Maeve E Wallace1, Pauline Mendola1, Danping Liu1, Katherine L Grantz1. 1. The authors are with the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
Abstract
OBJECTIVES: We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. METHODS: Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor's or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. RESULTS: Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. CONCLUSIONS: High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur.
OBJECTIVES: We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. METHODS: Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor's or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. RESULTS: Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. CONCLUSIONS: High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur.
Authors: May Sudhinaraset; Dovile Vilda; Jessica D Gipson; Marta Bornstein; Maeve E Wallace Journal: Am J Prev Med Date: 2020-10-13 Impact factor: 5.043
Authors: Brittany D Chambers; Jennifer Toller Erausquin; Amanda E Tanner; Tracy R Nichols; Shelly Brown-Jeffy Journal: J Racial Ethn Health Disparities Date: 2017-12-07