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Racial and Ethnic Disparities in Low Birthweight Among Urban Unmarried Mothers

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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  1. Boardman, J., Powers, D., Padilla, Y., & Hummer, R. (2002). Low birth weight, social factors, and developmental outcomes. Demography, 39, 353–368.

    Article  PubMed  Google Scholar 

  2. Reichman, N. (2005). Low birth weight and school readiness. The Future of Children, 15(1), 91–116.

    Article  PubMed  Google Scholar 

  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 

  4. Hummer, R., Biegler, M., De Turk, P., Forbes, D., Frisbie, W., Hong, Y., & Pullum, S., (1999). Race/ethnicity, nativity and infant mortality in the United States. Social Forces. 77(3), 1083–1118.

    Article  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 

  6. Hughes, D., & Simpson, L. (1995). The role of social change in preventing low birth weight. The Future of Children, 5, 87–102.

    Article  PubMed  CAS  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.

  8. Markides, K., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: An epidemiologic paradox. Public Health Reports, 101, 253–265.

    PubMed  CAS  Google Scholar 

  9. Guendelman, S., & Abrams, B. (1995). Dietary intake among Mexican-American women: Generational differences and a comparison with White non-Hispanic women. American Journal of Public Health, 85, 20–25.

    PubMed  CAS  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 

  14. Schoendorf, K., Hogue, C., Kleinman, J., & Rowley, D. (1992). Mortality among infants of black as compared with white college-educated parents. New England Journal of Medicine, 326, 1522–1526.

    Article  PubMed  CAS  Google Scholar 

  15. McGrady, G., Sung, J., Rowley, D., & Hogue, C. (1992). Preterm delivery and low birth weight among first-born infants of black and white college graduates. American Journal of Epidemiology, 136, 266–276.

    PubMed  CAS  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].

  17. Sung, J., McGrady, G., Rowley, D., Hogue, C., Alema-Mensah, E., & Lypson, M. (1993). Interactive effect of race and marital status in low birthweight. Ethnicity and Disease, 3, 129–136.

    PubMed  CAS  Google Scholar 

  18. Reichman, N., Teitler, J., Garfinkel, I., & McLanahan, S. (2001). Fragile families: Sample and design. Children and Youth Services Review, 23, 303–326.

    Article  Google Scholar 

  19. Geronimus, A. (1992). The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity and Disease, 2, 207–221.

    PubMed  CAS  Google Scholar 

  20. Geronimus, A. (1996). Black/white differences in the relationship of maternal age to birthweight: A population-based test of the weathering hypothesis. Social Science and Medicine, 42, 589–597.

    Article  PubMed  CAS  Google Scholar 

  21. Reichman, N., & Teitler, J. (2006). Paternal age as a risk factor for low birthweight. American Journal of Public Health, 96, 862–866.

    Article  PubMed  Google Scholar 

  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.

  23. Padilla, Y., & Reichman, N. (2001). Low birthweight: do unwed fathers help? Children and Youth Services Review, 23, 505–530.

    Article  Google Scholar 

  24. Carlson, M., McLanahan, S., & England, P. (2004). Union formation in fragile families. Demography, 41, 237–262.

    Article  PubMed  Google Scholar 

  25. Mason, J. (1991). Reducing infant mortality in the United States through “Healthy Start.”. Public Health Reports, 106, 479–483.

    PubMed  CAS  Google Scholar 

  26. Bird, S., Chandra, A., Bennett, T., & Harvey, S. (2000). Beyond marital status: Relationship type and duration and the risk of low birth weight. Family Planning Perspectives, 32, 281–287.

    Article  PubMed  CAS  Google Scholar 

  27. Doucet, H., Baumgarten, M., & Infante-Rivard, C. (1989). Low birth weight and household structure. Journal of Developmental and Behavioral Pediatrics, 10, 249–252.

