Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

Mustillo, Sarah A.; Krieger, Nancy; Gunderson, Erica P.; Sidney, Stephen; McCreath, Heather; Kiefe, Catarina I.

doi:10.2105/ajph.94.12.2125

Cited by 325 publications

(322 citation statements)

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“…Our study complements the few existing empirical studies of racism and infant health outcomes. However, not unlike other studies that have investigated racism and birth outcomes, [28][29][30]48 our observed association between racism and low birth weight did not attain statistical significance in adjusted analyses, and therefore our empirical findings are only mildly suggestive of a relationship. We relied on retrospective selfreports of birth outcomes from a sample birth cohort that cannot be generalized to the counties, and our sample may have been inadequately powered for the measured associations.…”

Section: Discussioncontrasting

confidence: 98%

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Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

et al. 2011

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Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a crosssectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N=629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.

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Section: Discussioncontrasting

confidence: 98%

“…[21][22][23] Perceived discrimination has been associated with low selfrated mental and physical health, [24][25][26] low birth weight, [27][28][29] and preterm delivery 30,31 among African Americans. Perceived discrimination has also been associated with hypertension 32,33 and smoking, 34 which are risk factors during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

et al. 2011

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“…The fact that a third of Whites perceived that they had been the direct target of unfair treatment because of race is a somewhat surprising statistic, but it is fairly comparable with White rates reported in other studies (e.g., Krieger et al, 2005;Mustillo et al, 2004), is less than a majority, and is considerably lower than that for African Americans, in accordance with hypothesized racial differences. In addition, the African Americans and Whites studied here exhibited a similar pattern of association between perceived racism and the other stress variables (for Whites, rs ranged from .24 for pregnancy anxiety to .44 for stressful life events; for African Americans, rs ranged from .29 for pregnancy anxiety to .53 for stressful life events), suggesting that racism is a form of stress that can be validly assessed in both groups.…”

Section: Discussionsupporting

confidence: 77%

Racial differences in birth outcomes: The role of general, pregnancy, and racism stress.

Dominguez¹,

Dunkel-Schetter²,

Glynn³

et al. 2008

Health Psychology

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Objective-This study examined the role of psychosocial stress in racial differences in birth outcomes.Design-Maternal health, sociodemographic factors, and 3 forms of stress (general stress, pregnancy stress, and perceived racism) were assessed prospectively in a sample of 51 African American and 73 non-Hispanic White pregnant women.Main Outcome Measures-The outcomes of interest were birth weight and gestational age at delivery. Only predictive models of birth weight were tested as the groups did not differ significantly in gestational age.Results-Perceived racism and indicators of general stress were correlated with birth weight and tested in regression analyses. In the sample as a whole, lifetime and childhood indicators of perceived racism predicted birth weight and attenuated racial differences, independent of medical and sociodemographic control variables. Models within each race group showed that perceived racism was a significant predictor of birth weight in African Americans, but not in non-Hispanic Whites.Conclusions-These findings provide further evidence that racism may play an important role in birth outcome disparities, and they are among the first to indicate the significance of psychosocial factors that occur early in the life course for these specific health outcomes. Keywords stress; racism; pregnancy; birth weight; health disparities African Americans are twice as likely as non-Hispanic Whites, the most common referent group, to die before their first birthday (Mathews, Menacker, & MacDorman, 2004). In this Correspondence concerning this article should be addressed to Tyan Parker Dominguez, School of Social Work, SWC 224, University of Southern California, Los Angeles, CA 90089-0411, or Christine Dunkel-Schetter, Department of Psychology, 405 Hilgard Avenue, University of California, Los Angeles, CA 90095-1563. tyanpark@usc.edu or dunkel@psych.ucla.edu. NIH Public Access Author ManuscriptHealth Psychol. Author manuscript; available in PMC 2010 May 12. Published in final edited form as:Health Psychol. 2008 March ; 27(2): 194-203. doi:10.1037/0278-6133.27.2.194. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript country, low birth weight (LBW; <2,500 g) and preterm delivery (PTD; <37 weeks) are leading causes of infant death in the overall population, behind congenital anomalies, and the leading causes of death for African American infants (Mathews et al., 2004). Compared with White infants, African American infants have two times the rate of LBW and PTD, and three times the rate of very low birth weight (<1,500 g) and very preterm delivery (<32 weeks) (Martin et al., 2005). These poorer birth outcomes have serious implications not only for infant survival, but also for childhood growth and development (e.g., Botting, Powls, Cooke, & Marlow, 1998) and some important health outcomes in adulthood (e.g., Rich-Edwards et al, 1997). Thus, understanding and eventually eliminating racial disparities in adverse birth outcomes is a major public health priority in the United ...

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“…Research on stressors for African American women reveals that during pregnancy, they anticipate their children experiencing racial inequalities which includes the possibility of negative police interactions. The psychosocial stress produced by racial and gendered inequities is associated with disproportionately higher rates of adverse birth outcomes among African American women, regardless of their socioeconomic position [11][12][13][14][15][16]. Studies have also revealed significant associations between intersectional racial and gendered stress (that includes parenting demands) and antenatal depression [17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Anticipated Negative Police-Youth Encounters and Depressive Symptoms among Pregnant African American Women: A Brief Report

et al. 2017

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The widely publicized violent encounters between police and African American youth have unknown consequences for the emotional and mental health of pregnant African American women. Since studies document the hypervigilance black mothers exert to protect children from violence and racism and findings also reveal the association between racial and gendered stress (which includes parenting stressors) and depressive symptoms during pregnancy, an examination of the effects of stress from anticipated negative experiences between black youth and police on maternal mental health is warranted. Between July and August 2014, 100 mostly low income pregnant African American women who lived in metropolitan Atlanta and were in their first and second trimesters completed the Edinburgh postnatal depression scale, selected items from the Jackson, Hogue, Phillips contextualized stress measure, and a demographic form. Bivariate and logistic regression analyses were conducted in response to questions that asked: (1) is the anticipation of negative encounters between black youth and police associated with antenatal depressive symptoms and (2) how does the presence of prior children, male or female, contribute to the association? For question 1, the results showed that anticipated negative African American youth-police experiences were significantly associated with antenatal depressive symptoms χ 2 (2, N = 87) = 12.62, p = .002. For question 2, the presence of a preschool-aged male child in the home was significantly associated with antenatal depression (p = .009, odds ratio = 13.23). The observed associations between antenatal depressive symptoms and anticipated negative policeyouth encounters have implications for clinical-and community-based interventions responding to the unique psychosocial risks for pregnant African American women.

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Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

Cited by 325 publications

References 46 publications

Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

Racial differences in birth outcomes: The role of general, pregnancy, and racism stress.

Anticipated Negative Police-Youth Encounters and Depressive Symptoms among Pregnant African American Women: A Brief Report

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