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

DOI: 10.1007/978-1-4419-9616-9_10

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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