Persons who were perceived to be Arabs experienced a period of increased harassment, violence, and workplace discrimination in the United States in the weeks immediately following September 11, 2001. Drawing on prior studies that have hypothesized that experiences of discrimination increase the risk of preterm birth and low birth weight, this study explores whether there was an effect on birth outcomes for pregnant women of Arab descent. California birth certificate data are used to determine the relative risk of poor birth outcomes by race, ethnicity, and nativity for women who gave birth in the six months following September 2001, compared with the same six calendar months one year earlier. The relative risk of poor birth outcomes was significantly elevated for Arabic-named women and not for any of the other groups.
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American-Arab Anti-Discrimination Committee Research Institute. 2003. “Report on Hate Crimes and Discrimination Against Arab Americans: September 11, 2001 to October 11, 2002.” Available online at http://www.adc.org/hatecrimes
Barker, D.L. 1995. “Fetal Origins of Coronary Heart Disease.” BMJ 311:171–74.
Buekens, P. and M. Klebanoff. 2001. “Preterm Birth Research: From Disillusion to the Search for New Mechanisms.” Paediatric and Perinatal Epidemiology 15(Suppl. 2):159–61.
California Department of Justice. 2001. Hate Crime in California, 2001. Sacramento, CA: Criminal Justice Statistics Center.
Clark, R., N.B. Anderson, V.R. Clark, and D.R. Williams. 1999. “Racism as a Stressor for African Americans: A Biopsychosocial Model.” American Psychologist 54:805–16.
Collins, J.W., Jr., and R.J. David. 1997. “Urban Violence and African-American Pregnancy Outcome: an Ecologic Study.” Ethnicity and Disease 7:184–90.
Collins, J.W., Jr., R.J. David, A. Handler, S. Wall, and S. Andes. 2004. “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination.” American Journal of Public Health 94:2132–38.
Collins, J.W., Jr., R.J. David, R. Symons, A. Handler, S.N. Wall, and L. Dwyer. 2000. “Low-Income African-American Mothers’ Perception of Exposure to Racial Discrimination and Infant Birth Weight.” Epidemiology 11:337–39.
Couzin, J. 2002. “Quirks of Fetal Environment Felt Decades Later.” Science 296:2167–69.
Doblhammer, G. and J.W. Vaupel. 2001. “Lifespan Depends on Month of Birth.” Proceedings of the National Academy of Sciences of the United States of America 98:2934–39.
Dole, N., D.A. Savitz, I. Hertz-Picciotto, A.M. Siega-Riz, M.J. McMahon, and P. Buekens. 2003. “Maternal Stress and Preterm Birth.” American Journal of Epidemiology 157:14–24.
Dole, N., D.A. Savitz, A.M. Siega-Riz, I. Hertz-Picciotto, M.J. McMahon, and P. Buekens. 2004. “Psychosocial Factors and Preterm Birth Among African American and White Women in Central North Carolina.” American Journal of Public Health 94:1358–65.
Elo, I.T., M. Turra, B. Kestenbaum, and B.R. Ferguson. 2004. “Mortality Among Elderly Hispanics in the United States: Past Evidence and New Results.” Demography 41:109–28.
Finch, B.K. 2003. “Socioeconomic Gradients and Low Birth-Weight: Empirical and Policy Considerations.” Health Services Research 38:1819–41.
Gortmaker, S.L. and P.H. Wise. 1997. “The First Injustice: Socioeconomic Disparities, Health Services Technology, and Infant Mortality.” Annual Review of Sociology 23:147–70.
Hack, M., N.K. Klein, and H.G. Taylor. 1995. “Long-Term Developmental Outcomes of Low Birth Weight Infants.” The Future of Children 5:176–96.
Hedegaard, M., T.B. Henriksen, N.J. Secher, M.C. Hatch, and S. Sabroe. 1996. “Do Stressful Life Events Affect Duration of Gestation and Risk of Preterm Delivery?” Epidemiology 7:339–45.
