June 01, 2008

Racism as a Risk Factor for Infant Mortality

author_janis By Janis Prince Inniss

One segment of the PBS documentary Unnatural Causes: Is Inequality Making Us Sick? examined infant mortality in the U.S. clip_image002Infant mortality is a measure of the number of babies who die in their first year of life, a figure expressed as a portion of 1,000 live births. 

What causes babies to die so early? Congenital abnormalities, being born too early and too small, and Sudden Infant Death Syndrome (SIDS), are the leading causes of infant death. According to the Central Intelligence Agency World Factbook’s 2007 estimate, the infant mortality rate in the U.S. is 6.37; according to this report 41 countries reported better rates than the U.S. 

In fact, according to the State of the World's Mothers report, the U.S. has the second worst infant mortality rate in the developed world! Although there may be many good reasons for the rates of other countries to appear better than they really are, a few things are clear about the U.S. rate. 

First, the infant mortality rate has decreased significantly over the last four or so decades; it was 26.0 in 1960. Second, among all women in the U.S., African American women have the highest infant mortality rate. Third, infant mortality rates for African Americans are almost two and a half times that of whites (13.6 compared to 5.6)

clip_image005If you’re familiar with the relationship between class and race, this disparity in infant mortality might not be particularly surprising. It might make sense that African Americans would experience higher infant mortality rates as result of factors related to their lower socioeconomic status (SES); for example, low-income pregnant women might not seek prenatal care due to a lack of health insurance and tight finances. However, research on the topic finds that increases in SES and education do not erase this racial gap. As you will see in the video, infant mortality rates for white college graduates is 3.7 per 1,000 while that for black college graduates is three times as high (10.2 per 1,000). Infant mortality rates for black college graduates are on par with that of whites without a high school education—who have a rate of 9.9 per 1,000. 

clip_image008Another hypothesis put forward to explain the differential infant mortality rates is a possible genetic component responsible for the disparity. Researchers reasoned that looking at the infant mortality rates of other black women should confirm such a “prematurity gene”. Yet, black women from Africa and the Caribbean do have not have the same kinds of infant mortality rates as African-American women; African women have infant mortality rates similar to that of white American women and babies born to Caribbean women are heavier at birth than those of African-American women. 

Further, after one generation of living in the U.S. these immigrant groups have infant mortality rates similar to that of African Americans, suggesting that there is something about the black American experience that leads to poor infant mortality. Hmm. J0283941

But how could race impact infant mortality? In a word, racism. Researchers have found that women who perceive racial prejudice are two times more likely to have a very low birth weight baby. Social scientists are now examining the relationship between the stress that racial prejudice produces and its adverse impact on the body; such stress may cause the release of stress hormones that trigger labor, for example. Watch Drs. Lu and Jones discuss the life course perspective and the impact of this kind of stress over a lifetime:

In a number of previous posts, I have discussed issues related to race, ethnicity, culture and related concepts. Perhaps like you, readers have questioned whether race is even relevant in today’s multiracial, multiethnic world. More than forty years have passed since the Civil Rights Act of 1964 barred segregation in public places in the U.S. So racial prejudice is history! But is it really? 

Most young Americans grew up before the passage of this act. Many of your parents, professors, ministers, and doctors, can tell personal stories of what life was like before the passage of that legislation. History doesn’t seem so ancient then. And what are the present day remnants of racial prejudice? Is that history too? Just as we may begin to feel comfortable that race and related concepts are simply well, historical concepts, the findings surrounding infant mortality suggest remind us that while we may argue about definitions and the utility of these ideas, people’s experiences demonstrate that none of this is simply academic flexing. Racism and its perception impacts lives, including—perhaps most especially—the smallest lives among us.


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very interesting study. I was not aware of these numbers. One question if you don't mind. You summarize the research like this " Researchers have found that women who perceive racial prejudice are two times more likely to have a very low birth weight baby." However, you intoroduce this paragraph by saying "But how could race impact infant mortality? In a word, racism."

You state objectively that racism is the cause of this disparity, but the research you cite, according to you, says the higher infant mortality is caused by the perception of racism.

My question is this, do you consider the "perception of racism" to be the same as "racism?"

Good question, Joe Miller. In another word, no! The research on the existence/persistence of racism—at least in certain areas of American life—is unequivocal. As you mention, the research I referenced specifically looks at the perception of racism and low birth weight babies. Considering the two sorts of findings, the conclusion is that the women who perceive racism, are seeing/feeling something that is ‘objectively’ real.

Though infant mortality rates for African-Americans may be much higher than those of whites, the fertility rates are also much higher. In 1999 the fertility rate for African-Americans was 95.1 per 1,000 whereas the fertility rate for whites was only 68.4 per 1,000. With more births, the probability of an increased infant mortality rate is increased as well. I do however believe that you are right about the connection between racism and infant mortality rate. Stress from racial prejudice can lead to premature labor, and genetic factors can result in infant deaths as well.

I recently read an article from American Renaissance that says, "Genetics may play a greater role than previously thought in accounting for black womens higher rate of premature births, researchers at Washington University School of Medicine have found." I believe as the article says that black women may just be genetically predisposed to pre-term deliveries. It's possible that both genetics and racial disparity may account for African-American womens' higher infant mortality rates. But, I think it's nonsense to blame it all on racial disparity which is drastically better than in the past.


Mary G:
The author acknowledged the role of genetics in infant mortality, and clearly stated that in other locales populated by African American women (where the sting of racism may not be so keenly felt) that the infant mortality rate is lower. To say that racial disparity is 'drastically better than in the past' is also folly, because in this case it is a matter of perception, not general trend. African American youth today has not perceived the racism of the 60s, and will never be able to compare. The ongoing struggle with racism and its effects on infant mortality is highlighted among those who immigrated to the US from a less prejudicial locale. After a year, mortality among immigrants is at the same level as for US African American women.

This is an interesting take on the subject. I had not heard these statistics before. Infant mortality is almost always thought to be solely associated with developing countries with poor medical care and sanitation. I think that the statistics pointed out in your post are very good for people to keep in mind when in comes to racism as it is an intersting association. However, a previous post pointed out also how African Americans tend to have a higher number or births per woman as well and that can affect the statistics.

Considering the two sorts of findings, the conclusion is that the women who perceive racism, are seeing/feeling something that is ‘objectively’ real.

I found this article very interesting, although I'm not completely convinced that racism is the reason for the low infant mortality. Racism is a big factor in some situations so it could be in infant mortality also.

That was a very interesting post. I understand that the infant mortality could be form racism but I do not think that it would be the complete reason.

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