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Personal Versus Group Experiences of Racism and Risk of Delivering a Small-for-Gestational Age Infant in African American Women: a Life Course Perspective

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Abstract

The majority of studies investigating the relationship between racism/racial discrimination and birth outcomes have focused on perceived experiences of racism/racial discrimination directed at oneself (personal racism). However, evidence suggests individuals report with greater frequency racism/racial discrimination directed at friends, family members, or other members of their racial/ethnic group (group racism). We examined how much African American (AA) women report lifetime experiences of perceived racism or racial discrimination, both personal and group, varied by maternal age. We also investigated whether reports of personal and group racism/racial discrimination were associated with the risk of delivering a small-for-gestational age (SGA) infant and how much maternal age in relation to developmental life stages (adolescence [≤ 18 years], emerging adulthood [19–24 years], and adulthood [≥ 25 years]) moderated the relationship. Data stem from the Baltimore Preterm Birth Study, a hybrid prospective/retrospective cohort study that enrolled 872 women between March 2000 and July 2004 (analyzed in 2016–2017). Spline regression analyses demonstrated a statistically significant (p value for overall association < 0.001) and non-linear (p value = 0.044) relationship between maternal age and the overall racism index. Stratified analysis showed experiences of racism overall was associated with a higher odds ratio of delivering an SGA infant among AA women aged ≥ 25 years (OR = 1.45, 95% CI 1.02–2.08). The overall racism index was not associated with the SGA infant odds ratio for emerging adults (OR = 0.86, 95% CI 0.69–1.06) or adolescents (OR = 0.92, 95% CI 0.66–1.28). Multiple aspects of racism and the intersection between racism and other contextual factors need to be considered.

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Abbreviations

AA:

African American

BW:

Birth weight

CI:

Confidence interval

FRS:

Family Resource Scale

GA:

Gestational age

OR:

Odds ratio

PNC:

Prenatal care

PTB:

Preterm birth

SD:

Standard deviation

SGA:

Small-for-gestational age

References

  1. Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: final data for 2014. Natl Vital Stat Rep. 2016;65(4):1–122.

    PubMed  Google Scholar 

  2. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep. 2017;66(1):1.

    PubMed  Google Scholar 

  3. Mathews T, MacDorman MF. Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep. 2013;62(8):1–26.

    PubMed  Google Scholar 

  4. Xu J, Murphy SL, Kochanek KD, Bastian BA. Deaths: final data for 2013. Natl Vital Stat Rep. 2016; 64(2):1–19.

  5. Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2014. Natl Vital Stat Rep. 2015;64(12):1–64.

    PubMed  Google Scholar 

  6. Mathews T, MacDorman MF, Thoma ME. Infant mortality statistics from the 2013 period linked birth/infant death data set. Natl Vital Stat Rep. 2015;64(9):1–28.

    Google Scholar 

  7. Catov JM, Lee M, Roberts JM, Xu J, Simhan HN. Race disparities and decreasing birth weight: are all babies getting smaller? Am J Epidemiol. 2016;183(1):15–23.

    Article  PubMed  Google Scholar 

  8. Bediako SM, Griffith DM. Eliminating racial/ethnic health disparities: reconsidering comparative approaches. J Racial Ethn Health Disparities. 2012;2(1):5.

    Google Scholar 

  9. Kramer MS, Ananth CV, Platt RW, Joseph K. US Black vs White disparities in foetal growth: physiological or pathological? Int J Epidemiol. 2006;35(5):1187–95.

    Article  PubMed  Google Scholar 

  10. Hilmert CJ, Dominguez TP, Schetter CD, Srinivas SK, Glynn LM, Hobel CJ, et al. Lifetime racism and blood pressure changes during pregnancy: implications for fetal growth. Health Psychol. 2014;33(1):43–51.

    Article  PubMed  Google Scholar 

  11. Elo IT, Culhane JF, Kohler IV, O’Campo P, Burke JG, Messer LC, et al. Neighbourhood deprivation and small-for-gestational-age term births in the United States. Paediatr Perinat Epidemiol. 2009;23(1):87–96.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Love C, David RJ, Rankin KM, Collins JW. Exploring weathering: effects of lifelong economic environment and maternal age on low birth weight, small for gestational age, and preterm birth in African-American and white women. Am J Epidemiol. 2010;172(2):127–34.

    Article  PubMed  Google Scholar 

  13. Grobman WA, Parker CB, Willinger M, Wing DA, Silver RM, Wapner RJ, et al. Racial disparities in adverse pregnancy outcomes and psychosocial stress. Obstet Gynecol. 2018;131(2):328–35.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gennaro S. Overview of current state of research on pregnancy outcomes in minority populations. Am J Obstet Gynecol. 2005;192(5 Suppl):S3–S10.

