Racial disparities in pregnancy outcomes

Blacks are more likely than whites to experience adverse pregnancy outcomes. Preterm and stillbirths are much more common among blacks than whites. To better understand racial disparities in pregnancy outcomes, I develop a heuristic model using a structural perspective of race and combination of the medical and social epidemiological model. Using data from the National Maternal and Infant Health Survey 1988 (NMIHS), I then investigate medical and social epidemiological explanations for the racial disparity in preterm and stillbirths. Findings indicate that medical risks explain only a small amount of the racial gap, but are important predictors of preterm and stillbirths. Social epidemiological variables explain a larger share of the racial gap in preterm and stillbirths than medical risks but a disparity remains. A competing risks analysis shows that risks of preterm and stillbirths differ for blacks and whites. The amalgamation of medical and social epidemiological models is important for understanding why blacks are more likely to experience preterm and stillbirths and needs to be considered as physicians and medical professionals seek to reduce the racial gap. If substantial efforts are not made to reduce inequalities on important social and economic resources attempts to reduce inequalities in medical risks may be futile.