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Black–White Disparities in Birth Outcomes: Is Racism-Related Stress a Missing Piece of the Puzzle?

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Handbook of African American Health

Abstract

For decades, large disparities in birth outcomes have been observed between babies born to African- American (black) women and those born to European-American (white) women. Adverse birth outcomes – being born “too early” (premature or preterm birth, before 37 completed weeks of pregnancy) or “too small” (low birth weight, less than 5½ pounds) – are powerful predictors not only of infant survival, but also of child health, development, and serious disability (Institute of Medicine, 2007). Recent research reveals that low birth weight and premature birth also are strong predictors of chronic disease in adulthood, including cardiovascular disease and diabetes, which are major causes of premature mortality (Barker, 2006; Phillips, Jones, & Goulden, 2006; Whincup et al., 2008). As shown in Figs. 10.1 and 10.2, the disparities generally have been persistent, until recently when relative disparities began to narrow somewhat, for undesirable reasons: the rates of both preterm birth (PTB) and low birth weight (LBW) worsened among white women, with little (PTB) or no (LBW) improvement among black women. (For simplicity, throughout this chapter “black” and “white” are used to refer only to non-Hispanic women.)

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References

  • Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2007). Low birthweight among US Hispanic/Latino subgroups: The effect of maternal foreign-born status and education. Social Science & Medicine, 65(12), 2503–2516.

    Article  Google Scholar 

  • Acevedo-Garcia, D., Soobader, M. J., & Berkman, L. F. (2005). The differential effect of foreign-born status on low birth weight by race/ethnicity and education. Pediatrics, 115(1), e20–e30.

    Google Scholar 

  • Albandar, J. M. (2005). Epidemiology and risk factors of periodontal diseases. Dental Clinics of North America, 49(3), 517–532, v–vi.

    Article  Google Scholar 

  • Barker, D. J. (2006). Adult consequences of fetal growth restriction. Clinical Obstetrics and Gynecology, 49(2), 270–283.

    Article  Google Scholar 

  • Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39(3), 263–272.

    Google Scholar 

  • Braveman, P., Marchi, K., Egerter, S., Kim, S., Metzler, M., Stancil, T., et al. (2010). Poverty, near-poverty, and hardship around the time of pregnancy. Meternal and Child Health Journal, 14(1), 20–35.

    Article  Google Scholar 

  • Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., et al. (2005). Socioeconomic status in health research: One size does not fit all. Journal of the American Medical Association, 294(22), 2879–2888.

    Article  Google Scholar 

  • Collins, J. W., Jr., & David, R. J. (2004). Pregnancy outcome of Mexican-American women: The effect of generational residence in the United States. Ethnicity & Disease, 14(3), 317–321.

    Google Scholar 

  • Collins, J. W., Jr., & Shay, D. K. (1994). Prevalence of low birth weight among Hispanic infants with United States-born and foreign-born mothers: the effect of urban poverty. American Journal of Epidemiology, 139(2), 184–192.

    Google Scholar 

  • Collins, J. W., Wu, S. Y., & David, R. J. (2002). Differing intergenerational birth weights among the descendants of US-born and foreign-born Whites and African Americans in Illinois. American Journal of Epidemiology, 155(3), 210–216.

    Article  Google Scholar 

  • David, R. J., & Collins, J. W., Jr. (2007). Disparities in infant mortality: What’s genetics got to do with it? American Journal of Public Health, 97(7), 1191–1197.

    Article  Google Scholar 

  • David, R. J., & Collins, J. W., Jr. (1997). Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites. The New England Journal of Medicine, 337(17), 1209–1214.

    Article  Google Scholar 

  • Dominguez, T. P., Dunkel-Schetter, C., Glynn, L. M., Hobel, C., & Sandman, C. A. (2008). Racial differences in birth outcomes: the role of general, pregnancy, and racism stress. Health Psychology, 27(2), 194–203.

    Article  Google Scholar 

  • Geronimus, A. T. (1996). Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis. Social Science & Medicine, 42(4), 589–597.