    Article  PubMed  Google Scholar 

  15. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75–84.

    Article  PubMed  Google Scholar 

  16. Willis E, McManus P, Magallanes N, Johnson S, Majnik A. Conquering racial disparities in perinatal outcomes. Clin Perinatol. 2014;41(4):847–75.

    Article  PubMed  Google Scholar 

  17. Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. Matern Child Health J. 2003;7(1):13–30.

    Article  PubMed  Google Scholar 

  18. Misra DP, Guyer B, Allston A. Integrated perinatal health framework. A multiple determinants model with a life span approach. Am J Prev Med. 2003;25(1):65–75.

    Article  PubMed  Google Scholar 

  19. Smedley A, Smedley BD. Race as biology is fiction, racism as a social problem is real: anthropological and historical perspectives on the social construction of race. Am Psychol. 2005;60(1):16–26.

    Article  PubMed  Google Scholar 

  20. Gee GC, Walsemann KM, Brondolo E. A life course perspective on how racism may be related to health inequities. Am J Public Health. 2012;102(5):967–74.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Jones CP. Invited commentary: “race,” racism, and the practice of epidemiology. Am J Epidemiol. 2001;154(4):299–304.

    Article  CAS  PubMed  Google Scholar 

  22. Harrell SP. A multidimensional conceptualization of racism-related stress: implications for the well-being of people of color. Am J Orthop. 2000;70(1):42–57.

    Article  CAS  Google Scholar 

  23. Omi M, Winant H. Racial formation in the United States. New York, NY: Routledge; 2014.

  24. Jones CP. Levels of racism: a theoretic framework and a gardener’s tale. Am J Public Health. 2000;90(8):1212–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A, et al. Racism as a determinant of health: a systematic review and meta-analysis. PLoS One. 2015;10(9):e0138511.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Giurgescu C, McFarlin BL, Lomax J, Craddock C, Albrecht A. Racial discrimination and the black-white gap in adverse birth outcomes: a review. J Midwifery Womens Health. 2011;56(4):362–70.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Acevedo-Garcia D, Rosenfeld LE, Hardy E, McArdle N, Osypuk TL. Future directions in research on institutional and interpersonal discrimination and children’s health. Am J Public Health. 2013;103(10):1754–63.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Paradies Y. A systematic review of empirical research on self-reported racism and health. Int J Epidemiol. 2006;35(4):888–901.

    Article  PubMed  Google Scholar 

  29. Slaughter-Acey JC, Caldwell CH, Misra DP. The influence of personal and group racism on entry into prenatal care among African American women. Womens Health Issues. 2013;23(6):e381–7.

    Article  PubMed  Google Scholar 

  30. Slaughter-Acey JC, Sealy-Jefferson S, Helmkamp L, Caldwell CH, Osypuk TL, Platt RW, et al. Racism in the form of micro aggressions and the risk of preterm birth among black women. Ann Epidemiol. 2016;26(1):7–13. e11

    Article  PubMed  Google Scholar 

  31. Alhusen JL, Bower KM, Epstein E, Sharps P. Racial discrimination and adverse birth outcomes: an integrative review. J Midwifery Womens Health. 2016;61(6):707–20.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Priest N, Paradies Y, Trenerry B, Truong M, Karlsen S, Kelly Y. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Soc Sci Med. 2013;95:115–27.

    Article  PubMed  Google Scholar 

  33. Hagiwara N, Alderson CJ, Mezuk B. Differential effects of personal-level vs group-level racial discrimination on health among Black Americans. Ethn Dis. 2016;26(3):453–60.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ruggiero KM. The personal/group discrimination discrepancy. J Soc Issues. 1999;55(3):519–36.

    Article  Google Scholar 

  35. Taylor DM, Wright SC, Moghaddam FM, Lalonde RN. The personal/group discrimination discrepancy perceiving my group, but not myself, to be a target for discrimination. Personal Soc Psychol Bull. 1990;16(2):254–62.

    Article  Google Scholar 

  36. Crosby F. The denial of personal discrimination. Am Behav Sci. 1984;27(3):371–86.

    Article  Google Scholar 

  37. Dominguez TP, Dunkel-Schetter C, Glynn LM, Hobel C, Sandman CA. Racial differences in birth outcomes: the role of general, pregnancy, and racism stress. Health Psychol. 2008;27(2):194–203.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mendez DD, Hogan VK, Culhane JF. Institutional racism, neighborhood factors, stress, and preterm birth. Ethn Health. 2014;19(5):479–99.

