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Joint effects of structural racism and income inequality on small-for-gestational-age birth

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  • Wallace, M.E.
  • Mendola, P.
  • Liu, D.
  • Grantz, K.L.

Abstract

Objectives. We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. Methods. Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor's or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. Results. Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. Conclusions. High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur. © 2015, American Public Health Association Inc. All rights reserved.

Suggested Citation

  • Wallace, M.E. & Mendola, P. & Liu, D. & Grantz, K.L., 2015. "Joint effects of structural racism and income inequality on small-for-gestational-age birth," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 1681-1688.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302613_8
    DOI: 10.2105/AJPH.2015.302613
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    Cited by:

    1. Jeffers, Noelene K. & Berger, Blair O. & Marea, Christina X. & Gemmill, Alison, 2023. "Investigating the impact of structural racism on black birthing people - associations between racialized economic segregation, incarceration inequality, and severe maternal morbidity," Social Science & Medicine, Elsevier, vol. 317(C).
    2. Altman, Molly R. & Oseguera, Talita & McLemore, Monica R. & Kantrowitz-Gordon, Ira & Franck, Linda S. & Lyndon, Audrey, 2019. "Information and power: Women of color's experiences interacting with health care providers in pregnancy and birth," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    3. Riley, Taylor & Schleimer, Julia P. & Jahn, Jaquelyn L., 2024. "Organized abandonment under racial capitalism: Measuring accountable actors of structural racism for public health research and action," Social Science & Medicine, Elsevier, vol. 343(C).
    4. Jahn, Jaquelyn L. & Chen, Jarvis T. & Agénor, Madina & Krieger, Nancy, 2020. "County-level jail incarceration and preterm birth among non-Hispanic Black and white U.S. women, 1999–2015," Social Science & Medicine, Elsevier, vol. 250(C).
    5. Veni Kandasamy & Ashley H Hirai & Jay S Kaufman & Arthur R James & Milton Kotelchuck, 2020. "Regional variation in Black infant mortality: The contribution of contextual factors," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    6. Neblett, Enrique W., 2023. "Racism measurement and influences, variations on scientific racism, and a vision," Social Science & Medicine, Elsevier, vol. 316(C).
    7. Cubbin, Catherine & Kim, Yeonwoo & Vohra-Gupta, Shetal & Margerison, Claire, 2020. "Longitudinal measures of neighborhood poverty and income inequality are associated with adverse birth outcomes in Texas," Social Science & Medicine, Elsevier, vol. 245(C).
    8. Riley, Taylor & Enquobahrie, Daniel A. & Callegari, Lisa S. & Hajat, Anjum, 2024. "Structural gendered racism and preterm birth inequities in the United States," Social Science & Medicine, Elsevier, vol. 348(C).
    9. Jennifer B. Kane & Claire Margerison-Zilko, 2017. "Theoretical Insights into Preconception Social Conditions and Perinatal Health: The Role of Place and Social Relationships," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(5), pages 639-669, October.

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