Dr. Emily Smith-Greenaway Shares Research on Bereavement’s Far-Reaching Impacts

Earlier this month, Evermore hosted a conversation with Dr. Emily Smith-Greenaway, a grief and bereavement researcher in California and associate professor of sociology and spatial sciences at the University of Southern California, to discuss her research on bereaved people and her work on the COVID-19 bereavement multiplier.

The bereavement multiplier is a tool used to track how many people have been directly impacted by a COVID-19 death. According to research findings from Dr. Smith-Greenaway, on average, for every death due to COVID-19, approximately nine people have been or will be bereaved. With more than 1 million Americans having died of COVID-19 thus far, that leaves approximately more than 9 million people bereft.

COVID-19 multiplier over the course of the pandemic in the United States“This multiplier [tool] allows us to really track how many bereavement events there have been in the midst of an ongoing mortality crisis,” says Dr. Smith-Greenaway. “This gives us a really different scale of the height of this mortality crisis by emphasizing how many people have been intimately affected by COVID mortality.”

While the Centers for Disease Control and Prevention measures deaths in the United States, it doesn’t measure how many people are impacted by those deaths. Dr. Smith-Greenaway’s multiplier tool therefore offers an important and useful way to begin to understand the scale and impact of bereavement in this country.

“We can absolutely extend this approach to other causes of death,” says Smith-Greenaway. “What I think is so useful about that is that I expect there will be inversions sometimes – how some less common causes of death may still have an outsized effect in terms of bereavement. It’s a tool we can absolutely use to really get a sense of the lingering effects of certain mortality crises the U.S. is facing beyond COVID.”

Dr. Smith-Greenaway’s research also examines the ways in which social inequality intersects with mortality and how those disparities affect the experience of survivors, at an international scale.

“Inequality and mortality conditions also mean inequality in access to kin and social support and this really unequal burden of bereavement that we see playing out across the globe,” says Dr. Smith-Greenaway. 

Dr. Smith-Greenaway’s work found that younger people are disproportionately impacted by COVID-19 deaths. 

“Really early in the pandemic, the narrative was that this mortality shock was disproportionately affecting older adults,” says Smith-Greenaway. “We see actually it’s younger people who are bearing the brunt of these losses because they’re disproportionately losing grandparents and parents.”  

https:///youtu.be/tmUx2tj6TcA

In a study that followed a group of young children from birth through adolescence, Dr. Smith-Greenaway found that the death of a maternal grandparent played a significant role in the academic success of young boys. Data showed that boys who lost a grandparent earlier on in life – between the ages of five and nine – are significantly more vulnerable to lowered cognitive skills for reading comprehension and verbal and math ability. 

“This is really striking because developing these skills on time is really important for youths’ subsequent academic skills and their subsequent behavioral outcomes and academic outcomes,” says Dr. Smith-Greenaway. “Interestingly, we’re not finding anything in terms of young girls.”

Dr. Smith-Greenaway surmises this disparity is a product of the way we typically socialize boys into muting their grief. This type of socialization could be the direct cause as to why research points to these disadvantages in academic skills. 

According to Dr. Smith-Greenaway, it’s the impact of bereavement on boys from historically marginalized communities that are really driving the effects seen in the data. Non-Hispanic Black boys and Hispanic boys showed significant impacts to their verbal, math, and reading abilities after experiencing the death of a grandparent between the ages of five and nine. 

Dr. Smith-Greenaway’s work also found that Black and Hispanic boys suffered from more severe depressive systems when compared to their white peers after the death of a grandparent. 

“There’s also work emphasizing how racial minority boys, in particular, tend to have this ‘suffocated grief,’” says Dr. Smith-Greenaway. “Their grief is viewed as just bad behavior, or acting out, rather than acknowledging that it’s just their very normal reaction to a loss.”

In a global study on the deaths of children under five, Dr. Smith-Greenaway discovered some monumental disparities, not only in child loss, but also in the impact of those losses on mothers. This study found that 30 to 40 percent of sub-Saharan African mothers between the ages of 20 and 44, have experienced the loss of a child – a number that increases to 50 to 60 percent for women ages 45 to 49. 

