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Birth outcome racial disparities: A result of intersecting social and environmental factors

Heather H Burris1, Michele R Hacker2

  • 1Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA.

Seminars in Perinatology
|August 19, 2017
PubMed

Insights

Societal factors like poor education and income inequality contribute to toxic exposures and stress, increasing adverse birth outcomes for Black infants. Addressing these root causes is crucial for eliminating racial disparities in infant health.

Area of Science:

  • Environmental health
  • Public health
  • Sociology

Background:

  • Adverse birth outcomes (preterm birth, low birth weight, infant mortality) disproportionately affect Black and low-income infants in the U.S.
  • Healthcare improvements have not resolved these persistent racial disparities.
  • Societal factors are increasingly recognized as significant contributors to these health inequities.

Purpose of the Study:

  • To review societal factors contributing to adverse birth outcomes and racial disparities.
  • To examine the role of education, income inequality, and residential segregation.
  • To understand how these factors lead to toxic environmental exposures and psychosocial stress.

Main Methods:

  • Literature review synthesizing research on societal factors and birth outcomes.
  • Analysis of the interplay between environmental exposures, psychosocial stress, and racial disparities.
  • Qualitative assessment of the combined impact of societal and environmental factors.

Main Results:

  • Suboptimal education, income inequality, and residential segregation contribute to toxic exposures and psychosocial stress.
  • Black women experience higher exposure levels to many toxic chemicals and psychosocial stressors.
  • The combined impact of environmental exposures and stress on racial disparities in birth outcomes is substantial but not fully quantified.

Conclusions:

  • Eliminating racial disparities in adverse birth outcomes requires addressing societal determinants.
  • Primary prevention strategies must focus on improving education, income equity, and neighborhood conditions.
  • A comprehensive societal approach is necessary for improving infant health equity.

Keywords:
Environmental healthLow birth weightPreterm birthPsychosocial stressRacial disparitiesSocial epidemiology

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