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Each year in the United States, an estimated 700 to 900 women die from pregnancy or childbirth-related causes, while another 65,000 nearly die, according to the Centers for Disease Control and Prevention. It’s the highest rate of maternal mortality in the industrialized world.

Within the U.S., there are drastic racial disparities — black mothers die at three to four times the rate of white mothers. As NPR previously reported:

“A black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 300 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition.”

And then, there are the babies. In Minnesota, African-American and American Indian infants are more than twice as likely as white babies to die in their first year.

Many social scientists and medical researchers agree that the disparities in maternal mortality is due to racism, not race. And there’s a growing consensus that racial discrimination experienced by black mothers during their lifetime makes them less likely to carry their babies to full term.

“Structural racism will restrict access for black women or people of color in general to health-promoting factors like wealth, income, safe housing, quality of education and health care, and the result is a disadvantage,” said Rachel Hardeman, an assistant professor at the University of Minnesota who researches health equity. “There have been studies throughout the years that have actually looked at how that accumulated process can really impact the health and well-being of African-American or black women.”

And that’s before they even get to the hospital or the delivery room.

Unconscious or implicit bias can also play a role in the quality of care or a woman’s relationship with her physician. Some women have reported feeling disrespected by their health care providers, while others say they’re even made to feel apologetic for being pregnant, said Clara Sharp, a doula at Ahavah Birthworks.

That’s where culturally centered care can step in, when expectant and new moms can develop a relationship with someone who looks like them and can relate to them. That can lead to mothers seeking more care during and after pregnancy.

“We’re a safe person to talk to. These moms are not going to tell everything to their providers. They’re not going to talk about all their struggles. They’re not going to talk about what stresses them every day,” Sharp said. “But that sister doula — that’s what we call ourselves — she’ll talk to her about that.”

Read more and listen to the full conversation on MPRNews.org.

The Department of Business, Economic Development and Tourism (DBEDT) released a report recently, “Demographic, Social, Economic, and Housing Characteristics for Selected Race Groups in Hawaii,” which shows the different lifestyles among the 14 top race groups in Hawaii.

“We have the most diversified culture, workforce, and lifestyle among all the states in the nation,” said DBEDT Director Luis P. Salaveria. “This gives us an advantage in terms of international trade and tourism by supplying the diversified work force and providing a wide variety of food and cultural activities. At the same time, there are more demand for government and private services, especially in the areas of education and health care.”

Chief State Economist Dr. Eugene Tian noted that the Pacific Islander groups (Samoan, Marshallese, Guamanian or Chamorro, and Tongan) have significantly larger household sizes, higher poverty rates, higher unemployment rates, lower home ownership, and lower per capita income. Population in these groups are the youngest in the state.

Some highlights from this report are:

• Nearly a fourth, 23.7 percent of Hawaii’s population identified as multiracial during the 2011-2015 period while the share of multiracial population in the U.S. was 3 percent during the same time period.
• The top five “race alone or in combination” groups were as follows: White (43 percent) Filipino (25 percent), Japanese (22.1 percent), Native Hawaiian (21.3 percent) and Chinese (14.1 percent).
• The median age in Hawaii was 38 years old. Of the groups studied, Japanese had the oldest median age at 43.9 years, and the Marshallese had the youngest median age at 18.5.
• 53.8 percent of the population living in Hawaii during the 2011-2015 period were born in Hawaii. Native Hawaiians had the largest share of native-born population. The Marshallese had the largest share of foreign-born population.
• An estimated 33.5 percent of all households had at least one child living in it, and an estimated 32.5 percent of households had at least one person 65 or older living in it.
• More than 95 percent of the White, Japanese, Black or African American, and Okinawan populations in Hawaii had at least a high school diploma during the 2011-2015 period.
• Blacks or African Americans aged 16 and older had the highest rates of labor force participation in Hawaii. Okinawans had the lowest civilian unemployment rate during the 2011-2015 period.
• One-tenth, 10.4 percent of civilian workers in Hawaii were self-employed during the 2011-2015 period. The Vietnamese had the highest rates of self-employment.
• The median household income in Hawaii was $69,515. Of the top five largest race groups in Hawaii, Filipinos had the highest household income and Native Hawaiians had the lowest.
• An estimated 7.7 percent of families in Hawaii lived in poverty during the 2011-2015 period. An estimated 11.2 percent of all people in Hawaii lived in poverty.
• Homeownership rates in Hawaii were among the lowest in the nation. An estimated 56.9 percent of homes in Hawaii were owner occupied while the U.S. home ownership was 63.9 percent. Only three race groups had homeownership rates greater than the national average: Okinawans (77.3 percent), Japanese (73.6 percent) and Chinese (64.1 percent).

