A tale of two generations: Maternal skin color and adverse birth outcomes in Black/African American women

Jaime C. Slaughter-Acey, Tony N. Brown, Verna M. Keith, Rhonda Dailey, Dawn P. Misra

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


We examined how sociopolitical context (marked by generational cohort) and maternal skin color interacted to influence preterm delivery (PTD) rates in sample of Black women. Data were from 1410 Black women, ages 18–45 years, residing in Metropolitan Detroit, MI enrolled (2009–2011) in the Life-course Influences on Fetal Environments (LIFE) Study. Because we hypothesized that generational differences marked by changes in the sociopolitical context would influence exposure to racism, we categorized women into two cohorts by maternal birth year: a) Generation X, 1964–1983 and b) Millennial, 1984–1993. Descriptive results showed similar PTD rates by generational cohort, Generation X: 16.3% vs. Millennials: 16.1%. Yet, within each generation, PTD rates varied by women's skin tone (categorized: light, medium, and dark brown). Poisson regression models confirmed a significant interaction between generational cohort and maternal skin tone predicting PTD (P = 0.001); suggesting a salubrious association between light brown skin tone (compared to medium and dark) and PTD for Generation X. However, Millennials with medium and dark brown skin experienced lower PTD rates than their light Millennial counterparts. Research should consider sociopolitical context and the salience of skin tone bias when investigating racial health disparities, including those in perinatal health.

Original languageEnglish (US)
Article number113552
JournalSocial Science and Medicine
StatePublished - Nov 2020

Bibliographical note

Funding Information:
This work has been supported in part by Russell Sage Foundation (Grant # 96-18-03 to JCSA), the National Heart, Lung, and Blood Institute (Grant 1R21HL150424-01 to JCSA) and the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD; Grant #R01HD058510 to DPM and Grant #L60 HD103047 to JCSA). The authors also gratefully acknowledge support from the Minnesota Population Center ( P2C HD041023 ) funded through a grant from the NICHD. Any opinions expressed are those of the author(s) alone and should not be construed as representing the opinions of the Russel Sage Foundation or the National Institutes of Health.

Publisher Copyright:
© 2020 Elsevier Ltd

Copyright 2020 Elsevier B.V., All rights reserved.


  • Colorism
  • Low birthweight
  • Preterm delivery
  • Racial classification
  • Racism
  • Skin tone
  • Sociopolitical context

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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