Dr. Smith-Greenaway’s work highlighted striking inequalities in child loss between women in African countries compared to women in other countries. For this research, Smith-Greenaway looked at demographic and health survey data spanning more than 20 years for mothers of multiple age groups in 20 sub-Saharan African countries.

While many initiatives have focused on the disparities in infant mortality between white and African communities, the disparity is even greater when looking at mortality in children. 

Total child loss burden among mothers 45-49 years old, expressed per 1,000

“In some sub-Saharan African countries, it’s more common to have witnessed a child die than it is to have witnessed all of your children survive beyond the age of five,” says Smith-Greenaway. “This work is trying to attend to the fact that losing a child is this underappreciated dimension of global health inequality that manifests in womens’ lives.” 

Dr. Smith-Greenaway’s work also uncovered yet another trend associated with child mortality – intimate partner violence (IPV). In a 2020 study, Dr. Smith-Greenaway concluded that child loss corresponds with a higher risk of intimate partner violence in a number of sub-Saharan African countries. The increase was found, somewhat surprisingly, not in communities where child death was more common, but in communities where it was both less likely and where there was greater parity in education between genders.

Although there is nothing in the data to explain why this increase in IPV exists, Dr. Smith-Greenaway suspects it could be a result of maternal blame for the death of the child. 

“It suggests that maybe where child loss isn’t as expected, there’s less of a support system in place for when you do lose a child because it’s just a less common experience in the community,” says Smith Greenaway. “We do see that that comes with an outsized risk of IPV.” 

Here in the US, in 2020, the most recent year data is available, the CDC recorded more than 3.4 million deaths in the United States, the most on record. That leaves more than 30 million people in the U.S. recently bereaved, yet the death of a loved one and its implications most often remain invisible. 

Thanks to research like Dr. Smith-Greenaway’s, which you can learn more about here, Americans can begin to understand the global breadth of bereavement, and we can establish an increased awareness of these issues so that families may find support when they need it more than ever. 

This is why, at Evermore, we work every day to raise awareness and develop our nation’s bereavement care systems. Our work centers around evidence-driven advocacy for the bereaved children and families because no one should be left to bare knuckle their way through the aftermath alone.  With millions impacted domestically and around the globe, we can – and should – do more to help our friends, families, and communities. 

Three Very Different (Yet Similar) Stories of Pregnancy and Infant Loss

Since October is Pregnancy and Infant Loss Awareness Month – which aims to bring more acknowledgement and recognition to the grief, stress, and hardship parents experience after a miscarriage or the death of a newborn baby – we decided to share three stories of loss to contextualize this unique, and challenging maternal experience. 

According to the Centers for Disease Control and Prevention (CDC), approximately 20,000 infants died in the U.S. in 2020 before their first birthday – that’s approximately 542 deaths for every 100,000 live births. Another 24,000 babies are stillborn in the U.S. each year. When taken collectively, the annual incidence of stillbirth and infant deaths is approximately equivalent to the number of deaths by suicide. Not to mention that as many as half of all pregnancies end in miscarriage. 

“It is an underappreciated and often unrecognized type of loss, particularly for mothers,” says Evermore founder Joyal Mulheron. “Like other forms of loss, miscarriage or the loss of an infant can often create compounding hardship and accumulating stress for the parents. However, over recent years, these losses are receiving increasing attention.”

Hollywood has produced at least two notable films on pregnancy loss. “Roma,” which swept the awards circuit, and “Pieces of a Woman,” which earned Vanessa Kirby a nomination for best actress from the Academy Awards. Both films contribute to the growing recognition that these losses are deserving of social and legal support.   

