The first ever report to speak to Black mothers about their education and attitudes to air pollution has found that almost half of all black mothers do not feel educated on the fatal impact of air pollution during their pregnancy.
The report, by Global Black Maternal Health, was commissioned by Impact on Urban Health and has spoken directly to Black pregnant women and mothers in London communities about the effects of air pollution on unborn children, revealing its findings along with 14 recommendations for policymakers and healthcare professional bodies.
58% of Black mothers shared that they knew ‘nothing at all’ about the impact of air pollution on their unborn fetus in pregnancy. This is despite 89% of respondents feeling concerned about the about air pollution in their local area
Pregnant women exposed to air pollution are more likely to have children who are born prematurely, underweight or stillborn and to have reduced live birth rate and maternal depressive symptoms.
Black communities in London are more likely to breathe illegal levels of air pollution than White or Asian communities. Air pollution contributes up to 43,000 deaths in the UK per year. According to government data from 2022 - London has the highest percentage of deaths attributable to air pollution, with an estimated 4,000 deaths caused by air pollution each year.
Until now, no research to date into air pollution and pregnancy has spoken directly to the communities that are more adversely affected. This ground-breaking report spoke to Black mothers and pregnant women living in London boroughs to determine existing knowledge, behaviours and attitudes to air pollution.
The report has found that the majority of Black mothers (66%) know a little about the impact of air pollution on their health, with just over a third (38%) stating that they know a lot. However, when asked about the effects of air pollution on health during pregnancy, almost half (44%) stated that they knew nothing at all, rising to 58% who felt that they knew nothing at all when it came to the health of their baby in the womb.
Whilst the majority of respondents are concerned or somewhat concerned about the impact of air pollution on their health, their baby’s health, and the long-term impact of air pollution on their child once born, the findings show that just over a quarter (26%-31%) reported that they were not at all concerned. This rises to 49% for Black Caribbean respondents, in comparison to 25% of Black African and 17.5% of Mixed respondents.
Agnes Agyepong, CEO of Global Black Maternal Health said: “We wanted to commission this report to take the first step towards truly understanding the disproportionate impact that air pollution can have on Black communities. Many times reports show race is an increased risk factor, but rarely do these reports delve into the contextual nuances and systematic issues at play. Previous studies of air pollution have not included the very women who are amongst the most impacted. We stand at a crucial crossroads. We have the power to effect change, and to challenge the systems that perpetuate these disparities, and it starts with amplifying the voices of Black women.”
The report does also indicate the positive effects of education on action too, with 54% of respondents indicating that they had made some changes to their lifestyle in their current or most recent survey, but over a third (39%) still had not. Some mothers could not for various reasons, including systemic barriers to action (for example, having a limited choice about the area in which they live).
Dr Karen Joash, Consultant in Obstetrics and Gynaecology “It is now known that particles from air pollutants reach the placenta interface as evidenced by microscopic studies. These particles are likely to lead to epigenetic changes and imprinting which is passed through the generations to have long lasting health effects in these communities. This simply demonstrates the wider determinant of health. When the air that communities breathe brings disease rather than life it leads to inequitable outcomes from birth. The findings of this report must trigger change and trigger research, system and policy change to lead to cleaner air for all.”
Air pollution is a worldwide issue, with almost all the global population breathing air that exceeds WHO guideline limits. Research shows that air pollution is now responsible for 20% of deaths globally. It is already recognised as a significant threat to health at Government level and initiatives to improve the air quality (such as the Clean Air Strategy and London’s ULEZ scheme) have already been implemented. Its significance has also been realised in the context of England’s National Health Service, with the UK’s first Children’s Environmental Assessment Service at the Royal London Hospital (Barts NHS Health Trust) set to open in 2023.
Nikita Sinclair, Portfolio Manager at Impact on Urban Health, said: “Time and time again, research shows that the health effects of air pollution are unfair. And a significant example of this inequality is that air pollution affects the health of unborn babies still developing in the womb.
“As the first-ever air pollution study speaking directly to Black mothers and Black pregnant women, this research will bring previously unheard experiences to life. Perspectives uncovered through this partnership will challenge policymakers and professional bodies to do more to protect the health of Black mothers and babies in cities.”
The report recommends that efforts must now be made to convey the health impacts of air pollution to those communities deemed most at risk in a way that is meaningful and engaging. There are clear avenues for offering this education within antenatal care. Recommendations include policy-level action to actively drive down the levels of pollution in the worst affected areas, increasing awareness and education of air pollution both inside and outside of the home and building a bridge between communities that are most affected and policymakers.