Narrowing the black/white racial gap: An exploration of socioeconomic predictors of low birth weight in the United States using the linked birth-infant death data, 1995-2001

Objective: This paper examines the role of socioeconomic determinants (i.e. marital status, education and access to prenatal care) on low birth weight (LBW) for Black and Whites in the U.S. Methods: Data from the Center of Disease Control and Prevention Linked Birth-Infant Death files between 1995 and 2001 were used. Descriptive statistics and logistic regression models were performed to evaluate how socioeconomic determinants influence racial disparities on LBW in the U.S. Results: Blacks are 1.6 times more likely to have a LBW than Whites, even after controlling for maternal age, marital status, education, access to prenatal care and time. LBW has not changed substantially over these years, but LBW increased over this period among Whites. Among White and Black women, increasing maternal age (OR=1.0 CI 1.0-1.0) and having a high school education or higher was associated with a higher likelihood of LBW (Whites OR=1.3, 95% CI 1.2-1.3; Blacks OR=1.5, 95% CI 1.5-1.6). Access to prenatal care was associated with lower LBW among Whites (OR=.4, 95% CI .4-.4) and Blacks (OR=.4, 95% CI .3-.4). Being married was also associated with LBW for Blacks (OR=1.2, 95% CI 1.1-1.3) but not Whites. Conclusion: Results were consistent with other findings in the literature (e.g. race, maternal age and access to prenatal care). However, some results were counterintuitive. Higher educational attainment and marriage are usually protective factors for adverse pregnancy outcomes. Reasons for increased likelihood of LBW may be moderating factors such as multiple births and stress.