We sat down with both Vanessa Kirby and Academy Award-winning actress Ellen Burstyn, who both starred in the 2020 film, “Pieces of a Woman.” The film follows Martha, a young mother whose life changes irrevocably when her home birth ends in an unimaginable tragedy — her baby is stillborn. Played by Kirby, Martha is forced to navigate difficult relationships with loved ones — and her own emotional journey — as she learns to live with the grief of losing her baby. 

https:///youtu.be/fq9qnZXzI0c

“Whatever Martha’s feeling is unknowable to everybody else, and as much as she needs and wants to reach out to other people, I think it’s so colossal that she doesn’t know how,” says Kirby. “I think that’s the frustration that people around her feel, that they can’t get in touch with where she’s gone. Because I think even she doesn’t know.”

As seen in the film, a miscarriage or stillbirth can be a very personal experience — one that can be hard to communicate to anyone who hasn’t experienced it themselves. Although this grieving journey is unique for every mother, there’s often a feeling of isolation for mothers who experience the death of their babies.

“Even though this is a deeply painful movie, we kind of hoped that it would make people feel less alone with the magnitude and the solitary nature of deeply grieving someone,” says Kirby. “The nature of it is having to go through it alone, having to navigate through time, space, and reality, when your reality is completely different and has been shattered. You have to pick up the pieces and try and reform them.”

“Pieces of a Woman” breathes new life into this complicated issue and exposes viewers to an authentic account of the internal and external experiences that mothers must face after losing a baby.

In addition to the emotional toll of such losses, losing a pregnancy or infant is often physically taxing for women, who may experience pain and discomfort from pregnancy loss, or the toll of labor and delivery, only to be followed by the grief of losing a child whose arrival had been joyously anticipated. 

Gina Mathias, who lives in Maryland, couldn’t escape the feeling of guilt after her experience with stillbirth. She felt personally responsible for the death of her son — after all, she’d been carrying him and felt she should have been able to feel if there had been complications with her pregnancy. 

https:///youtu.be/kq5-8QjhNVY

“Ultimately, I was the only person responsible for Forrest’s life,” says Mathias. “At the end of the day, I was his mother and I was supposed to protect him.”

Miscarriages and stillbirths are often unexpected and unexplained, which can leave mothers and their families with an ambiguous loss to grieve, and with few answers for why the loss occurred. 

“It’s really hard living with not knowing why your child died,” says Mathias. “If there was something that you did wrong, if there was something you could have done to prevent it.”

To further complicate the experience, many medical providers are not trained or equipped to aid mothers and their families with the nuanced, emotional challenges of miscarriage, stillborn death, and the death of an infant. 

After Mathias’ stillbirth, she was brought to the maternity ward with other birthing mothers. “All around us we could hear other women giving birth and their crying babies,” says Mathias. “And that was just too much.”

Recent data from the CDC show that the U.S. infant mortality rate has continued to disproportionately impact Black women and their families. In 2020, the infant mortality rate for Black babies was nearly 11 deaths for every 1,000 live births, which is double the rate for White babies. 

Although it happened more than 30 years ago, the stress and pain of losing two children is still a fresh wound for Jackie Williams, a Black woman and bereavement doula who lives in Maryland.

https:///youtu.be/hQMKizr5LhA

“It’s like a wound that you’ve put a little dirt over, but if a strong wind blows, it’ll blow the dirt away and that wound is resurfaced,” says Williams. “On the dark days, I felt really alone and I felt as though, with [my daughter] Carolyn, I blamed myself for her death for years and years.”

Williams was 20 years old when she lost Carolyn only about five months after her birth. This experience was devastating for a young mother with little access to resources, and Jackie says she became so consumed with the death of her daughter that she began to contemplate taking her own life. 

“At that point, that was my lowest,” says Williams. “I wondered — if I take enough pills, I could just die without any pain. Because I wanted to die, but I didn’t want to hurt.”

Williams struggled for years with the grief and pain of losing her daughter until she made the decision to seek out a therapist. The pure act of being able to talk with someone about her experience provided her with the support she needed to begin her healing journey. 

Although therapy helped change the trajectory of Williams’s life, there is still much more that can be done to improve the support and care for women who are grieving the loss of a child. 

