It’s in the Groundwater

Bayard Love and Deena Hayes-Greene of the Racial Equity Institute developed the groundwater approach metaphor to help build a practical understanding of structural racism. Our SURF group talked a lot about this metaphor, and the imagery of groundwater was in my mind while creating this piece.

In a 2021 article published in the American Journal of Obstetrics and Gynecology titled “Urban-rural differences in pregnancy-related deaths, United States, 2011-2016”, researchers “sought to compare pregnancy-related mortality across and within urban and rural counties by race and ethnicity and age”. The following table is presented in the article:

In this animated data art piece, each confidence interval in Table 3 is represented as a line of water dripping deeper and deeper into the ground. Different colors are used to distinguish the different race and ethnicity groups, ordered by lowest to highest risk.

If we think how a more typical data visualization might present the data in Table 3, we might imagine something like this:

A few notable observations:

• within each race and ethnicity group, pregnancy-related deaths increase the more rural a county is

• within each urban-rural categorization, pregnancy-related deaths are lowest among “White” or “Hispanic” and highest among “Black” mothers

• there is substantial uncertainty around some of the estimates, particularly for the “American Indian or Alaska Native” group

Most notably, the highest pregnancy-related mortality ratio among “White” mothers (19.7 deaths per 100,000 births, 95% CI: 16.9 - 22.8, in the most rural counties) is much lower than the lowest pregnancy-related mortality ratio among “Black” mothers (36.7 deaths per 100,000 births, 95% CI: 34.3 - 39.3, in the most urban counties).

In the data art piece, the y-axis is flipped such that the higher the pregnancy-related mortality, the deeper the water line seeps into the ground.