Testing the Association Between Traditional and Novel Indicators of County-Level Structural Racism and Birth Outcomes among Black and White Women

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Shelly L Brown-Jeffy, Associate Professor (Creator)
Jennifer Toller Erausquin, Associate Professor (Creator)
Tracy R. Nichols, Associate Professor and Doctoral Program Coordinator (Creator)
Amanda Elizabeth Tanner, Associate Professor (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/

Abstract: Despite decreases in infants born premature and at low birth weight in the United States (U.S.), racial disparities between Black and White women continue. In response, the purpose of this analysis was to examine associations between both traditional and novel indicators of county-level structural racism and birth outcomes among Black and White women. We merged individual-level data from the California Birth Statistical Master Files 2009–2013 with county-level data from the United States (U.S.) Census American Community Survey. We used hierarchical linear modeling to examine Black-White differences among 531,170 primiparous women across 33California counties. Traditional (e.g., dissimilarity index) and novel indicators (e.g., Black to White ratio in elected office) were associated with earlier gestational age and lower birth weight among Black and White women. A traditional indicator was more strongly associated with earlier gestational age for Black women than f or White women. This was the first study to empirically demonstrate that structural racism, measured by both traditional and novel indicators, is associated with poor health and well being of infants born to Black and White women. However , finding s indicate traditional indicators of structural racism, rather than novel indicators, better explain racial disparities in birth outcomes. Results also suggest the need to develop more innovative approaches to: (1) measure structural racism at the county-level and (2) reform public policies to increase integration and access to resources.

Additional Information

Journal of Racial and Ethnic Health Disparities, 2018, 5: 966-977.
Language: English
Date: 2017
Structural racism, Gestational age, Low birth-weight, Racial disparities

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