Read more on TheGardenIsland.com

The following was written by and from the perspective of Henry Berman on the Exponent Philanthropy Blog.

I’ve come to think of myself as a storyteller. Not in the sense of a professional who can weave a tale, but rather someone who listens, observes, reflects, and then shares.

My first life—the one before nonprofits and philanthropy—was in film, video, multimedia, and communications. I also studied education, and my success was found at their intersection—fusing the disciplines of communications and learning to change audiences’ behaviors.

As I moved into the world of nonprofits as a board member, fundraiser, and, in one instance, a museum founder, I’ve brought a film director’s perspective of considering the entire script first, before pushing in for the details and intimacy of the close-up.

When I was given the gift allowing me to add foundation trustee to my resume, the same skills I honed as a storyteller became infused in my work, as I hope they are in yours. Perhaps more than anything, a good story has the power to make us think and act.

As you work with funders, volunteers, board members, and colleagues, you want your story to shine. Which means that you need to tell it the way you want, lest someone else tells it for you.

How then do you do this?

If you read up on storytelling, you’ll find many techniques and lots of “how to” advice for crafting a good story. I encourage you to find and study those resources, keeping in mind that not all of them will work for you every time. Find those that resonate and build on them.

In my case, I keep returning to two basic mantras that for decades have served as my guide and kept me grounded: (1) take the audience from the familiar to the unfamiliar, and (2) always make sure they can see themselves in the story.

Let’s unpack those from a nonprofit’s perspective.

Take the audience from the familiar to the unfamiliar

Imagine for a moment your nonprofit provides programming using art to support the social and emotional growth of children with autism. Now also imagine you want to explain your work to someone with no understanding of this kind of treatment—or perhaps even autism.

Too often we tend to jump directly to speaking about the results, without any context. We arrive at the destination, but our listeners miss the richness of the journey.

Now think if you craft a story that begins by asking if anyone in the audience has been involved in creating art. Painting or photography, perhaps. Or spent time admiring art—maybe while visiting a local museum. Then you might ask how they felt. Did it calm them? Did it allow them to express feelings in reaction to the experience?

In doing this, you’re directing them to the path you want them to follow. You’ve focused them on what they know and possibly experienced: the opportunity art offers for expression. And, from there, it’s a few short steps to showing the parallels to your work.

Make sure the audience see themselves in the story

Making sure your audience can see themselves in the story involves a similar way of thinking. Let’s use the same example and assume you’re asking funders to support your organization.

As you tell your story, keep your audience front of mind. Think about how your story can become their story. Think about it as the gateway into their imagination where they can see potential. Where they can dream, think, and go beyond boundaries to consider new possibilities for support, cooperation, involvement, and more.

I suggest you include the thoughts of someone whose child or grandchild has benefited from your program—ideally someone similar to those in your audience. You want your audience to hear their own voices.

Film director and storyteller Sidney Lumet (think 12 Angry Men, Dog Day Afternoon, Network, Fail-Safe, and Serpico among many others) said, “While the goal of all movies is to entertain, the kind of film in which I believe, goes one step further. It compels the spectator to examine one facet or another of his own conscience. It stimulates thought and sets the mental juices flowing.”

Isn’t that exactly what you want with your stories? To prime others to engage with your worthy cause?

One final note to my fellow funders reading this post: A compelling story told in a way that engages requires an audience willing to listen. Open your eyes, ears, and mind to the stories of your community and consider how hand-in-hand you can craft the story’s next chapter.

Read more on ExponentPhilanthropy.org.

Growing up, Joyce Guo rarely talked about sex or intimate relationships with her parents, conversations that might have been more difficult because she identifies as queer and gender nonbinary.

“I think I probably would have wanted a more open dialogue about gender and sexuality,” said Guo, 20, a sophomore at Columbia College Chicago. “I think the general noncommunication came from both sides.”