    Article  PubMed  CAS  Google Scholar 

  28. Henshaw, D. (1998). Unintended pregnancy in the United States. Family Planning Perspectives, 30, 24–29, 46.

    Google Scholar 

  29. Reichman, N., & Teitler, J. (2003). Effects of psychosocial risk factors and prenatal interventions on birth weight: Evidence from New Jersey’s HealthStart Program. Perspectives on Sexual and Reproductive Health, 35, 130–137.

    Article  PubMed  Google Scholar 

  30. Koenig, H., McCullough, M., & Larson, D. (2001). Handbook of religion and health. Oxford: Oxford University Press.

    Google Scholar 

  31. Magaña, A., & Clark, N. (1995). Examining a paradox: Does religiosity contribute to positive birth outcomes in Mexican American populations? Health Education Quarterly, 22, 96–109.

    PubMed  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.

  33. Wadhwa, P., Sandman, C., Porto, M., Dunkel-Schetter, C., & Garite, T. (1993). The association between prenatal stress and infant birth weight and gestational age at birth: A prospective investigation. American Journal of Obstetrics and Gynecology, 169, 858–865.

    PubMed  CAS  Google Scholar 

  34. Morenoff, J. (2003). Neighborhood mechanisms and the spatial dynamics of birth weight. American Journal of Sociology, 108, 976–1017.

    Article  Google Scholar 

  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 

  37. Reichman, N., & Pagnini, D. (1998). Urban inequalities? Birth outcomes across New Jersey cities. Applied Behavioral Science Review, 6, 111–135.

    Article  Google Scholar 

  38. Corman, H., Noonan, K., Reichman, N., & Dave, D. (2005). Demand for illicit drugs among pregnant women. Advances in Health Economics and Health Services Research, 16, 41–60.

    Article  PubMed  Google Scholar 

  39. Frisbie, W., Forbes, D., & Hummer, R. (1998). Hispanic pregnancy outcomes: Additional evidence. Social Science Quarterly, 79, 149–160.

    Google Scholar 

  40. Finch, B., Frank, R., & Hummer, R. (2000). Racial/ethnic disparities in infant mortality: The role of behavioral factors. Social Biology, 47, 244–263.

    PubMed  CAS  Google Scholar 

  41. Starfield, B., Shapiro, S., Weiss, J., Liang, K., Ra, K., Paige, D., & Wang, X. (1991). Race, family income, and low birth weight. American Journal of Epidemiology, 134, 1167–1196.

    PubMed  CAS  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.

    Article  PubMed  CAS  Google 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..

  44. Shiono, P., Rauh, V., Park, M., Lederman, S., & Zuskar, D. (1997). Ethnic differences in birthweight: the role of lifestyle and other factors. American Journal of Public Health, 87, 787–793.

    Article  PubMed  CAS  Google Scholar 

  45. Zambrana, R., Dunkel-Schetter, C., Collins, N., & Scrimshaw, S. C. (1999). Mediators of ethnic-associated differences in infant birth weight. Journal of Urban Health, 76, 102–116.

    Article  PubMed  CAS  Google Scholar 

  46. American College of Physicians (1997). Inner-city health care. Annals of Internal Medicine, 126, 485–490.

    Google Scholar 

  47. Lopez-Gonzalez, L., Aravena, V., & Hummer, R. (2005). Immigrant acculturation, gender, and health behavior. Social Forces, 84, 581–593.

    Article  Google Scholar 

  48. Lu, M., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7, 13–30.

    Article  PubMed  Google Scholar 

  49. Misra, D., Guyer, B., & Allston, A. (2003). Integrated perinatal health framework: A multiple determinants model with a lifespan approach. American Journal of Preventive Medicine, 25, 65–75.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

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.

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Correspondence to Nancy E. Reichman.

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Reichman, N.E., Hamilton, E.R., Hummer, R.A. et al. Racial and Ethnic Disparities in Low Birthweight Among Urban Unmarried Mothers. Matern Child Health J 12, 204–215 (2008). https://doi.org/10.1007/s10995-007-0240-1

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  • DOI: https://doi.org/10.1007/s10995-007-0240-1

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