    Article  PubMed  Google Scholar 

  39. Giurgescu C, Zenk SN, Dancy BL, Park CG, Dieber W, Block R. Relationships among neighborhood environment, racial discrimination, psychological distress, and preterm birth in African American women. J Obstet Gynecol Neonatal Nurs. 2012;41(6):E51–61.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Rankin KM, David RJ, Collins JW Jr. African American women’s exposure to interpersonal racial discrimination in public settings and preterm birth: the effect of coping behaviors. Ethn Dis. 2011;21(3):370–6.

    PubMed  Google Scholar 

  41. Misra D, Strobino D, Trabert B. Effects of social and psychosocial factors on risk of preterm birth in black women. Paediatr Perinat Epidemiol. 2010;24(6):546–54.

    Article  PubMed  Google Scholar 

  42. Rosenthal L, Earnshaw VA, Lewis TT, Reid AE, Lewis JB, Stasko EC, et al. Changes in experiences with discrimination across pregnancy and postpartum: age differences and consequences for mental health. Am J Public Health. 2015;105(4):686–93.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Earnshaw VA, Rosenthal L, Lewis JB, Stasko EC, Tobin JN, Lewis TT, et al. Maternal experiences with everyday discrimination and infant birth weight: a test of mediators and moderators among young, urban women of color. Ann Behav Med. 2013;45(1):13–23.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Clark R, Anderson NB, Clark VR, Williams DR. Racism as a stressor for African Americans: a biopsychosocial model. Am Psychol. 1999;54(10):805–16.

    Article  CAS  PubMed  Google Scholar 

  45. Misra DP. Racial disparities in perinatal health: a multiple determinants perinatal framework with a lifespan approach. Harvard Health Policy Rev. 2006;7(1):72–90.

    Google Scholar 

  46. Davis RE, Couper MP, Janz NK, Caldwell CH, Resnicow K. Interviewer effects in public health surveys. Health Educ Res. 2010;25(1):14–26.

    Article  CAS  PubMed  Google Scholar 

  47. Liu YC, Blair EM. Predicted birthweight for singletons and twins. Twin Res. 2002;5(6):529–37.

    Article  PubMed  Google Scholar 

  48. Misra DP, Slaughter-Acey JC, Giurgescu C, Sealy-Jefferson S, Nowak A. Why do black women experience higher rates of preterm birth? Curr Epidemiol Rep. 2017;4(2):83–97.

    Article  Google Scholar 

  49. Caughy MOB, O’Campo PJ, Muntaner C. Experiences of racism among African American parents and the mental health of their preschool-aged children. Am J Public Health. 2004;94(12):2118–24.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Voskamp BJ, Kazemier BM, Schuit E, Mol BWJ, Buimer M, Pajkrt E, et al. Birth weight ratio as an alternative to birth weight percentile to express infant weight in research and clinical practice: a nationwide cohort study. Obstet Gynecol Int. 2014;2014:1–9.

    Article  Google Scholar 

  51. Talge NM, Mudd LM, Sikorskii A, Basso O. United States birth weight reference corrected for implausible gestational age estimates. Pediatrics. 2014;133(5):844–53.

    Article  PubMed  Google Scholar 

  52. Arnett JJ. Conceptions of the transition to adulthood: perspectives from adolescence through midlife. J Adult Dev. 2001;8(2):133–43.

    Article  Google Scholar 

  53. Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.

    Article  CAS  PubMed  Google Scholar 

  54. Dunst CJ, Leet HE. Measuring the adequacy of resources in households with young children. Child Care Health Dev. 2006;13(2):111–25.

    Article  Google Scholar 

  55. Misra DP, O’Campo P, Strobino D. Testing a sociomedical model for preterm delivery. Paediatr Perinat Epidemiol. 2001;15(2):110–22.

    Article  CAS  PubMed  Google Scholar 

  56. Allison PD. Missing data. Thousand Oaks, CA: Sage Publications, Inc; 2001.

    Google Scholar 

  57. Stone CJ, Koo C-Y. Additive splines in statistics. Proc Stat Comp Sect Am Statist Assoc. 1985;27:45–8.

    Google Scholar 

  58. Harrell F. Regression modeling strategies: with applications to linear models, logistic and ordinal regression, and survival analysis. New York, NY: Springer; 2015.

    Book  Google Scholar 

  59. Buis ML. POSTRCSPLINE: Stata module containing post-estimation commands for models using a restricted cubic spline. https://EconPapers.repec.org/RePEc:boc:bocode:s456928; https://econpapers.repec.org/software/bocbocode/S456928.htm. Accessed April 10, 2017.

  60. Harrell F. SAS macros for assisting with survival and risk analysis, and some SAS procedures useful for multivariable modeling. January 31, 2003. Available at: http://biostat.mc.vanderbilt.edu/wiki/Main/SasMacros. Accessed May 20, 2012, 2014.