“The deep bonds of motherhood do not simply stop when your child dies,” says Mulheron. “It’s not uncommon for mothers to want to continue parenting their child in death too. This is why we are working to expand legislation and develop other tools to support mothers and families in the aftermath of loss. The nation is woefully behind and there is a lot more work to do.” 

Can Working with a Medium Help You Connect With a Lost Loved One?

Jena Kirkpatrick with her son, Ellis McClane.

Jena Kirkpatrick was hesitant to visit a medium after experiencing the death of her 19-year-old son, Ellis McClane, who died in a car accident in 2011. But five years after her loss, Jena decided to take a chance and scheduled an appointment. 

“That’s something everyone wants for the people who have passed — to talk to them again,” says Kirkpatrick, who also works at Evermore coordinating communications and outreach. 

However, Jena felt uncomfortable during her reading. She was keen to the medium’s overly zealous attempts to know her son, and she struggled to make connections between the medium’s messages and her personal experiences. At one point, the medium told her Ellis had become frustrated because she wasn’t catching the references in the messages he was sharing.

“It hurt my feelings,” says Kirkpatrick. “I let myself be vulnerable in the situation, and then I felt a little pissed off that the medium hurt my feelings because I didn’t understand his message. … I just wanted to hear that my kid loves me and he’s okay.”

Psychic mediums claim they can receive messages from the spirits of people who’ve passed on and can act as channels between those who have died and their surviving loved ones. This is why psychic mediums can be an attractive choice to aid in the grieving process. However, every psychic reading is a unique experience — some leave grieving loved ones in more pain and distress, while others provide a deep sense of spiritual connection.

For her part, Kirkpatrick was undeterred by her disappointing experience and decided to reach out to another medium, this time a friend who was beginning to share her clairvoyant gifts with others. To Kirkpatrick’s utter delight, this reading experience was much different. 

“We did a couple of readings, and they were phenomenal,” says Jena. “It was much more positive. I felt like she was a lot more kind and empathetic and really took [the reading] in this beautiful and spiritual way.” 

It was in this reading Jena finally received the message she had been yearning for — her son is always with her. Jena already had a strong sense that she was receiving messages from Ellis — she sees him in her dreams and often encounters butterflies while in nature — but now she had more reason to believe she really was hearing from her son regularly, in various ways.

“He said, ‘I can always be with you because I’m everywhere, Mom,’” says Jena. “I am always watching out for you, and when you hear me talking to you, it truly is what I’m saying.”

The permanency of losing a loved one can be one of the most perplexing parts of coping with death. It can be unfathomable to accept that you will never speak with your loved one again. This may be one reason why so many people choose to work with mediums after experiencing the death of a loved one, as suggested by research. 

A 2012 study found that grieving parents reported finding support groups and psychics as the most helpful coping methods in their grief. The same study also found that about 30 percent of grieving parents received a reading from a psychic within the first four years of their child’s death.

Furthermore, a 2014 study revealed that grieving people experienced less intense grief after a psychic reading when compared to a visit with a mental health professional.

The Szewcyzk family.

Barbara and Walt Szewcyzk visited multiple psychic mediums for readings following the death of their son, Alex Szewcyzk. Alex died by suicide five years ago in their home after years of struggling with his mental health and alcohol use. 

Almost immediately after his death, Barbara began to feel as though Alex was still communicating with the family. As they gathered around the kitchen table to discuss funeral arrangements along with Walt’s sister, Barbara suddenly got the feeling that Alex was not a fan of the lavish service they were putting together. Moments later, Walt’s sister’s phone began randomly playing the popular ballad, “Hello” by Adele, even after being turned off. 

Barbara took this as a sign from Alex, and soon after, she decided to see a psychic medium.  

“I got there, and she started talking about Alex,” says Barbara. “She described his death, and she wouldn’t have known, she couldn’t have known. She gave me a lot of insight and I left there [feeling] pretty comforted.” 

Barbara was able to find the confirmation she had been looking for — that Alex was always around her, watching over her. 

As she watched her husband struggle with the death of their son, and in an attempt to aid her family through their grieving process, Barbara encouraged Walt to speak with the same medium that provided her initial reading. Walt told Barbara he would trust her, and she booked him an appointment.