New research from Northwestern University explores how parents of LGBTQ teens often struggle when discussing sex with their children, sometimes because of discomfort or lack of information. However, a separate university study of gay and bisexual male teens found that many longed to be closer to their parents and better able to converse with them about sexuality and dating.

Historically, there’s been very little academic study of how parenting can affect the sexual behavior of LGBTQ youths, said researcher Michael Newcomb, associate director for scientific development for the Institute for Sexual and Gender Minority Health at Northwestern’s Feinberg School of Medicine.

“We know a lot about how parents can influence the heterosexual teen’s sexual health, but we know very little about how parents can affect the sexual health of LGBTQ teens,” he said. “And in some ways, the same parenting practices would be relevant to LGBTQ teens, like talking to your kids about sex, monitoring who they’re hanging out with, who they’re dating, all those types of things.”

Yet even among parents who were open to talking to their children, many acknowledged a level of ignorance when it comes to LGBTQ sex.

“Those parents are unintentionally leaving out information that’s very specific to LGBTQ sexuality that might leave those young people unprepared for the situations they would have to encounter and can put them at risk,” Newcomb said.

The study, published last month in the journal Sexuality Research and Social Policy, surveyed 44 parents of LGBTQ teens from across the country in online focus groups.

More than three-quarters of parents reported talking with their teen about using protection and about half described educating their kids about potential health risks. Roughly a quarter were concerned about predators or violence, particularly the parents of gay boys and transgender teens.

“I wanted my daughter to know that if you do not tell your partner you are transgender from the beginning, they might kill you,” the mother of a 17-year-old heterosexual transgender teen told researchers.

One mom who was feeling ill-equipped to answer questions sent her bisexual daughter to a lesbian friend. “I felt challenged that I’m straight, my daughter is dating a gal, and I didn’t know anything about that,” she said. “All my sex talks were about how not to get pregnant and how babies are conceived.”

Some parents reported feeling isolated because they didn’t have other parents of LGBTQ teens to talk with or compare parenting strategies with.

“One thing that has me wondering is how other parents of (LGBTQ) teens deal with same-sex overnights,” said the parent of a 14-year-old. “At (my child’s) age, we would never allow (her) to spend the night with the opposite sex if she were straight.”

The majority, though, reported that the sexual orientation or gender identity of the child didn’t impair communication or change the content of those discussions. One mother said she gave the same advice to her gay son and straight son. “Use condoms, no means no, and be careful who you share your body with,” she said.

However, Newcomb said this kind of equal and fair parenting can have unintended consequences if parents are leaving out additional information on sexual health and safety that might be necessary for LGBTQ teens, depending on the kind of sex they’re having.

In another recent study, researchers from the institute surveyed 52 gay or bisexual teen boys on communication with their parents about sex.

Fifty-six percent said their sexual orientation had a negative effect on their relationship with their parents, some reporting hostile exchanges or derogatory labels.

One 15-year-old boy said he and his father argue a lot, sometimes about his sexuality. “He and I were arguing once and he called me and my ex ‘faggots,’ and that’s the worst I’ve been mad at him,” he said.

But 26 percent reported no change after coming out, and another 10 percent said relationships with family members actually improved.

While many parents surveyed reported that their children were not having sex or in relationships, some of the teens who were interviewed indicated that they are sexually active or dating but hiding it from their parents.

Newcomb added that there can be more incentive for LGBTQ teens to hide relationships or sexual aspects of their lives if they’re more afraid of being judged or misunderstood by adults than straight teens.

“(Me) being gay has made my parents act more cautious about my relationships instead of being happy for them,” said one 16-year-old. “For this reason, I don’t tell my parents about relationships because I don’t want them to be overly worried for no reason.”

Newcomb encouraged parents of LGBTQ kids to broach the topics of sex and dating, even if they think their children haven’t entered that stage of life yet.

“The more information we can give to people, the more we can demystify what sex is actually like, it allows young people to be more prepared to have sex safely,” he said.

Guo, who was not part of the research, said that without communication from their families, many LGBTQ youths search for other outlets like the media or popular culture for guidance on sex and relationships.

