Multidimensional structural racism predicts birth outcomes for Black and White Minnesotans

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1 Scopus citations

Abstract

Objective: The objective of this study is to determine the linkage between multidimensional structural racism typologies and preterm birth (PTB), low birthweight (LBW), and small-for-gestational-age (SGA) birth among infants of White, US-born Black, and foreign-born Black pregnant people in Minnesota. Data Sources: The measures of structural racism were based on the 2017 American Community Survey 5-year estimates and the 2017 jail incarceration data from the Vera Institute of Justice. Birth outcomes of infants born in 2018 were based on birth records from the Minnesota Department of Health. Study Design: We conducted a latent class analysis to identify multidimensional structural racism typologies in 2017 and related these typologies to birth outcomes of pregnant people who gave birth in Minnesota in 2018 using Vermunt's 3-step approach. Racial group-specific age-adjusted risks of PTB, LBW, and SGA by structural racism typologies were estimated. Data Collection: Study data were from public sources. Principal Findings: Our analysis identified three multidimensional structural racism typologies in Minnesota in 2017. These typologies can have high structural racism in some dimensions but low in others. The interactive patterns among various dimensions cannot simply be classified as “high” (i.e., high structural racism in all dimensions), “medium,” or “low.” The risks of PTB, LBW, and SGA for US-born Black pregnant Minnesotans were always higher than for their White counterparts regardless of the typologies in which they lived during pregnancy. Furthermore, these excess risks among US-born Black pregnant people did not vary significantly across the typologies. We did not find clear patterns when comparing the predicted risks for infants of US- and foreign-born Black pregnant people. Conclusion: Multidimensional structural racism increases the risks of adverse birth outcomes for US-born Black Minnesotans. Policy interventions to dismantle structural racism and eliminate birth inequities must be multi-sectoral as changes in one or a few dimensions, but not all, will unlikely reduce birth inequities.

Original languageEnglish (US)
Pages (from-to)448-457
Number of pages10
JournalHealth services research
Volume57
Issue number3
DOIs
StatePublished - Jun 2022

Bibliographical note

Funding Information:
This project was funded by the Robert J. Jones Urban Research and Outreach-Engagement Center, University of Minnesota. Additional support was provided by the Minnesota Population Center which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant P2C HD041023). All funders have no involvement in the design, data analysis, interpretation of the study results, drafting of the manuscript, or the decision to submit this paper for publication. The authors would like to thank Miamon Queeglay and Alyssa Fritz for their help with project management and background literature search.

Funding Information:
This project was funded by the Robert J. Jones Urban Research and Outreach‐Engagement Center, University of Minnesota. Additional support was provided by the Minnesota Population Center which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant P2C HD041023). All funders have no involvement in the design, data analysis, interpretation of the study results, drafting of the manuscript, or the decision to submit this paper for publication. The authors would like to thank Miamon Queeglay and Alyssa Fritz for their help with project management and background literature search.

Publisher Copyright:
© 2022 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.

Keywords

  • birth outcomes
  • latent construct
  • measurement
  • racial inequities
  • structural racism
  • Infant, Low Birth Weight
  • Birth Certificates
  • Humans
  • Child, Preschool
  • Infant
  • Minnesota
  • Pregnancy
  • Systemic Racism
  • Premature Birth/epidemiology
  • Female
  • Racism
  • Infant, Newborn

PubMed: MeSH publication types

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

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