Black/White disparities in pregnant women in the United States: An examination of risk factors associated with Black/White racial identity

Abstract

This paper explores racial disparities and risk factors of adverse pregnancy outcomes in Black and White pregnant women in the US. The study uses a cross-sectional approach to explore Black and White disparities using data from the 2012 National Survey on Drug Use and Health (NSDUH), which collects interview data from approximately 70,000 randomly selected participants. We included several self-reported conditions that we categorised as individual and social stressors (e.g. measures of institutionalised racism, individual health behaviours, access to quality care and social context factors). We used descriptive statistics, univariate and multivariate analyses in risk factors of adverse pregnancy outcomes between Black and White women. Black women who were pregnant had a lower socioeconomic status and experienced more measures of institutionalised racism compared to White women who were pregnant. More white women who were pregnant were married, had higher levels of educational attainment, higher income levels, and greater employment opportunities. White pregnant women also had higher levels of private health insurance and less dependency on government programmes for access to healthcare. Results from the regressions indicated that Black pregnant women were less likely to be married (OR = 0.01), less likely to have higher income levels (OR = 0.31) and less likely to be employed (OR = 0.52). However, Black pregnant women were more likely to be younger (OR = 1.82). For the health-eroding behaviours, Black pregnant women were less likely to smoke (OR = 0.53) and use alcohol (0.52). After assessing the SES Household-level stressors (access to healthcare), Black pregnant women were more likely to have Medicaid/CHIP (OR = 3.21) and health coverage through government assistant programmes (OR = 3.80); however, less likely to have private health insurance (OR = 0.38). There are differences in risk factors of adverse pregnancy outcomes between White and Black pregnant women based on measures of individual level/social stressors, institutionalised racism, health behaviours and access to care.

An Exploration of Socio-demographic, Economic, and Environmental Factors in Black/White Disparities in Low Birth Weight Outcomes: A Cross-Sectional Study

“…In contrast to a study which indicated that NH Black women had lower employment levels 10 , in the present research, a higher percentage of NH White women stated that they were not expecting to work next year (e.g. had a lower percentage of employment levels).…”

“…There were categories for missing and excluded data, assessed by such categories as refused, do not know, missing, multiple answers, not asked, skipped, or n/a (which were not used in this study). Similar to other studies only assessing Black/White disparities 10 , 11 , the populations of interest in this study were only NH Blacks and Whites.…”

Examination of maternal near-miss experiences in the hospital setting among Black women in the United States

“…Institutionalized racism is a fundamental cause of the limited resources in Black communities as it results in lower income, inequality in social environments, and less access to health insurance and gainful employment opportunities. 18,[42][43][44] This dearth of resources is a deterrent to attracting highly skilled healthcare providers and community resource investment. Furthermore, this lack of resources and standardized practices may be detrimental during times of health care crises.…”

Naming racism in the public health classroom

“…The field of maternal and child health offers a compelling example of well-documented evidence demonstrating the role that racism plays on health outcomes [36,37]. Specifically, public health scholarship has exhaustively documented the elevated risk of maternal and infant complications during pregnancy for Black women (when compared to White women) [38][39][40].…”