“It caused me to fall into not-so-great situations,” Guo said. “When it comes to seeing queer representations … through the eyes of media, oftentimes there’s no humanity to it or they’re two-dimensional. There’s very low standards.”

Read more on ChicagoTribune.com

When we first see Elizabeth Bennett, in the 2005 film of Pride and Prejudice, she is walking through a field, surrounded by birdsong and trees. Nature, for Jane Austen’s heroines, is always a source of solace and inspiration. And as Florence Williams shows in her new book, The Nature Fix: Why Nature Makes Us Happier, Healthier, and More Creative, modern technology is now revealing what goes on in our brains when we step outdoors—and why nature is so good for us.

When National Geographic caught up with Williams by phone in Washington, D.C., she explained why even a house plant can make us feel good, why the practice of “forest bathing” is now supported by the Japanese government, and how trees can lower the murder rate in our cities.

National Geographic: You open your book with a simple question: “What makes people happy? Does place matter, or not so much?” Tell us about the Mappiness project—and what you call “our epidemic dislocation from the outdoors.”

Williams: The Mappiness project was developed in the U.K. by a happiness researcher called George MacKerron. It’s a brilliant idea, which tries to capture in real time what people are doing and how it makes them feel. I downloaded this app onto my phone and used it for about a year. The way it works is, it pings you at random times a couple of times a day and gives you a list of options. Are you driving, doing childcare, cooking, hanging out with friends? Are you outside or inside and how are you feeling? Like, “I feel happy, not so happy.”

At the end of the year I got my data, which showed how I was spending my time and which activities made me feel a certain way. I try to spend a lot of time outside, make an effort to exercise. But I was shocked at how few times the app caught me doing those things; and how often it caught me doing things that didn’t give me a lot of satisfaction. Things like commuting or doing chores.

One of the things I found out was that most people are not that happy when they are at work. They’re happiest when they are on vacations, with friends, making or listening to music. One of the surprising finds was that they’re also very, very happy when they are outside.

The epidemic dislocation from the outdoors, as I call it, has been occurring for the last several decades but has gone very little remarked upon. Children, adults, we are all spending vastly less amounts of time outside than we used to. For example, 70 percent of today’s mothers in the U.S. recalled playing outdoors every day as children but only 26 percent of them say their kids play outside daily. That’s a huge change. After school, kids used to come home, meet up with their friends, and go run around the neighborhood. I used to do that. Now kids are totally scheduled. If they are outside, it’s with adults in some organized sporting activity. There’s not that free, exploratory play that a lot of experts think children need in order to gain a strong sense of themselves and learn social skills and problem solving.

National Geographic: You write, “Science is now bearing out what the Romantic poets knew to be true.” Tell us what the latest neuroscience is telling us about the therapeutic effects of nature.

Williams: The Romantic poets emerged during the dawn of industrialization. They saw tremendous benefits to being in places that weren’t crowded or dirty, that were more pastoral, like the Alps. The alpine tour took off in the late 18th century to early 19th century. What was unique about it was that it wasn’t about finding peace in God or finding religion. It was about this more immediate connection to nature and how that spurred our spiritual imaginations, how being in more rural, natural environments made us whole as people. You see it in writers like Wordsworth, Coleridge, or Rousseau but also in novelists, like Jane Austen, whose heroines always go marching out when they’re upset or need to work something out.

Today, technology is allowing neuroscientists to take some of their measurement devices into the field, like these portable EEG units that are capable of measuring brain waves, away from the lab. Neuroscientists, especially in the U.K. and U.S., are starting to look at how people’s brains respond to different environments. What they’re seeing is that if their volunteers are walking through a city or noisy area, their brains are doing different things than if they are walking in a park. The frontal lobe, the part of our brain that’s hyper-engaged in modern life, deactivates a little when you are outside. Alpha waves, which indicate a calm but alert state, grow stronger. When psychologists talk about flow there seems to be a lot of alpha engagement there. Buddhist monks, meditators, are also great at engaging alpha waves.

National Geographic: A study in Illinois even showed that proximity to nature can lower the murder rate. Do we just need to plant trees and we can dispense with cops?

