America, take a look in the mirror.

America, take a look in the mirror.

The United States is not unequivocally and indisputably the greatest nation on Earth. Sure, it has its many benefits, but it also has a huge number of flaws. This simple statement may spark anger and outrage from some. To others it is not shocking or surprising, it is their reality. But it certainly runs contrary to the recent reoccurrence in nationalist thought and rhetoric, mainstreamed most recently by the Trump administration and supporters. There is a clear message from many in power: “America is the greatest nation in the world”, and seemingly, those who would challenge that are our enemies.

The concept of “American exceptionalism”, this idea of the United States being somehow unique and immune from forces which other countries face, is not new. Throughout the history of the country there have been ebbs in flows in the terminology and manifestation of this thought, but the basic principle has held constant. An interesting history of American exceptionalism thought and the term can be found here. Throughout our history, the prevailing thought that America is above the rest has been consistent.

By no means is the United States a terrible nation, far from it, and one would be remiss to not acknowledge the many privileges and freedoms afforded to the people in the United States. When the United States is viewed relatively, in the context of all other countries, it is stable and secure and has relatively good access the basic needs and rights to food, clean water, healthcare, and education.

However, one would also be remiss to not acknowledge the many ways in which the United States is lacking and falling behind other industrialized, high-income nations. An ethnocentric promotion of American superiority and ideas demonstrates a clear lack of critical reflection and moreover, dangerously ignores the ways in which the United States fails in terms of healthcare and equality for women. There are, of course, a myriad of other issues that could be (and need to be) discussed in the U.S. context as well, including economic and social inequality, racism, xenophobia…the list goes on. However, for the purpose of this piece, the focus is an aspect women’s healthcare, maternal mortality rate. There is far more to a woman’s health, yet maternal mortality rate is an almost universally used and recognized metric for women’s health.

The U.S. currently has the highest rate of maternal mortality of any developed country in the world. Let that sink in for a moment. Women in the U.S. are more likely to die than women in any other developed nation. Other nations around the world are working hard to lower the rate in their country, and there has been significant improvements. For example, the maternal mortality rate in a number of sub-Saharan countries has been halved since 1990; in Asia and North Africa the improvements were even more significant (Full WHO report). And yet, shockingly, in the U.S. the rate of women dying of pregnancy-related complications is continuing to climb upwards.

These rates are absolutely inexcusable in a country that possesses the level of resources and medical advancements that exist in the U.S. How could it be that an increasing number of women are dying during pregnancy and childbirth, often from preventable causes, in the “greatest” country in the world?

This is infuriating enough. And yet, racism, which we cannot forget lies in the bedrock of this “great” nation, compounds and worsens maternal mortality rates even further.  Compared with white women, black women are 3to 4 times as likely to die due to pregnancy-related causes.

Until we can prevent more and more women from losing their lives in a process which is fundamental to all human life, we cannot purport superiority as a nation.

With the culture of American dominance, it may be that many citizens, including women, don’t even realize this shocking status indicator of health (or more appropriately, lack thereof). Women may not even realize that the dangers they face and the challenges the encounter in the health care system are not inevitable and unpreventable. Every other developed nation has found a way to manage these issues and risks far more successfully than the U.S.

A chart detailing the high spending of the U.S. on healthcare expenditures

The United States needs to reflect inwards and take an honest and critical look at the many ways in which disparities in health still plague our country. The ability to be pregnant and give birth safely, regardless of race or socioeconomic status, should be the bare minimum of our expectations for health care in the United States. Our society cannot function without healthy mothers and healthy babies-this truly is the basis of all life. Moreover, the inequality and issues do not end there. Full access to all types of healthcare are out of reach for many women in the U.S. This is due, in part, to exorbitantly high medical care costs and inequality in insurance coverage and ability to pay. 

It is with this knowledge that American citizens and organizations must be extremely cautious about promoting the United States and its policies as superior to all others. Not only does this ignore the very significant and real issues at play in the United States, it also pushes colonial thought which assumes that the United States and its culture are better than those found in “developing nations”.

The United States has a long history of sending delegations, money, and in-kind aid to nations we perceive to be still “developing”. In many instances this aid and support has been warranted and helpful, and yet there are also many examples of times when that help was at best, innocently but culturally misguided or at worst intentionally harmful or self-serving to American interests.

 

A cautionary tale of this practice can be found in the ubiquitous feminist book on women’s health, “Our Bodies, Ourselves”, specifically the Spanish language edition, "Nuestros Cuerpos, Nuestros Vidas". This book was not written to consciously or intentionally promote the United States as superior and it many ways its spread was a wonderful example of a global movement of social change. However, when this book was simply directly translated into Spanish, it drew the ire of Latina women reading it who claimed that it was written from a white, Western, and middle class women’s experience, which did not recognize that others have very different lived experiences.

This example serves to show that when dealing with other nations in any regard, the United States needs to be quick to recognize the ways in which it is carrying and continuing ethnocentric assumptions that position the United States as the center, norm, and end goal for other nations. While this was not the intention of OBOS, it is understandable that Latina readers would have a knee-jerk, negative reaction to the directly translated book, given the history of American exceptionalism thought and practice.

The United States of America is not the greatest nation on Earth. How can it be when there is still such shocking disparity and failings in healthcare for women? As a nation, we have a lot of inequity, disparity, and issues that need to be discussed and resolved. We can start with halting the rise in maternal mortality rates, but it can’t end there for women’s health or for the health of all citizens. Before we proclaim our superiority or try to pass on our ideas and policies to the world without cultural adaptation, we need to take a long, hard look in the mirror.