Hobel, C. and J. Culhane. 2003. “Role of Psychosocial and Nutritional Stress on Poor Pregnancy Outcome.” The Journal of Nutrition 133:1709S-17S.
Hobel, C.J., C. Dunkel-Schetter, S.C. Roesch, L.C. Castro, and C.P. Arora. 1999. “Maternal Plasma Corticotropin-Releasing Hormone Associated With Stress at 20 Weeks’ Gestation in Pregnancies Ending in Preterm Delivery.” American Journal of Obstetrics and Gynecology 180:S257–63.
Hogue, C.J., S. Hoffman, and M.C. Hatch. 2001. “Stress and Preterm Delivery: A Conceptual Framework.” Paediatric and Perinatal Epidemiology 15(Suppl.) 2:30–40.
Holzman, C., J. Jetton, T. Siler-Khodr, R. Fisher, and T. Rip. 2001. “Second Trimester Corticotropin-Releasing Hormone Levels in Relation to Preterm Delivery and Ethnicity.” Obstetrics and Gynecology 97:657–63.
Iyasu, S., K. Tomashek, and W. Barfield. 2002. “Infant Mortality and Low Birth Weight Among Black and White Infants—United States, 1980–2000.” Morbidity and Mortality Weekly Report 51(27):589–92. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/ mm5127a1.htm
Jackson, F.M., M.T. Phillips, C.J. Hogue, and T.Y. Curry-Owens. 2001. “Examining the Burdens of Gendered Racism: Implications for Pregnancy Outcomes Among College-Educated African American Women.” Maternal and Child Health Journal 5:95–107.
Kong, D. 2001. “Communities Mourn Four Men Believed to Be Killed in Backlash Violence After Attacks.” The Associated Press State and Local Wire. October 10. Accessed online at http://web.lexis-nexis.com/universe/document?_m=bbedb524801f6d57d19e8f7e489bcaee&_ docnum=1&wchp=dGLbVzz-zSkVA&_md5=fca482edc989a3682b51e70ae0a75074
Krieger, N. 1999. “Embodying Inequality: A Review of Concepts, Measures, and Methods for Studying Health Consequences of Discrimination.” International Journal of Health Services 29:295–352.
Krieger, N. and S. Sidney. 1996. “Racial Discrimination and Blood Pressure: The CARDIA Study of Young Black and White Adults.” American Journal of Public Health 86:1370–78.
Lauderdale, D.S. and B. Kestenbaum. 2000. “Asian American Ethnic Identification by Surname.” Population Research and Policy Review 19:283–300.
—. 2002. “Mortality of Elderly Asian American Populations Based on Medicare and Social Security Data.” Demography 39:529–40.
Lockwood, C.J. 1999. “Stress-Associated Preterm Delivery: The Role of Corticotropin-Releasing Hormone.” American Journal of Obstetrics and Gynecology 180:S264–66.
Mancuso, R.A., C.D. Schetter, C.M. Rini, S.C. Roesch, and C.J. Hobel. 2004. “Maternal Prenatal Anxiety and Corticotropin-releasing Hormone Associated With Timing of Delivery.” Psychosomatic Medicine 66:762–69.
Martin, J.A., B.E. Hamilton, P.D. Sutton, S.J. Ventura, F. Menacker, and M. Munson. 2003. “Births: Final Data for 2002.” National Vital Statistics Report 52(10):1–113.
McLean, M., A. Bisits, J. Davies, W. Walters, A. Hackshaw, K. De Voss, and R. Smith. 1999. “Predicting Risk of Preterm Delivery by Second-Trimester Measurement of Maternal Plasma Corticotropin-Releasing Hormone and Alpha-fetoprotein Concentrations.” American Journal of Obstetrics and Gynecology 181:207–15.
Meyer, I.H. 2003. “Prejudice as Stress: Conceptual and Measurement Problems.” American Journal of Public Health 93:262–65.