“He said to me, ‘I just wish Alex had given me a letter. I just wish he had explained to me what was going on,’” Barbara says of a conversation she had with her husband shortly before his visit with the medium.

Much like Jena Kirkpatrick, Walt had his reservations. His religious upbringing and scientific training made him question the legitimacy of psychic readings. He also worried about the medium’s credibility and authenticity. But after finding himself lost after the death of his son, Walt decided to be open to the possibilities. 

During his reading, the medium presented Walt with a letter written with words she channeled from Alex — the letter Walt had always wished he had received from his son after his passing.

“The experience with the medium blew my mind,” says Walt. “I felt wonderful after I left [the appointment]. It reinforced that something is here, and that led me to an organization called DOPS.”

DOPS, or the Division of Perceptual Studies at the University of Virginia, is a “university-based research group devoted to the investigation of phenomena that challenge mainstream scientific paradigms regarding the nature of human consciousness,” according to their website. The research team at DOPS seeks to explore human experiences that may provide evidence that consciousness does survive a bodily death. 

“When you tie that in — science with real life experience — you really find that there is something there,” says Walt. “Life does exist and there is a realm around us that we can’t see because of our physical limitations.”

To others curious about whether they should see a medium to connect with a loved one who’s passed on, Walt suggests really looking into the messages that the medium provides, not forcing yourself to make connections where they don’t exist, and being open to a new reality that may call into question your current convictions.

“These mediums — the genuine ones that can bridge that gap — can provide not just healing for those who are grieving, but a renewal of an individual’s consciousness and help them grow,” says Walt. “My grief has been transformed into an energy that drives me to be a better human being. One that I think is truly rooted in the message of Christ.”

Yanie Brewer is a psychic who visits with hundreds of people like Walt and Barbara as part of her work. She says she’s been able to see and hear the spiritual world since birth. At the age of three, Yanie was nearly legally blind. As a result, she could see more of the spiritual world than her own earthly reality. As she got older, it seemed only natural that she uses her intuitive gifts to help others. 

“It’s very healing because, on the other side, people only tell the truth,” says Brewer. “It can be very healing for people to understand that their loved ones still have life on the other side.”

Yanie advises people not to let one “bad reading” ruin the opportunity to connect with a loved one. Andrew Witt, who also works as a psychic agrees, and recommends that people seek out multiple readers to find someone they can connect with. 

Witt also stated that the quality of a reading can largely depend on the beliefs, expectations, and openness of those seeking answers. He added that it’s also important to work with the medium during the reading to get confirmation that the connection is happening with the spirit of the intended person.

“Nothing that comes from spirits is judgmental,” says Witt. “[The messages] are always very respectful and always very empowering. If [the reading] doesn’t meet those criteria, then that’s something that’s not the real deal.”

Working with a medium after the death of a loved one is a personal choice — one that should only be made when it feels right for you, and if you feel ready to try the experience. If you know friends who’ve worked with mediums, you might first ask them to refer you to someone they’ve had a positive experience with. 

Before scheduling an appointment, check out the medium’s website or social media presence to explore whether you feel connected to the person. When you identify a medium that feels like a good match, go in with an open mind and heart.

The Bereavement Benefit Most Women Don’t Know About (But Should!)

As many as half of all pregnancies end in miscarriage. Even though 87 percent of women have experienced a miscarriage while employed, an alarming number of women aren’t aware that the Family Medical Leave Act (FMLA) allows for time off from work after a miscarriage and stillbirth. 

These were the findings from a survey conducted by InHerSight in partnership with Evermore. InHerSight uses data to help women find employers and companies that support women’s goals and needs. This survey, conducted earlier this year, included 1,300 women, with the goal of assessing their awareness of their right to time off work under FMLA after experiencing a miscarriage or stillbirth. 

