Racial and Ethnic Disparities in Low Birthweight Among Urban Unmarried Mothers
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We examined racial and ethnic disparities in low birthweight (LBW) among unmarried mothers and the extent to which demographic, economic, psychosocial, health, health care, and behavioral factors explain those disparities.
Using a sample of 2,412 non-marital births from a national urban birth cohort study, we estimated multiple logistic regression models to examine disparities in LBW between non-Hispanic white (NHW), non-Hispanic black (NHB), U.S.-born Mexican-origin (USMO), and foreign-born Mexican-origin (FBMO) mothers.
NHW mothers were almost as likely as NHB mothers to have LBW infants. USMO mothers had 60% lower odds and FBMO mothers had 57% lower odds than NHW mothers of having LBW infants. FBMO mothers had no advantage compared to USMO mothers. Controlling for prenatal health and behaviors substantially reduced the LBW advantages for USMO and FBMO mothers. The odds of LBW for NHB mothers relative to NHW mothers increased with the addition of the same covariates.
Racial and ethnic disparities in LBW among unmarried mothers—an economically disadvantaged population—do not mirror those in the general population. Prenatal health and behaviors are strongly associated with LBW in this group and explain a sizable portion of the Mexican-origin advantage. The lack of a significant black-white disparity in this group suggests that poverty plays an important role in shaping racial disparities in the general population. The finding that controlling for prenatal health and behaviors widens rather than narrows the racial disparity suggests that efforts to ameliorate black-white disparities in LBW should focus on social and health risks throughout the life course.
KeywordsLow birthweight Racial disparities Ethnic disparities Non-marital birth Unmarried mothers
This research was funded by the National Institute of Child Health and Human Development Grants R01HD43371 and R01HD35301. The study was approved by the Institutional Review Boards of Robert Wood Johnson Medical School and the University of Texas at Austin.
- 3.Martin, J., Hamilton, B., Sutton, P., Ventura, S., Menacker, F., & Munson, M. (2005). Births: Final data for 2003. National Vital Statistics Reports, 54(2), 1–116.Google Scholar
- 5.Landale, N., Oropesa R., & Gorman, B. (1999). Immigration and infant health: Birth outcomes of immigrant and native-born women. In D. J. Hernandez (Ed.), Children of immigrants: Health, adjustment and public assistance. Washington, DC: National Academy Press.Google Scholar
- 7.Proctor, B, & Dalaker, J. (2003). Poverty in the United States: 2002. U.S. Census Bureau, Current Population Reports P60-222. Washington, D.C.: U.S. Government Printing Office.Google Scholar
- 10.Sherraden, M., & Barrera, R. (1996). Maternal support and cultural influences among Mexican immigrant mothers. Families in Society: The Journal of Contemporary Human Services, 77, 298–313.Google Scholar
- 11.Sherraden, M., & Barrera, R. (1996). Poverty, family support, and well-being of infants: Mexican immigrant women and childbearing. Journal of Sociology and Social Welfare, 23, 27–54.Google Scholar
- 12.Rumbaut, R., & Weeks, J. (1996). Unraveling a public health enigma: Why do immigrants experience superior perinatal health outcomes? Research in the Sociology of Health Care, 138, 337–391.Google Scholar
- 13.Moore, J., Stinson, L., & Welniak, E. (2000). Income measurement error in surveys: A review. Journal of Official Statistics, 16, 331–361.Google Scholar
- 16.Authors’ own calculations from the 2002 public use natality file for the U.S. from the National Center for Health Statistics [for information about how to access file, see http://www.cdc.gov/nchs/products/elec_prods/subject/natality.htm].
- 22.DeNavas-Walt, C., Proctor, B., & Lee, C. (2005). Income, poverty, and health insurance coverage in the United States: 2004. Current population reports. P60-229. Washington, D.C.: U.S. Census Bureau.Google Scholar
- 28.Henshaw, D. (1998). Unintended pregnancy in the United States. Family Planning Perspectives, 30, 24–29, 46.Google Scholar
- 30.Koenig, H., McCullough, M., & Larson, D. (2001). Handbook of religion and health. Oxford: Oxford University Press.Google Scholar
- 32.Glaeser, E., Vigdor, J. (2001). Racial segregation in the 2000 census: Promising news. April 2001. Center on Urban and Metropolitan Policy. The Brookings Institution. http://www.brookings.edu/es/urban/census/glaeser.pdf.
- 35.Ni, H., & Cohen, R. (2004). Trends in health insurance coverage by race/ethnicity among persons under 65 years of age: United States, 1997–2001. December 16, 2004. National Center for Health Statistics. http://www.cdc.gov/nchs/products/pubs/pubd/hestats/healthinsur.htm.
- 36.Arendt, R., Singer, L., Minnes, S., & Salvator, A. (1999). Accuracy in detecting prenatal drug exposure. Journal of Drug Issues, 29, 203–214.Google Scholar
- 39.Frisbie, W., Forbes, D., & Hummer, R. (1998). Hispanic pregnancy outcomes: Additional evidence. Social Science Quarterly, 79, 149–160.Google Scholar
- 42.Goldenberg, R., Cliver, S., Mulvihill, F., Hickey, C., Hoffman, H., Klerman, L., & Johnson, M. (1996). Medical, psychosocial, and behavioral risk factors do not explain the increased risk for low birth weight among black women. American Journal of Obstetrics and Gynecology, 175, 1317–1324.PubMedCrossRefGoogle Scholar
- 43.Reichman, N, & Schwartz-Soicher, O. (in press). Accuracy of birth certificate data by risk factors and outcomes: analysis of data from New Jersey. American Journal of Obstetrics and Gynecology..Google Scholar
- 46.American College of Physicians (1997). Inner-city health care. Annals of Internal Medicine, 126, 485–490.Google Scholar