The Black-White Disparity in Preterm Birth: Race or Racism?

Area of Science:

• Public Health
• Health Disparities Research
• Sociomedical Sciences

Background:

• Racism is a fundamental determinant of health, operating through various interconnected factors.
• Racial disparities in health outcomes, such as preterm birth, are significant public health concerns.
• Attributing health differences solely to biology overlooks the profound impact of social determinants.

Purpose of the Study:

• To examine the causal pathways linking racism to preterm birth.
• To highlight the role of racism as an upstream determinant of health.
• To underscore the need for policy interventions addressing racism to reduce health disparities.

Main Methods:

• This perspective synthesizes existing research and theoretical frameworks.
• It traces plausible causal pathways from racism to preterm birth.
• The analysis focuses on the Black-White disparity in preterm birth.

Main Results:

• Racism contributes to preterm birth through multiple midstream and downstream factors.
• Biological explanations for racial health disparities are often insufficient and misleading.
• Addressing racism is essential for mitigating adverse health outcomes.

Conclusions:

• Systemic racism is a root cause of significant health disparities, including preterm birth.
• Science-based policies must confront racism to achieve health equity.
• Interventions targeting racism are necessary to improve population health and reduce disparities.