Survey results were striking, with 77 percent of respondents indicating they were unaware they had access to this protection. Sixty-six percent of these women reported that they hadn’t been informed by their employer of their legal rights regarding leave under FMLA, which guarantees up to 12 weeks of unpaid leave if the employee is unable to work because of his or her own “serious health condition.”

While miscarriage and stillbirth are not specifically included in the definition of “serious health condition” in FMLA, Department of Labor statements and other legislative documents indicate miscarriage is covered by the policy. A woman whose pregnancy ends in miscarriage should be able to use FMLA leave if she’s unable to work due to physical recovery or emotional distress.


Even so, 91 percent of women who have experienced a miscarriage or stillbirth while employed reported taking no days off work to recover. Ninety-eight percent of the women surveyed reported not filing for leave under FMLA after experiencing a miscarriage or stillbirth.
[Read more about InHerSight’s findings here.]

“Knowing federal leave benefits should not be the responsibility of a newly grieving woman or family. Employers have a tremendous opportunity to provide a supportive workplace environment by ensuring that women are aware of their rights.”

As Evermore seeks to learn more about the realities of bereavement in the United States, and the impact of those realities, partners like InHerSight play a crucial role in gathering data and identifying areas in need of policy change and community support. Evermore partnered with InHerSight for this survey because of the company’s dedication to women employees and their benefits and well-being in the workplace. 

“Partners like InHerSight are critical in facilitating transformational social policy,” Mulheron says. “Bereavement is ubiquitous. Understanding the impact, collecting data on the family’s perspective, and then shining a spotlight on those experiences requires leadership. We are grateful to InHerSight and others who are advancing bereavement care in America.”

The findings from this survey indicate how important it is for workplaces to provide effective education and communication that cultivates a supportive environment for employees experiencing bereavement. At Evermore, we believe it is crucial that employers take greater initiative to inform their employees of the benefits and protections available to them. 

Benefits should be communicated through employee handbooks, during onboarding and orientation trainings, and throughout the duration of a worker’s employment. When the time comes for employees to exercise their benefits, employers should be prepared to guide them through the process and direct them to human resources (HR) for further assistance. 

Employers must also work hard to create a culture in which people can bring personal and emotionally challenging issues to their directors, managers, and HR personnel. To further support an inclusive workplace culture, Evermore also recommends that employers institute five days of paid bereavement leave for all employees. 

“According to the Department of Labor, only 56 percent of America’s workforce qualifies for FMLA benefits,” Mulheron says. “That leaves millions of women working in the gig economy, in small employers, or as solopreneurs who have no benefit at all.” 

In 2021, Senator Tammy Duckworth (D-IL) and Congresswoman Ayanna Pressley (D-MA) introduced legislation that aims to raise awareness about pregnancy loss and provide paid leave benefits for workers experiencing the pain of a miscarriage or stillbirth. The Support Through Loss Act supports bereaved workers by increasing access to workplace supports and access to resources and adequate care. 

“Pregnancy loss should be met with care, compassion, and support. It is a common experience, but many struggle in silence due to the lack of awareness and cultural stigma,” says Pressley in a press release detailing the legislation. “Our bill sends a message to families that they are not alone.”

It is also imperative that employees know how to advocate for themselves in order to access the benefits available to them. If you are unaware of the benefits at your workplace, ask your manager or an HR representative to guide you through company policy. Evermore encourages readers to communicate their knowledge with coworkers, improve awareness in the workplace, and work together to create a workplace where benefits are a continuous topic of conversation.

Bereavement Is Not Simply a Mental Health Issue

Experiencing the death of a loved one can be one of the most traumatic and painful experiences someone can face in life. Such losses can be overwhelming, resulting in intense and difficult emotions of sadness, emptiness, shock, and despair. 

The bereavement process that conjoins grief — the handling of a loved one’s affairs, the navigation of various systems (medical, law enforcement, government benefits, health care) — only adds to the mental distress many families experiences. [Read about the difference between grief and bereavement.]

But grief and bereavement are far more than emotional or mental health experiences. Both processes, bereavement in particular, also have material and practical impacts that can profoundly affect the quality of life — and lifespan — of someone who is grieving the loss of a spouse, parent, child, or sibling.