Williams: [Laughs] In Illinois, Frances Kuo looked at housing projects with a lot of trees versus those without trees, and she found a lower crime rate and lower rates of aggression. She thought that exposure to nature was an indirect but still significant effect. It wasn’t necessarily because the trees were causing people to be less violent. It was that living in a place with trees created an environment where neighbors spent more time outside, hanging out in their courtyards, talking to each other. These social connections were facilitated by green space. It’s a very interesting and under-recognized aspect of green space.

National Geographic: One of the pioneers of urban parks was Frederick Law Olmsted. He’s one of your heroes, isn’t it?

Williams: He is! He was kind of like Zelig; he kept showing up in significant parts of American history. He was a journalist for a while and spent time in the pre-Civil War South documenting slavery. He made some very cogent arguments against it, and was one of the first people to do that for a major newspaper. As a restless child, he didn’t like school but he loved trees and tramping through the countryside. Later, while spending time in California working as a mining engineer, he saw Yosemite and made some of the first, most cogent arguments about why Yosemite should be protected.

Then, of course, he designed Central Park, one of the most famous parks in the world, and went on to design city parks all over the U.S.. What he did that was different and significant was that he recognized that people needed nature in order to get along with one another, in order to be their best selves, that it was a place where people could let off steam, especially the working classes, who normally didn’t have access to green spaces. Beautiful parks were the preserve of the gentry and Olmstead recognized that there was a class injustice with regard to access to beautiful spaces. He had a social mission to create parks that could be used by all people, which is a fundamentally democratic idea. He distributed flyers to doctors’ offices in poor neighborhoods all over New York City telling doctors: Please tell your patients to go to Central Park because it will help them feel better! [Laughs] He was way ahead of his time!

National Geographic: In Japan, people do something called shinrin yoku, or “forest bathing.” Tell us about Yoshifumi Miyazaki and the health benefits of this practice.

Williams: [Laughs] It’s not exactly a bath. Forest bathing refers to being in an environment where all your senses are engaged. Something researchers in Japan recognized about urban life is that when we are indoors we rely mostly on our eyes and ears, but our other senses are underutilized. They think this is partly related to why outdoor environments make our stress levels go down. We can hear the sound of a creek gurgling, feel the wind blowing on our cheeks or smell the aroma of the woods, especially in Japan where there are lots of wondrous cypress trees.

Our sensory system evolved in the natural world and when we’re in those spaces, our brains become relaxed because these are things that we were designed to look at, hear and to smell. Miyazaki is one of the researchers who are trying to quantify this kind of mystical experience by measuring people’s heart rates, blood pressure, and cortisol levels. They have made some amazing discoveries. For instance, our immune cells, or “natural killer cells,” which fight cancer, increase in forests. As a result, Japan now has 48 therapy trails. The forest service is taking this seriously, as a public health benefit. They’re medicalizing the forest!

National Geographic: Soldiers who served in Iraq and Afghanistan sometimes suffer from severe PTSD. Tell us about the river-rafting trip you did with a program called Higher Ground.

Williams: It’s one of the neatest things I’ve ever done. I was invited on an all-women’s rafting trip for six days down the Salmon River, in the middle of the largest wilderness area in the lower 48, continental U.S. The participants were all veterans from various U.S. wars; some were older, some younger women, some had been in combat inadvertently because they had been driving convoys on roads that were filled with bombs. Some had experienced what we call “military sexual trauma,” or MST, which unfortunately is very common.

They suffered from a range of physical and also severe psychological wounds. Some hadn’t left their homes in months or suffered from tremendous anxiety and depression, yet they were brave, tough women who had been in the armed services. Here was an opportunity for them to be together and experience nature. At the beginning, they were very withdrawn and angry. So I could watch them come out of their shells as the days went by. They told me they were sleeping better than they had slept in months, laughing with each other and gaining renewed confidence in their physical abilities because they were paddling these inflatable kayaks, doing things independently, which they hadn’t done in a long time. They were also in an environment that was calm and visually interesting. So they were able to bond with each other, socially, which is something the wilderness provides. It was potentially life-altering experience for them. And it was great for me, too.

National Geographic: Tell us about “the nature pyramid” and other practical strategies you can pass on to readers to use to get a bit more nature into our lives?

