Adverse Birth Outcomes

With respect to black women in particular Geronimus' "weather" hypothesis suggests that chronic stress created by deprivation of rights, racism and social and economic disadvantage leads to more rapid declines in early health in adulthood, among black women than white women in the United States. Work focused on physiological stress pathways highlights how time can cause faster biological aging, thus putting women at risk of adverse birth outcomes, including SGA newborns before they are pregnant. Physiological dis-regulation induced by chronic exposure stress can lead to excess cortisol, a hormone and corticotropin releasing, which can retard fetal growth. In addition, the metabolic processes in circulating maternal cardiovascular dysfunction

One of the most persisting health disparities is the birth outcomes between African Americans and White Americans. A significant portion in infant mortality is the increase of low birth weight, and preterm birth among black infants. The socially and economically disadvantaged population affects the maternal and child health outcomes. “The life course perspective “is the women’s life -course experiences that links to the maternal health and pregnancy outcome. It is used to understand how transitions and trajectories factors impact one’s life. The cumulative pathway mechanism how stress, exposures to the physical and the social environment in different life stages that accumulates over time affect health and causes dysfunction. Racial

Describe the impact of extremely low birth weight babies on family and society (short and long term, including economic considerations, ongoing care considerations, and comorbidities associated with prematurity).

Poverty stricken women are forced to live in communities with high crime and drug activity, increased unemployment and poor education school system. These adversities affect African American women at larger degrees throughout her lifetime. African American women are more likely to become a teen mother compared to other groups of women (Ukockis, 2016). This will place her at risks for economic hardships and physical, mental and emotional abuse.

In line with previous studies [9, 10]; we found out that maternal socioeconomic position was significantly associated with LBW. Mothers of Low SES (the poorest household wealth, no formal education, and no formal occupation) were more likely to give birth to LBW babies. The CSDH defines structural determinants of health as those conditions that generate social stratification in society. Consequently, social stratification gives rise to an unequal distribution of the social determinants of health, including material living and working conditions and psychosocial circumstances as well as behavioral and biological risk factors [8].

In the United States alone, the mortality rate among black infants is more than double the number of white infants in targeted urban areas in New York City ("Racism-induced stress linked with high black infant mortality rates," 2017). These numbers are continuing to increase as more and more evidence suggests that some of the significant causes are stress and anxiety amongst black mother’s due to racial discrimination and social factors. Researchers have sought out other possible explanations for why the black infant mortality rate is so high – such as drinking, obesity, poor eating habits, smoking, or access to prenatal care. However, none of the factors examined, combined or separate, were found to be substantial enough to fully account for

Yet, these preterm births and the deaths can be stopped and prevented with established, low cost involvements. There is a prominent, noticeable and

One aspect that has been analyzed in studies is that African American women adopt a very protective role when it comes to their children, specifically to protect them from racism (Jackson, F. M., Phillips, M. T., Rowland Hogue, C. J., & Curry-Owens, T. Y., 2001). This role can be adopted during and after pregnancy, which then leads to immense stress. When this co-occurs with gendered racism, experienced at work or other social interactions, it can provide for a very stressful response. African American women also have been reported to, as compared to white women, have greater responses in systolic blood pressure and slower diastolic blood pressure recovery in response to psychological challenges. Some might argue that this is only applicable in African American women who lack education or are not well off financially, however many studies have revealed that Black college-educated women have higher rates of PTB than their white college-educated counterparts (Schoendorf et al., 1992).

associations in a pathway model connecting race-based discrimination, stress, and negative preterm birth outcomes in African American women.

Socioeconomic factors include “poverty, marginal employment, low incomes, segregated living conditions, and inadequate education” (Cockerham, 2015). These factors are more common among blacks than whites and are known to cause poor health. Studies have shown that black women are more prone to be exposed to psychosocial stress from poverty and low-paying jobs, which plays an important role in triggering labor in pregnant women. With the elevated buildup of stress hormones, it can cause the body to trigger early labor and other pregnancy problems. Leading to higher rates of infant

-Race or ethnicity: Historically, minority populations in the United States have had higher rates of preterm delivery. In 2007, non-Hispanic White women accounted for the lowest number of preterm births in the United States, accounting for only 11.5% of all preterm births (MacDorman, 2011). In contrast, non-Hispanic Blacks, Puerto Ricans, American Indians and Hispanic women had preterm birth levels of 18.3%, 14.5%, 13.9% and 12.3% respectively (MacDorman, 2011). The Asian minority had the lowest risk at 10.9% (MacDorman, 2011). Some studies have attributed such significant differences to racial disparities in resources and health care (Dominguez, 2008; Vanderbilt & Wright, 2013). However, other studies such as Menon’s et al, which looked at differences in White versus Black women, suggest that racial disparities in preterm birth may

Multiple studies have been conducted on infant mortality and preterm birth in the United States. Many have identified how the rate of infant mortality and preterm birth is twice as high among African Americans women than White American women in the United States.(Orr et. al,2012; Dole et al,2004;Collins,2002) some studies convey socioeconomic as a major factor of preterm birth among African American’s. As Kleinman conveys in Racial differences in low birthweight: Trendsand risk factors when socioeconomic status increases the risk of giving birth to an infant of low birthweight decreases. On the other hand, there are some studies that convey high differences of preterm birth between black and white women of equal socioeconomic status.(Dole et

In addition to infant mortality, infant survivors of LBW and preterm delivery, often experience greater problems in childhood and adulthood. Some of these experiences include higher rates of respiratory illness, impaired growth, cognitive and emotional deficiencies, lower academic achievement and risk of hypertension, diabetes and mental health issues (Behrman and Butler, 2007, Conley and Bennett, 2000 and Raikkonen et al., 2007). The Center for Disease Control (CDC) report that African American pregnancies are at an elevated risk for poor birth outcomes. Figure 1. shows national birth outcomes for African American, Hispanic, and Caucasian pregnancies, as reported by the CDC in 2013:

The horrifying pregnancy mortality rates and health disparities that exist between races are striking as well as terrifying to me. Although I was aware of the existence of health disparities, I was still taken back by the discrepancies in pregnancy-related mortality ratios of “12.7 deaths per 100,000 live births” in white women, to “43.5 deaths per 100,000 live births” in black women (CDC, n.d). Through root cause analyses, as well as reflection on the analogy provided in Levels of Racism: A Theoretic Framework and a Gardener’s Tale, it is clear that in order to effectively address and make positive change in the aforementioned ratios, we must focus on correcting institutionalized racism, personally mediated racism and internalized racism.

In the United States, the process of childbirth is far more dangerous for African American women than it is for White women. For African American women, the path to a healthy birth is riddled with barriers. There are many health disparities between the two races. African American women face much higher low-birth and infant mortality rates; the Centers for Disease Control and Prevention has published that although infant mortality rates in the U.S. have dropped by over 10% in the past ten years, a large gap continues to exist between the health of the races during the entire childbirth process. (World Health Organization, 2010) In the United States, Black infants are more than twice as likely to die within the first year of life as a White infant, and this disparity has not seen advancements in the last century. Many of these deaths can be attributed to low birth weight, and preterm birth among black infants.