Morenoff, J.D. 2003. “Neighborhood Mechanisms and the Spatial Dynamics of Birth Weight.” American Journal of Sociology 108:976–1017.
Morrison, P.A., Kestenbaum, B., Lauderdale, D.S., Abrahamse, A.F. and A. El-Badry. 2003. “Developing an Arab American Surname List: Potential Demographic and Health Research Applications.” Presented at the annual meeting of the Southern Demographic Association, Alexandria, VA, October 23–25.
Murrell, N.L. 1996. “Stress, Self-esteem, and Racism: Relationships With Low Birth Weight and Preterm Delivery in African American Women.” Journal of the Black National Nurses’ Association 8:45–53.
Mustillo, S., N. Krieger, E.P. Gunderson, S. Sidney, H. McCreath, and C.I, Kiefe. 2004. “Selfreported Experiences of Racial Discrimination and Black-White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study.” American Journal of Public Health 94: 2125–31.
Neeraj, K., R. Kaestner, and C. Reimers. 2004. “Backlash: Effects of 9/11 on Immigrants, Muslims and Arabs Living in the U.S.” Presented at the annual meeting of the Population Association of America, Boston, April 1–3.
O’Campo, P., X. Xue, M.C. Wang, and M. Caughy. 1997. “Neighborhood Risk Factors for Low Birthweight in Baltimore: A Multilevel Analysis.” American Journal of Public Health 87:1113–38.
Office of Management and Budget. 1978. “Directive No. 15: Race and Ethnic Standards for Federal Statistics and Administrative Reporting.” In Statistical Policy Handbook. Washington, DC: Office of Federal Statistical Policy and Standards, U.S. Department of Commerce.
Paarlberg, K.M., A.J. Vingerhoets, J. Passchier, G.A. Dekker, A.G. Heinen, and H.P. van Geijn. 1999. “Psychosocial Predictors of Low Birthweight: A Prospective Study.” British Journal of Obstetrics and Gynaecology 106:834–41.
Passel, J.S. and D.L. Word. 1980. “Constructing the List of Spanish Surnames for the 1980 Census: An Application of Bayes Theorem.” Presented at the annual meeting of the Population Association of America, Denver, April 10–12.
Piper, J.M., E.F. Mitchel, Jr., M. Snowden, C. Hall, M. Adams, and P. Taylor. 1993. “Validation of 1989 Tennessee Birth Certificates Using Maternal and Newborn Hospital Records.” American Journal of Epidemiology 137:758–68.
Pritchard, C.W. and P.Y. Teo. 1994. “Preterm Birth, Low Birthweight and the Stressfulness of the Household Role for Pregnant Women.” Social Science and Medicine 38:89–96.
Reichman, N.E. and E.M. Hade. 2001. “Validation of Birth Certificate Data. A Study of Women in New Jersey’s HealthStart Program.” Annals of Epidemiology 11:186–93.
Rich-Edwards, J., N. Krieger, J. Majzoub, S. Zierler, E. Lieberman, and M. Gillman. 2001. “Maternal Experiences of Racism and Violence as Predictors of Preterm Birth: Rationale and Study Design.” Paediatric and Perinatal Epidemiology 15(Suppl. 2):124–35.
Rondo, P.H., R.F. Ferreira, F. Nogueira, M.C. Ribeiro, H. Lobert, and R. Artes. 2003. “Maternal Psychological Stress and Distress as Predictors of Low Birth Weight, Prematurity and Intrauterine Growth Retardation.” European Journal of Clinical Nutrition 57:266–72.
Rosenberg, L., J.R. Palmer, L.A. Wise, N.J. Horton, and M.J. Corwin. 2002. “Perceptions of Racial Discrimination and the Risk of Preterm Birth.” Epidemiology 13:646–52.
Ruggles, S., M. Sobek, et al. 2003. “Integrated Public Use Microdata Series: Version 3.0.” Minneapolis: Historical Census Projects, University of Minnesota. Available online at http://www. ipums.org
Samhan, H.H. 1999. “Not Quite White: Race Classifiation and the Arab-American Experience.” Pp. 209–26 in Arabs in America: Building a New Future, edited by M.W. Suleiman. Philadelphia: Temple University Press.