    Article  Google Scholar 

  • Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. Lancet, 371(9606), 75–84.

    Article  Google Scholar 

  • Guendelman, S., Buekens, P., Blondel, B., Kaminski, M., Notzon, F. C., & Masuy-Stroobant, G. (1999). Birth outcomes of immigrant women in the United States, France, and Belgium. Maternal and Child Health Journal, 3(4), 177–187.

    Article  Google Scholar 

  • Guendelman, S., Gould, J. B., Hudes, M., & Eskenazi, B. (1990). Generational differences in perinatal health among the Mexican American population: Findings from HHANES 1982–84. American Journal of Public Health, 80(S), 61–65.

    Article  Google Scholar 

  • Hitti, J., Nugent, R., Boutain, D., Gardella, C., Hillier, S. L., & Eschenbach, D. A. (2007). Racial disparity in risk of preterm birth associated with lower genital tract infection. Paediatric and Perinatal Epidemiology, 21(4), 330–337.

    Article  Google Scholar 

  • Hogan, V. K., Njoroge, T., Durant, T. M., & Ferre, C. D. (2001). Eliminating disparities in perinatal outcomes–lessons learned. Maternal and Child Health Journal, 5(2), 135–140.

    Google Scholar 

  • Hogue, C. J., & Bremner, J. D. (2005). Stress model for research into preterm delivery among black women. American Journal of Obstetrics & Gynecology, 192(5), S47–S55.

    Article  Google Scholar 

  • Horton, A. L., Boggess, K. A., Moss, K. L., Jared, H. L., Beck, J., & Offenbacher, S. (2008). Periodontal disease early in pregnancy is associated with maternal systemic inflammation among African American women. The Journal of Periodontology, 79(7), 1127–1132.

    Article  Google Scholar 

  • Howard, D. L., Marshall, S. S., Kaufman, J. S., & Savitz, D. A. (2006). Variations in low birth weight and preterm delivery among blacks in relation to ancestry and nativity: New York City, 1998–2002. Pediatrics, 118(5), e1399–e1405.

    Article  Google Scholar 

  • Institute of Medicine, Committee on Understanding Premature Birth and Assuring Healthy Outcomes, Board on Health Sciences Policy. (2007). Preterm birth: causes, consequences, and prevention. Washington, DC: The National Academies Press.

    Google Scholar 

  • Klatt, T. E., Cole, D. C., Eastwood, D. C., & Barnabei, V. M. (2010). Factors associated with recurrent bacterial vaginosis. The Journal of Reproductive Medicine, 55(1–2), 55–61.

    Google Scholar 

  • Kramer, M. R., & Hogue, C. R. (2009). What causes racial disparities in very preterm birth? A biosocial perspective. Epidemiological Reviews, 31, 84–98.

    Article  Google Scholar 

  • Kramer, M. S. (1987). Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663–737.

    Google Scholar 

  • Lopez, R. (2007). Periodontal treatment in pregnant women improves periodontal disease but does not alter rates of preterm birth. The Journal of Evidence-Based Dental Practice, 8(2), 38.

    Article  Google Scholar 

  • Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.

    Article  Google Scholar 

  • Lucas, J. W., Barr-Anderson, D. J., & Kington, R. S. (2005). Health status of non-Hispanic U.S.-born and foreign-born black and white persons: United States, 1992–95. Vital and Health Statistics, 10(226), 1–20.

    Google Scholar 

  • McDonald, H. M., Brocklehurst, P., & Gordon, A. (2007). Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews, 1, CD000262.

    Google Scholar 

  • McEwen, B. S., & Gianaros, P. J. (2010). Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences, 1186, 190–222.

    Article  Google Scholar 

  • Michalowicz, B. S., Hodges, J. S., DiAngelis, A. J., Lupo, V. R., Novak, M. J., Ferguson, J. E., et al. (2006). Treatment of periodontal disease and the risk of preterm birth. The New England Journal of Medicine, 355(18), 1885–1894.

