 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
James W. Collins Jr, MD, MPH1, Richard J. David, MD2, Arden S. Handler, DrPH3, Stephen N. Wall, MD, MSH4, and Bobby Sasson, MPH1. (1) Division of Neonatology, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, 773-880-4142, jcollins@northwestern.edu, (2) Division of Neonatology, Cook County Hospital, 1835 W. Harrison Street, Chicago, IL 60612-9985, (3) Community Health Sciences, University of Illinois School of Public Health, 1601 West Taylor, Chicago, IL 60612, (4) Pediatrics - Section of Neonatology, University of Chicago, MC 6060 - 5841 S. Maryland Ave, Chicago, IL 60637
Background. The failure of pregnancy-related variables to account for the racial disparity in the rates of VLBW has engendered speculation that lifetime, not pregnancy per se, factors underlie the African-American women’s reproductive disadvantage.
Objective. To determine the extent to which maternal lifetime exposure to interpersonal racial discrimination is associated with infant birth weight.
Methods. We performed a 3-year hospital-based, case-control study. Cases were African-American mothers (n=104) of very low birth weight (<1500g, VLBW), preterm (<37wks) infants. Controls were African-Americans mothers (n=208) of non-low birth weight (>2500g, non-LBW), term infants. A structured questionnaire was administered to both groups; it included questions regarding lifetime exposure to interpersonal racial discrimination in five domains. Employed participants answered additional questions about their specific lifetime experiences with interpersonal racism at their primary place of employment.
Results. The OR of VLBW for maternal lifetime exposure to interpersonal racial discrimination in 1 or more domains (“finding a job”, “at place of employment”, “in school”, “in public setting”, or “getting medical care”) equaled 1.9 (1.2-3.1). The OR of VLBW for maternal lifetime exposure to racism in 3 or more domains was 2.7 (1.3-5.4). These associations persisted independent of sociodemographic/behavioral risk factors. Among employed subjects, the responses most associated with VLBW included “whites assume you work at a lower status job than you do”; OR=2.3 (1.0-5.1) and “you are treated with less dignity than whites”; OR=2.0 (0.8-4.7).
Conclusions. These data provide evidence that African-American women’s lifetime exposure to interpersonal racial discrimination is an important risk factor for VLBW.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.