“The unexpected death of a loved one poses a dual threat to our national well-being. Before the COVID-19 pandemic, Americans reported unexpected deaths to be among the most common major life stressors and the single worst experience of their entire life,” says Evermore founder Joyal Mulheron. “Losing a loved one is not only a personal tragedy, but it casts a long shadow that can extend for decades because it places surviving parents, children, siblings, and spouses at significant risk for impaired health, premature death, and other disadvantages.”

We know that individuals who lose a family member, in particular, are at higher risk of premature death as a result of their loss (when compared to non-bereaved people). This is a medical outcome — not merely a mental health outcome — and one that can and should be prevented.

In a recent study from David Weaver of the University of South Carolina, it was concluded that in the United States today, an estimated two million children under the age of 18 have a mother or father who has died. Other rigorous population-level studies have found that when compared to non-bereaved children, bereaved children experience lower self-esteem, heightened risk of depression, suicide attempts, suicide, and premature death due to any cause. 

We know that bereavement is also associated with decreased academic attainment, increased violence and crime, incarceration, self-harm, suicide attempts and completions, and with substance abuse and psychiatric disorders. So, while bereavement does cause mental distress, it also becomes the precipitating event for other emergencies that decrease the health, social, and economic well-being of an individual. 

Findings from a research study conducted by Jason Fletcher of Yale University and Marsha Mailick, Jieun Song, and Barbara Wolfe of the University of Wisconsin–Madison concluded that females who have lost a sibling are at increased risk of completing fewer years of school, dropping out of high school, becoming pregnant as a teen, not attending college, and have an average reduction in income of 20 percent.

Bereavement magnifies existing racial inequities. For example, the Indian Health Service reports that American Indians and Alaskan Natives born today will live 5.5 years less than other racial groups in U.S. As a result, families will experience these deaths earlier in life and encounter associated hardships, only compounding and multiplying the impact of bereavement. 

Black Americans are also disproportionately impacted by the premature deaths of loved ones. Across the life course, they are three times as likely as White Americans to have two or more family members die by the time they reach the age of 30 — making these communities more vulnerable to negative social and health outcomes for the rest of their lives.

The systems surrounding a grieving and bereaved family should be oriented toward preventing the onset of addiction, disease, or even death for surviving family members, but also preventing other associated health and social outcomes. 

Let’s consider the real-world implications of just a single death…

When Alex — a husband, father, and sole income-earner in the family — passes away as the result of an accident, his spouse Bianca is immediately confronted with a slew of practical considerations.

She must make and pay for funeral arrangements, but she no longer has the support of Alex’s income. She’s also on the verge of losing the health care provided by Alex’s employer — for her and her eight-year-old daughter. 

Bianca now needs to find a job — while grieving — but may have to work evenings and miss the end of the school day for her eight-year-old daughter Marcella, who is in a state of shock, confusion, and trauma after learning her father won’t be coming home. 

Moreover, Marcella doesn’t want to get out of bed, is missing school, and her grades are beginning to decline, for the first time since she started school.

Without Alex’s income, suddenly housing, food, transportation, and health care are all on the line — all at once. This is more than grief. This is a family catastrophe. 

This is why people don’t only need support with the emotional side of loss, they also need social and practical support in continuing to live their lives — to pay bills, go to work, provide child care, seek appropriate benefits, navigate burial and funeral plans, and so on. 

As a society, we need to change and create policies so children and families can better cope with the instability they face in the aftermath of a death. These policies should be based on quality research and data [see our Facts & Figures] and provide economic support, access to quality health care, and meaningful community support programs for all children and families. 

We cannot only attend to families alone, however. We must provide education and resources for our frontline responders who attend to families in the aftermath of a death. This includes first responders — paramedics, firefighters, or law enforcement — employers, clergy, or schools. We need to equip our community leaders with the tools to help stabilize children and families.  

