Get started
Work

The effects of institutional racism, perceived discrimination and maternal stress on preterm birth

Year: 2019
Type: article
Study design: Observational Study
Abstract: There are tremendous racial/ethnic disparities in preterm birth that have not been ameliorated. Individual health risks do not explain these disparities, and there is limited research exploring the social and contextual factors contributing to these disparities. This research explores institutional racism as a fundamental cause of the racial/ethnic disparities in preterm birth. The Home Mortgage Disclosure Act (HMDA) database was used to create a measure for residential redlining and the 2000 US Census was used to create measures for residential redlining and percentage black. The Stress Pregnancy Evaluation Community Project (SPEAC), a cohort of pregnant women (N=3949), had linked vital birth records and geocoded addresses, which were linked to measures of redlining, segregation and percent black on the census tract level. Multilevel logistic and linear regression models were used to examine the relationship between institutional racism and preterm birth (and change in gestational age) using SAS 9.2. The first dissertation paper examined the distribution of residential redlining in the neighborhoods where the SPEAC cohort lived. We also examined the racial/ethnic differences in residences in redlined neighborhoods. We found that the majority of the SPEAC population lived in redlined neighborhoods and that non-Hispanic black women were more likely to live in redlined neighborhoods. The second dissertation paper examined the relationship between residential redlining and perceptions of discrimination, stress and neighborhood quality. We also examined racial/ethnic differences in these same perception measures. Black non-Hispanic women had a greater mean residential redlining index, greater perceived everyday discrimination score, and more adverse ratings of neighborhood quality compared to women of all other racial/ethnic groups. Residential redlining was positively associated with perceived poor neighborhood quality but was not associated with perceived discrimination or stress for the overall SPEAC population. However, residential redlining was associated with perceived discrimination among non-Hispanic white women only. Residential redlining was moderately associated with percent black on the census tract level and residential segregation. The final dissertation paper examined the relationship between residential redlining and the risk of preterm birth (and change in gestational age). We also examined racial/ethnic differences in preterm birth and whether residential redlining contributed to the black-white disparity in preterm birth. Residential redlining and perceptions of stress, discrimination and neighborhood quality were not significantly associated with preterm birth. Additionally, residential redlining did not contribute to the black-white disparity in preterm birth.
DOI: 10.17615/7w1h-m545
Language: English
Open Access status: green
OpenAlex ID: W130979005
FWCI:
Cites: 125
Cited by:
Related to: 20