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Racialized Economic Segregation and Disparities in the Risk of Stillbirth.

Amal Rammah1, Jasmine Drake2, Iman Moussa1

  • 1Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.

Journal of Racial and Ethnic Health Disparities
|July 9, 2025
PubMed
Summary
This summary is machine-generated.

Neighborhood privilege benefits White mothers but not non-White mothers, impacting stillbirth risk. Racialized economic segregation contributes to Black-White disparities, but much remains unexplained.

Keywords:
DisparitiesSegregationSpatial social polarizationStillbirth

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Area of Science:

  • Public Health
  • Sociology
  • Epidemiology

Background:

  • Growing evidence links neighborhood segregation to adverse maternal and infant health outcomes.
  • Limited research has explored the specific impact of segregation on stillbirth rates.

Purpose of the Study:

  • To investigate the association between racialized economic segregation and stillbirth.
  • To quantify the contribution of segregation and maternal risk factors to racial disparities in stillbirth.

Main Methods:

  • Retrospective cohort study of live births and stillbirths (2007-2020) in greater Houston, TX.
  • Utilized the Index of Concentrations at the Extremes (ICE) to assess neighborhood racialized economic segregation.
  • Applied Oaxaca-Blinder decomposition to analyze racial disparities in stillbirth.

Main Results:

  • Stillbirth prevalence was highest among non-Hispanic Black mothers (9.1/1000).
  • Neighborhood privilege reduced stillbirth odds for non-Hispanic White mothers but not for other racial/ethnic groups.
  • Segregation, maternal age, education, BMI, and smoking explained 21.2% of the Black-White stillbirth disparity.

Conclusions:

  • Neighborhood economic advantage benefits White mothers but not non-White mothers, possibly due to racial discrimination.
  • Racialized economic segregation modestly contributes to Black-White stillbirth disparities, with significant unexplained factors.
  • Further research is needed to identify individual and neighborhood factors contributing to disparities and reduce stillbirth risks.