This is why our work is centered around advocacy — to The White House and the U.S. Congress. And why we work to educate as many people as possible about the real and numerous impacts grieving and bereaved people experience in this country. And this is why your voice matters too. Join our advocacy network in advancing bereavement care for all.  

 

Resources & Related Reading

 

Bereavement Facts & Figures

Why is our nation so far behind in grief and bereavement services and policies?

Just How Many People in America Have Lost a Loved One?

 

The epidemiology of traumatic event exposure worldwide: results from the World Mental Health 

Survey Consortium, Benjet et al, 2016.

Parental Mortality and Outcomes among Minor and Adult Children, David Weaver, November 2019

A Sibling Death in the Family: Common and Consequential, Fletcher et al, January 2015.

Why Is Our Nation So Far Behind in Grief and Bereavement Services and Policies?

Why Is Our Nation So Far Behind In Grief and Bereavement Services and Policies?

National Grief Awareness Day — observed annually on August 30 —  was created by Angie Cartwright, who’s experienced immense grief in her life after the loss of her baby sister, newlywed husband, and mother. She helped establish this day of awareness in 2014, coinciding with her mother’s birthday, to encourage open and honest communication centering the myriad ways we cope with loss and bereavement, and to remind us all to support the people we know who are grieving. 

“Grief is the unique emotional response following the death of someone meaningful in your life,” says Evermore founder Joyal Mulheron. “It’s a term commonly used for anyone grieving a difficult change, like grieving our old lives before Covid.”

Everyone will experience the loss of a loved one at some point in their life, and this loss is seldom easy to accept or process. Each individual will experience grief differently, and unpredictably — it can wax and wane, reemerge at unexpected times, and linger longer than we’d like.

Coinciding with the grief process is bereavement — “the death event and surrounding systems, policies, and interactions that people experience in the aftermath of losing someone,” says Mulheron. “Bereavement includes the interactions a grieving person may have with institutions and people.”

Bereavement and grief are terms that are often used interchangeably, but their meanings are distinct. Although they can work in tandem, they are dealt with differently. 

For example, if a mother loses her child, she must not only navigate the emotional toll of her loss, but potentially do so with limited time off of work, because federal policy for bereaved parents only requires two weeks of paid leave for bereaved individuals. 

In this way, the feelings of anguish and sorrow that come with grief can make the bereavement process tumultuous, overwhelming, or disorienting. And vice versa. But understanding the difference between grief and bereavement can help people navigate a complex, often difficult coping process.  

While the unexpected or untimely death of a loved one is one of the most common traumatic events Americans experience, the journey through these events often remain invisible due to a lack of awareness about how policy decisions and institutional processes impact grief and bereavement. 

Researchers and policy-makers have long overlooked questions and statistics around bereavement. The Centers for Disease Control and Prevention (CDC), the largest monitor of health and wellness in the US, collects data on mortality events but overlooks the residual impacts — systemic, physical, and emotional — on surviving family and friends after a death event.

Bereavement has so little institutional support behind it, yet people can encounter these system deficiencies almost everywhere — the workplace, law enforcement interactions, the child welfare system, schools, federal benefits, health care, and housing. This neglect has created a public health problem with profound implications for the social and economic well-being of families, communities, and the nation as a whole.

For instance, when a child experiences the premature death of a parent, it can be difficult to find a qualified therapist or suitable in-school counselor. When compared to non-bereaved children, bereaved children experience lower self-esteem, lower grades, and more school failures, along with the heightened risk of depression, suicide, and premature death.

Individuals who are exposed to death at early ages are more vulnerable to negative social and health outcomes for the rest of their lives. These experiences cause greater cumulative disadvantages, induce greater levels of stress, and deplete financial resources.

For Indigenous, Black, and Latino people, and also people experiencing poverty, these deficiencies in our public and private systems have a disproportionate negative effect, creating additional challenges for the nation’s most vulnerable families for years following the loss of a loved one.

At Evermore, we believe bereavement care in America is broken. Which is why we’re committed to shifting policy and bringing more awareness to these issues — and how they impact real families — so that grieving can happen more naturally and loved ones can support when they need it more than ever.

 

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