Joint effects of structural racism and income inequality on small-for-gestational-age birth

M.E. Wallace, P. Mendola, D. Liu and K.L. Grantz

American Journal of Public Health, 2015, vol. 105, issue 8, 1681-1688

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. © 2015, American Public Health Association Inc. All rights reserved.

Keywords: adult; African American; Caucasian; epidemiology; female; health disparity; human; income; racism; small for date infant; socioeconomics; statistics and numerical data; United States; young adult, Adult; African Americans; European Continental Ancestry Group; Female; Health Status Disparities; Humans; Income; Infant, Small for Gestational Age; Racism; Socioeconomic Factors; United States; Young Adult (search for similar items in EconPapers)
Date: 2015
References: Add references at CitEc
Citations: View citations in EconPapers (9)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2015.302613

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302613_8

DOI: 10.2105/AJPH.2015.302613

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().