the beauty of this piece. In fact, that subhead, which initially suggests non-differentiated racism, is EXACTLY the kind of simplistic mental model that creates division and hurts understanding of the larger, connected problem, which the whole piece describes so eloquently. So — it’s Sunday. Read the whole thing.
What points do the authors make about the plight of black, urban, and both poor and middle-class women that causes a cascade of negative consequences that end up in premature infant death or miscarriage that DO NOT affect, for example, foreign born, black, middle class women? The answer is the combined stressors in their lives elevate the level of cortisol, a stress hormone, in these women’s bodies, which then manifests itself in premature infant death. So even though Guiding Principle Thinking may appear to be a label for a complex of conditions that result in a so-called “wicked problem” — a problem with many causes that intertwine together in larger society — it can actually be simplified to a particular Guiding Principle — long-term, historical, multi-factor racism creates a measurable health condition (increased stress) on black women that causes babies to die. And it leads to a series of achievable solution paths — reduce stress on pregnant African-American women through construction of a individually tailored, empathetic support network.
Classic systems thinking alone is only a part of understanding the problem. One can implement a series of algorithmic processes (like giving all women appropriate prenatal vitamins and folic acid — “If you’re pregnant, we’re going to supplement your diet”) but it’s not going to fix this problem. But Guiding Principle thinking can give us a big picture that we can use to attack this problem, and make a difference on the spatial and temporal scale so that any person who wants can choose to work on this problem.
And what is recommended in the article? From the article itself:
At one of those places, Ebeneezer Church of God in Christ, I met Julia Means, a nurse with a striking track record with Milwaukee’s infants. By her own count, Means has worked with 360 families in the last 12 years, through a program called Blanket of Love. Every single baby whose parents came to her group meetings lived to its first birthday, she told me. Her method is to “wrap the pregnant woman up in love.” Sometimes that’s meant finding a home for them, and furniture to fill it; or role-playing, to help them feel confident speaking to doctors; or educating them on safe sleeping conditions; or, in a few cases, helping women escape abusive partners in the middle of the night. Another way to put it is that she does what she can to reduce the stress in these women’s lives.
From a v-Meme perspective, this is heavily Performance/Goal-based, the goal being to insure both mother and child make it through the first year. It’s Communitarian in nature in that involves identifying the larger support system the woman as a unique individual needs inside her larger social space, where otherwise she may get lost. It involves more than just algorithms applied to a class — not just ‘every pregnant woman gets this.’ It’s more like ‘every individual woman gets what they need to thrive.’ So even though the problem is large and societal (racism + deep cultural roots = increased infant mortality) Guiding Principle Thinking helps us shape a larger strategy aimed at reducing one biological indicator, cortisol, inside birth mothers’ bodies, so they can thrive. And anyone can be empowered to help.
Of course, it all is constructed on empathy at multiple levels. Mirroring behavior, of happy mothers with their babies sharing baby group helps the expectant mother look forward to the transition of birth. Emotional empathy and support form accessible connections for love toward the mother. And the rational place-takers can also participate, by looking outward inside the community for opportunities to help solve the expectant or new mother’s challenges she will face during that first year. Conscious empathy can be provided by any people in the system, but training social workers to understand deeply also helps. And finally, if we have just a little global empathy, making the new mother feel that she is bringing a gift into the world, instead of applying negative racial stereotypes, that has to drop the stress level.
For those of us who want to believe that we operate in those higher levels, I’d encourage even larger thinking. I can remember a visit back to my family in northern Indiana, a site of industrial collapse that now none can deny, reading an article in the local paper that said 90% of African-American women bring babies into the world alone. The focus was very racial. But if you read a little further down, it said that this was in comparison to 31% of all babies of any racial demographic being born without a father. Clearly, there were, and are larger structural issues that are not race-based.
And why should you care? While I care deeply about the mothers’ trauma and the fallout to the community from having a mother who has lost an infant, it cannot go unrecognized that the children raised in such traumatic circumstances will also be traumatized, with the incumbent cognitive disadvantage of that trauma. Guiding Principle Thinking says that a society that regularly produces traumatized citizens will have a much harder time empathetically evolving than one with healthy individuals. And this effect will be seen for generations, through epigenetics. By working to adaptively fix the problems of individuals subject to a larger societal force, we are actually helping all of us, and all our children as well. For real. Because, like it or not, we are all connected.