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Racism: A Strong Factor in High Rate of Preterm Births in Black Women

Posted by Sidney, 18 Mar

Black women in the U.S. are over 50% more likely to give birth to preterm babies than white women. These premature birth statistics suggest an alarming racial disparity in preterm birth rates between Black and white women. Documented for over a century, what is the explanation for this gap?

Explaining Black/White Gap in Premature Births

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Teaming up with other experts in the medical field, Dr. Paula Braveman ( director of the Center on Social Disparities in Health, University of California-San Francisco) examined 24 assumed causes of premature births.

1. Genetic factors

Genetic differences contribute to the risk of preterm birth. However, surprisingly differences in genetics could not account for that alarming disparity between the two groups from the evidence gathered.

Susceptibility to preterm births can be inherited. But much as maternal influences in predicting gestational length seems more substantial, the father's gestational age also plays a part. If other factors like the environment and age of the father during conception can alter the genetic composition, then the effect of genetic factors on the racial disparity would indeed be minimal.

A mother’s socioeconomic factors

Researchers found that a mother's income, education, and health only account for 38% of the racial disparity in preterm births. However, some argued that these factors could be rooted in racism. For instance, when discriminatory barriers inhibit a Black woman's access to better health care, jobs, or education.

Racism-related stress

Its clear in Neuroscience that a chronic (long-term) stressor is more detrimental to health than an acute (short-term) stressor. Chronic stress leads to inflammation and immune system dysfunction. These two can cause premature births.

When the team asked Black women about their racism experiences, they didn't give accounts of racism by medics during pregnancy. Instead, they talked about their life experiences as far back as childhood.

Most of the research on the effects of racial discrimination on pregnancy only looks at the impact during the pregnancy. Very few incorporate how lifetime experiences of racism can account for complications during pregnancy.

Stressful experiences black women face throughout their lives can have a powerful impact on the body. The stress can be related to interpersonal interactions like getting passed over for a promotion, being called racist labels, and institutional discrimination.

So developing evidence points to racism-related stress as the main contributor to the disparity in the black/white premature birth statistics.

The racial composition of a mother's neighborhood

When looking at a mother's neighborhood's racial and ethnic composition, the researchers classified each neighborhood in terms of the proportion of Latino, non-Hispanic Black, and non-Hispanic white residents.

According to research that focused on single babies born to more than 477,000 black and white women in Texas between 2009 and 2011, the racial composition of a mother's neighborhood influences the risk of preterm birth:

- It was concluded that despite the ethnic and racial composition of where the mother's residence was, the odds of preterm deaths in black women were higher than in white women.

- Black/white preterm death disparities are highest in neighborhoods with higher concentrations of white residents and lowest where the concentration of white residents is low.

Conclusion:

When all other things are equal (age, marital status, prenatal care, education, and neighborhood poverty level), black women face a higher risk of premature births. Black women are significantly more affected by racial disparity regardless of their neighborhood's income status and lack of racial diversity.

After examining several assumed causes of premature births, the best explanation for the racial disparities in preterm birth rates is racism. However, the other factors don't solely explain the Black/white differences in preterm birth rates. For example, all mothers can be affected by low-income or high-poverty neighborhoods. But black women are impacted more severely.

All we need is to have racially inclusive policies that can improve the livelihoods of all mothers, especially black women living in non-white neighborhoods, by addressing factors that contribute to the overall health of a mother.

P.S. Read comprehensive research here.