Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes
In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed li...
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Frontiers Media S.A.
2021-09-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/frph.2021.684207/full |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paula Braveman Tyan Parker Dominguez Wylie Burke Siobhan M. Dolan David K. Stevenson Fleda Mask Jackson James W. Collins Deborah A. Driscoll Terinney Haley Julia Acker Gary M. Shaw Edward R. B. McCabe William W. Hay Kent Thornburg Dolores Acevedo-Garcia José F. Cordero Paul H. Wise Gina Legaz Kweli Rashied-Henry Jordana Frost Sarah Verbiest Lisa Waddell |
spellingShingle |
Paula Braveman Tyan Parker Dominguez Wylie Burke Siobhan M. Dolan David K. Stevenson Fleda Mask Jackson James W. Collins Deborah A. Driscoll Terinney Haley Julia Acker Gary M. Shaw Edward R. B. McCabe William W. Hay Kent Thornburg Dolores Acevedo-Garcia José F. Cordero Paul H. Wise Gina Legaz Kweli Rashied-Henry Jordana Frost Sarah Verbiest Lisa Waddell Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes Frontiers in Reproductive Health preterm birth racism health disparities maternal/infant health stress birth outcomes |
author_facet |
Paula Braveman Tyan Parker Dominguez Wylie Burke Siobhan M. Dolan David K. Stevenson Fleda Mask Jackson James W. Collins Deborah A. Driscoll Terinney Haley Julia Acker Gary M. Shaw Edward R. B. McCabe William W. Hay Kent Thornburg Dolores Acevedo-Garcia José F. Cordero Paul H. Wise Gina Legaz Kweli Rashied-Henry Jordana Frost Sarah Verbiest Lisa Waddell |
author_sort |
Paula Braveman |
title |
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes |
title_short |
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes |
title_full |
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes |
title_fullStr |
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes |
title_full_unstemmed |
Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes |
title_sort |
explaining the black-white disparity in preterm birth: a consensus statement from a multi-disciplinary scientific work group convened by the march of dimes |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Reproductive Health |
issn |
2673-3153 |
publishDate |
2021-09-01 |
description |
In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB. |
topic |
preterm birth racism health disparities maternal/infant health stress birth outcomes |
url |
https://www.frontiersin.org/articles/10.3389/frph.2021.684207/full |
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doaj-ddbfcfc99a83415db42530821e0a22ae2021-09-04T06:08:23ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532021-09-01310.3389/frph.2021.684207684207Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of DimesPaula Braveman0Tyan Parker Dominguez1Wylie Burke2Siobhan M. Dolan3David K. Stevenson4Fleda Mask Jackson5James W. Collins6Deborah A. Driscoll7Terinney Haley8Julia Acker9Gary M. Shaw10Edward R. B. McCabe11William W. Hay12Kent Thornburg13Dolores Acevedo-Garcia14José F. Cordero15Paul H. Wise16Gina Legaz17Kweli Rashied-Henry18Jordana Frost19Sarah Verbiest20Lisa Waddell21School of Medicine, University of California, San Francisco, San Francisco, CA, United StatesUSC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United StatesUniversity of Washington School of Medicine, Seattle, WA, United StatesAlbert Einstein College of Medicine, New York, NY, United StatesStanford University School of Medicine, Stanford, CA, United StatesMajaica LLC, Atlanta, GA, United StatesNorthwestern University School of Medicine, Chicago, IL, United StatesUniversity of Pennsylvania School of Medicine, Philadelphia, PA, United StatesSchool of Medicine, University of California, San Francisco, San Francisco, CA, United StatesSchool of Medicine, University of California, San Francisco, San Francisco, CA, United StatesStanford University School of Medicine, Stanford, CA, United StatesDavid Geffen School of Medicine at University of California, Los Angeles, CA, United States0University of Colorado, Denver, CO, United States1School of Medicine, Oregon State University, Portland, OR, United States2Brandeis University School for Social Policy and Management, Waltham, MA, United States3University of Georgia College of Public Health, Athens, GA, United StatesStanford University School of Medicine, Stanford, CA, United States4March of Dimes, White Plains, NY, United States4March of Dimes, White Plains, NY, United States4March of Dimes, White Plains, NY, United States5University of North Carolina at Chapel Hill, Chapel Hill, NC, United States4March of Dimes, White Plains, NY, United StatesIn 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB.https://www.frontiersin.org/articles/10.3389/frph.2021.684207/fullpreterm birthracismhealth disparitiesmaternal/infant healthstressbirth outcomes |