Williams: The nature pyramid is the idea that nature is something we have every day. One of the things we’re recognizing is that, like other medicines, nature follows a dose curve. A little bit of nature is helpful; a little more nature is even more helpful. If we think about how to access a little bit of nature in our daily lives, that’s a great start: house plants, going for walks on streets with trees and, as you move further up the pyramid, making an effort maybe once a month to go to a nature preserve or park outside the city. We are so fortunate in America. We have these incredible wilderness spaces and national parks, and science is showing that when we spend time in those spaces, it can be tremendously helpful for our sense of self, for problem solving, social bonding, and rites of passage.

In Finland, public health officials now recommend that citizens get 5 hours a month, minimum, in the woods, in order to stave off depression. This is evidence-based. They found that people need this time in order to preserve their mental health. A lot of Asian countries have also figured out that nature should be a fundamental part of democracy; that it’s a human right and a necessity. They try to incorporate nature into the fabric of everyday urban life. Nature isn’t something apart from city life. Nature is a part of it. In Singapore, they have the City In A Garden concept. You can’t build a skyscraper now without incorporating greenery on to the building itself! People have gardens on the roofs or on walls. Public housing projects have beautiful courtyards. I found that very impressive!

Learn more on NationalGeographic.com.

The idea of arts on prescription and social prescribing may seem like a new one, but it is actually more than 10 years since UK government policy first referenced linking patients with non-medical support in the community.

In the past couple of years, however, calls for the arts to be a core component of social prescribing in the UK have been growing. A recent report by Arts Council Wales, for example, has backed the idea. And, last summer, recommendations were put forward by an all-party parliamentary group for clinical commissioning groups, NHS trusts and local authorities to incorporate arts on prescription into their commissioning plans and redesign care pathways where appropriate.

At present there are a number of arts on prescription programmes operating around the UK – encompassing all kinds of human creativity including seated dance, creative writing, forum theatre and object handling in museums. There is a growing body of evidence which shows that different arts being prescribed have a positive impact on a variety of health conditions. One recent review, for instance, reported ten key benefits for those involved in these kinds of schemes. They included self esteem and confidence boosts, physical health improvements, better social connections and the acquisition of new skills.

But why the arts? Social prescribing aims to address the social causes of ill health and give people the support they need – such as advice about benefits, employment and housing. It can also include access to exercise, volunteering, and arts and creative activities. So it may seem like an advice system might be just as useful – but actually prescribing specific arts activities can have some unique benefits.

Mental health and wellbeing

There is growing evidence that several different types of arts schemes are not only cost effective, but can improve wellbeing and have a positive impact on levels of anxiety and depression.

Take singing, for example. Research has demonstrated that it can have a positive impact on mental health and wellbeing. In fact, several studies undertaken with older people have found that community singing appears to have a significant effect on their quality of life – helping ameliorate the effects of anxiety and depression. In addition, findings from a recently published study have demonstrated that new mothers taking part in singing and music groups experience a faster reduction in post-natal depression symptoms than those in control groups.

As we age, we are at risk of experiencing loneliness and social isolation through loss of social networks, as well as facing new limitations as a result of decreasing physical health. The arts can create social connections – and research has shown that participation in arts programmes enables older people to get in touch with others and extend existing networks of support in their communities, helping to alleviate loneliness and isolation.

The ongoing project, “Creative Journeys”, is looking at ways that the arts can help build social relationships in residential care homes. The study is due to finish in October 2018, but early indications are that the arts activities increase social interactions between residents, and between residents and staff with improved mood and wellbeing as a result.

Not only does evidence suggest participation in the arts may delay the onset of dementia, but also that it can impact on cognitive functioning, through stimulating memories, and attention. In addition, art-making can improve the mood, confidence and social engagement, of people living with dementia, and has been shown to enhance the relationship between the carer and the cared for.

Long-term conditions

Arts activities are also effective alongside treatment of a number of long-term conditions. Music, singing and visual arts can all improve confidence and the quality of life of people with stroke, for example. People living with Parkinson’s disease who take part in group singing and dance experience improvements in their voice and movements too.

In addition, the British Lung Foundation supports singing groups for people with chronic obstructive pulmonary disease (COPD) – and research has indicated that there are improvements in lung function and quality of life for people who join “singing for breathing” groups.

Whether it is traditional art lessons, joining a community singing group, or any other creative activity, the evidence is clear: participating in these activities has a positive impact on health and wellbeing.

Read more on TheConversation.com