  61. Lewin A, Mitchell SJ, Ronzio CR. Developmental differences in parenting behavior: comparing adolescent, emerging adult, and adult mothers. Merrill-Palmer Q. 2013;59(1):23–49.

    Article  Google Scholar 

  62. Beckfield J, Krieger N. Epi + demos + cracy: linking political systems and priorities to the magnitude of health inequities—evidence, gaps, and a research agenda. Epidemiol Rev. 2009;31:152–77.

    Article  PubMed  Google Scholar 

  63. Collins JW Jr, David RJ, Handler A, Wall S, Andes S. Very low birthweight in African American infants: the role of maternal exposure to interpersonal racial discrimination. Am J Public Health. 2004;94(12):2132–8.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Collins JW Jr, David RJ, Symons R, Handler A, Wall SN, Dwyer L. Low-income African-American mothers’ perception of exposure to racial discrimination and infant birth weight. Epidemiology. 2000;11(3):337–9.

    Article  PubMed  Google Scholar 

  65. Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol. 2003;157(1):14–24.

    Article  CAS  PubMed  Google Scholar 

  66. Dole N, Savitz DA, Siega-Riz AM, Hertz-Picciotto I, McMahon MJ, Buekens P. Psychosocial factors and preterm birth among African American and White women in Central North Carolina. Am J Public Health. 2004;94(8):1358–65.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Hutcheon JA, Platt RW. The missing data problem in birth weight percentiles and thresholds for “small-for-gestational-age”. Am J Epidemiol. 2008;167(7):786–92.

    Article  PubMed  Google Scholar 

  68. Kramer MS. Socioeconomic disparities in preterm birth. Paediatr Perinat Epidemiol. 2015;29(3):169–71.

    Article  PubMed  Google Scholar 

  69. Osypuk TL, Slaughter-Acey JC, Kehm RD, Misra DP. Life-course social mobility and reduced risk of adverse birth outcomes. Am J Prev Med. 2016;51(6):975–82.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Carter RT. Racism and psychological and emotional injury: recognizing and assessing race-based traumatic stress. Couns Psychol. 2007;35(1):13–105.

    Article  Google Scholar 

  71. Sellers RM, Smith MA, Shelton JN, Rowley SA, Chavous TM. Multidimensional model of racial identity: a reconceptualization of African American racial identity. Personal Soc Psychol Rev. 1998;2(1):18–39.

    Article  CAS  Google Scholar 

  72. Bentley-Edwards KL, Stevenson HC. The multidimensionality of racial/ethnic socialization: scale construction for the Cultural and Racial Experiences of Socialization (CARES). J Child Fam Stud. 2015;25(1):96–108.

    Article  Google Scholar 

  73. Hughes D, Rodriguez J, Smith EP, Johnson DJ, Stevenson HC, Spicer P. Parents’ ethnic-racial socialization practices: a review of research and directions for future study. Dev Psychol. 2006;42(5):747–70.

    Article  PubMed  Google Scholar 

  74. Mays VM, Cochran SD, Barnes NW. Race, race-based discrimination, and health outcomes among African Americans. Annu Rev Psychol. 2007;58:201–25.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Carter RT, Forsyth JM, Mazzula SL, Williams B. Racial discrimination and race-based traumatic stress: an exploratory investigation. Handbook of Racial-Cultural Psychology and Counseling. 2005;2:447–76.

    Google Scholar 

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Funding

This research was supported by NIH grant R01 HD038098 to Dr. Misra. The NIH took no role in any part of the study, including the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Support was also provided by the Drexel University to Dr. Slaughter-Acey.

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Authors and Affiliations

  1. Department of Health Systems and Sciences Research, College of Nursing and Health Profession, Drexel University, 1601 Cherry St, Mail Stop 71044, Philadelphia, PA, 19102, USA

    Jaime C. Slaughter-Acey

  2. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA

    Jaime C. Slaughter-Acey

  3. Graduate School of Education, University of Pennsylvania, Philadelphia, PA, 19131, USA

    Lloyd M. Talley & Howard C. Stevenson

  4. Department of Family Medicine and Public Health Science, School of Medicine, Wayne State University, Detroit, MI, 48201, USA

    Dawn P. Misra

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  1. Jaime C. Slaughter-Acey
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  2. Lloyd M. Talley
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  4. Dawn P. Misra
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Correspondence to Jaime C. Slaughter-Acey.

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Slaughter-Acey, J.C., Talley, L.M., Stevenson, H.C. et al. Personal Versus Group Experiences of Racism and Risk of Delivering a Small-for-Gestational Age Infant in African American Women: a Life Course Perspective. J Urban Health 96, 181–192 (2019). https://doi.org/10.1007/s11524-018-0291-1

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