Structural Heteropatriarchy and Birth Outcomes in the United States

Area of Science:

• Public Health
• Sociology
• Reproductive Health

Background:

• Structural sexism and discrimination against lesbian, gay, and bisexual (LGB) populations are linked to adverse health outcomes.
• The combined impact of these intersecting systems of inequality on health remains understudied.

Purpose of the Study:

• To develop and validate a composite measure of structural heteropatriarchy.
• To examine the association between structural heteropatriarchy and birth outcomes.

Main Methods:

• Utilized data from the National Longitudinal Study of Adolescent to Adult Health (Waves I-V).
• Developed a composite measure of structural heteropatriarchy, including state-level LGB policies, family planning policies, and indicators of structural sexism.
• Employed multivariate regression analyses to assess the relationship between heteropatriarchy and birth outcomes, controlling for covariates.

Main Results:

• Higher levels of structural heteropatriarchy were significantly associated with an increased risk of preterm birth.
• Higher levels of structural heteropatriarchy were associated with decreased birth weight.
• No significant association was found between heteropatriarchy and clinical low birth weight, nor were there interactions with race, ethnicity, or sexual identity, indicating a universal negative effect.

Conclusions:

• Structural heteropatriarchy negatively impacts birth outcomes, specifically preterm birth and birth weight, for all pregnant individuals.
• Gender and sexuality should be considered as interconnected systems of oppression influencing population health.
• Further research is recommended to explore the effects of heteropatriarchy on other health outcomes and its intersection with other structural inequalities like racism.