    Article  Google Scholar 

  • Newton, E. R., Piper, J. M., Shain, R. N., Perdue, S. T., & Peairs, W. (2001). Predictors of the vaginal microflora. American Journal of Obstetrics &Gynecology, 184(5), 845–853, discussion 853–855.

    Article  Google Scholar 

  • Nuru-Jeter, A., Dominguez, T. P., Hammond, W. P., Leu, J., Skaff, M., Egerter, S., et al. (2009). “It’s the skin you’re in”: African American women talk about their experiences of racism. An exploratory study to develop measures of racism for birth outcome studies. Maternal and Child Health Journal, 13(1), 29–39.

    Article  Google Scholar 

  • Ojeda, V. D., Patterson, T. L., & Strathdee, S. A. (2008). The influence of perceived risk to health and immigration-related characteristics on substance use among Latino and other immigrants. American Journal of Public Health, 98(5), 862–868.

    Article  Google Scholar 

  • Pallotto, E. K., Collins, J. W., Jr., & David, R. J. (2000). Enigma of maternal race and infant birth weight: a population-based study of US-born Black and Caribbean-born Black women. American Journal of Epidemiology, 151(11), 1080–1085.

    Google Scholar 

  • Park, Y., Neckerman, K. M., Quinn, J., Weiss, C., & Rundle, A. (2008). Place of birth, duration of residence, neighborhood immigrant composition and body mass index in New York City. International Journal of Behavioral Nutrition and Physical Activity, 5, 19.

    Google Scholar 

  • Phillips, D. I., Jones, A., & Goulden, P. A. (2006). Birth weight, stress, and the metabolic syndrome in adult life. Annals of the New York Academy of Sciences, 1083, 28–36.

    Article  Google Scholar 

  • Pollack, A. (2010, June 14). Awaiting the genome payoff: The genome at 10. New York Times.

    Google Scholar 

  • Savitz, D. A., & Murnane, P. (2010). Behavioral influences on preterm birth: a review. Epidemiology, 21(3), 291–299.

    Article  Google Scholar 

  • Singh, G. K., & Hiatt, R. A. (2006). Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. International Journal of Epidemiology, 35(4), 903–919.

    Article  Google Scholar 

  • Singh, G. K., & Yu, S. M. (1996). Adverse pregnancy outcomes: Differences between US- and foreign-born women in major US racial and ethnic groups. American Journal of Public Health, 86(6), 837–843.

    Article  Google Scholar 

  • Starfield, B., Shapiro, S., Weiss, J., Liang, K. Y., Ra, K., Paige, D., et al. (1991). Race, family income, and low birth weight. American Journal of Epidemiology, 134(10), 1167–1174.

    Google Scholar 

  • Wadhwa, P. D., Culhane, J. F., Rauh, V., Barve, S. S., Hogan, V., Sandman, C. A., et al. (2001). Stress, infection and preterm birth: A biobehavioural perspective. Paediatric and Perinatal Epidemiology, 15(S2), 17–29.

    Article  Google Scholar 

  • Whincup, P. H., Kaye, S. J., Owen, C. G., Huxley, R., Cook, D. G., Anazawa, S., et al. (2008). Birth weight and risk of type 2 diabetes: A systematic review. Journal of the American Medical Association, 300(24), 2886–2897.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, Center on Social Disparities in Health, San Francisco, CA, USA

    Paula Braveman

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  1. Paula Braveman
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Correspondence to Paula Braveman .

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Editors and Affiliations

  1. John Jay College of Criminal Justice, City University of New York, Tenth Ave. 899, New York, 10019, New York, USA

    Anthony J. Lemelle

  2. , Sociology, Virginia Polytechnic Institute and State, Blacksburg, 24061, USA

    Wornie Reed

  3. , Sociology and Criminal Justice, Clark Atlanta University, Atlanta, 30314, Georgia, USA

    Sandra Taylor

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Braveman, P. (2011). Black–White Disparities in Birth Outcomes: Is Racism-Related Stress a Missing Piece of the Puzzle?. In: Lemelle, A., Reed, W., Taylor, S. (eds) Handbook of African American Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9616-9_10

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