Closing the gap, opening the process: why study social contributors to preterm delivery among black women.

In the United States, the excess rates of infant mortality, VLBW, and preterm delivery among African American families relative to white families are known as "the gap." A group of researchers in the Division of Reproductive Health at the Centers for Disease Control and Prevention proposed that the study of causes of the gap in preterm delivery and the potential interventions to eliminate this disparity required a multidisciplinary approach to elucidate the biologic pathways, stressors, and social environment associated with preterm birth. They encouraged studies that examined the social and political impact of being an African American woman in the United States, racism, and the combined effects of gender, racism, and relative social position, as potential unmeasured etiologic factors that contribute to the gap. The studies conducted represent the expertise of anthropologists, sociologists, medical researchers, and epidemiologists who study both individual and social causes and then also provide a theoretical interpretation by those who lived the experience, (e.g., the study participants) rather than just the researchers' interpretation of the causes of and prevention strategies for the gap.