Singh, A. 2002. “We Are Not the Enemy: Hate Crimes Against Arabs, Muslims and Those Perceived to be Arabs or Muslims After September 11.” Human Rights Watch Report, Vol. 14, No. 6(G). Human Rights Watch, New York.
U.S. Department of Health and Human Services. 2000. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office.
Wadhwa, P.D., J.F. Culhane, V. Rauh, and S.S. Barve. 2001. “Stress and Preterm Birth: Neuroendocrine, Immune/Inflammatory, and Vascular Mechanisms.” Maternal and Child Health Journal 5:119–25.
Wadhwa, P.D., T.J. Garite, M. Porto, L. Glynn, A. Chicz-DeMet, C. Dunkel-Schetter, C.A. Sandman. 2004. “Placental Corticotropin-Releasing Hormone (CRH), Spontaneous Preterm Birth, and Fetal Growth Restriction: A Prospective Investigation.” American Journal of Obstetrics and Gynecology 191:1063–69.
Wadhwa, P.D., M. Porto, T.J. Garite, A. Chicz-DeMet, and C.A. Sandman. 1998. “Maternal Corticotropin-Releasing Hormone Levels in the Early Third Trimester Predict Length of Gestation in Human Pregnancy.” American Journal of Obstetrics and Gynecology 179:1079–85.
Whitehead, N., H.A. Hill, D.J. Brogan, and C. Blackmore-Prince. 2002. “Exploration of Threshold Analysis in the Relation Between Stressful Life Events and Preterm Delivery.” American Journal of Epidemiology 155:117–24.
Wilcox, A.J. 2001. “On the Importance—and the Unimportance—of Birthweight.” International Journal of Epidemiology 30:1233–41.
Williams, D.R., H.W. Neighbors, and J.S. Jackson. 2003. “Racial/Ethnic Discrimination and Health: Findings From Community Studies.” American Journal of Public Health 93:200–208.
Word, D.L. and R.C. Perkins, Jr. 1996. “Building a Spanish Surname List for the 1990’s: A New Approach to an Old Problem.” Technical Working Paper 13. U.S. Census Bureau, Washington, DC.
Young, P. 2001. “Anti-Arab Hate Crimes Declining; Civil Rights Incidents Drop to Near-Normal Levels Since Post-Attack Jump, Organizations Say.” Long Beach Press-Telegram, December 13, p.1.
Zapata, B.C., A. Rebolledo, E. Atalah, B. Newman, and M.C. King. 1992. “The Influence of Social and Political Violence on the Risk of Pregnancy Complications.” American Journal of Public Health 82:685–90.
Zhang, J. and W.A. Bowes, Jr. 1995. “Birth-Weight-for-Gestational-Age Patterns by Race, Sex, and Parity in the United States Population.” Obstetrics and Gynecology 86:200–208.
Zogby International. 2001. “Arab American Institute Poll Results: Arab Americans Are Strong Advocates of War Against Terrorism; Overwhelmingly Endorse President Bush’s Actions; Significant Numbers Have Experienced Discrimination Since Sept. 11.” Available at http://www.zogby.com/ news/ReadNews.dbm?ID=487
The author thanks the Center for Health Statistics of the California Department of Health Services for access to the data. However, all analyses, interpretations, and conclusions are the author’s. The author also thanks Bert Kestenbaum of the Office of the Actuary, Social Security Administration, for developing name lists specifically for the requirements of these data, and Peter Morrison and Bert Kestenbaum for comments on an early draft of the article.
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Lauderdale, D.S. Birth outcomes for Arabic-named women in California before and after September 11. Demography 43, 185–201 (2006). https://doi.org/10.1353/dem.2006.0008
- Preterm Birth
- African American Woman
- Birth Outcome
- Fetal Growth Restriction
- Hate Crime