Low Birth Weight Racial Disparity

Low Birth Weight Racial Disparity in United States

United States

Significant and persistent racial and ethnic disparities exist in birth outcomes such as low birth weight, preterm birth and infant mortality. Socioeconomic status does not solely explain racial disparities in low birth weight, as rates are higher among Black women even after controlling for socioeconomic status. The role of genetics has been dismissed by research, since low birth weight rates are much lower among Black infants born in Africa than those born in the United States.

Research has shown that higher lifetime exposure to chronic stressors, such as interpersonal and institutional racism, increases the risk for poor pregnancy outcomes among Black women. Racial discrimination may reduce access to such protective clinical and social resources as adequate prenatal care, employment and educational opportunities and stable housing. Limited social resources, unsafe and unhealthy environments and psychosocial stress experienced throughout a woman’s life leading up to pregnancy may independently or collectively contribute to adverse birth outcomes. 

Low birth weight infants (weighing less than 2,500 grams at birth) are at increased risk of a number of short- and long-term complications. Low birth weight and preterm birth are leading causes of infant mortality. The average hospital cost is estimated to be $27,200 for a low birth weight infant and $76,700 for a very low birth weight infant, compared with an average hospital cost of $3,200.

According to America’s Health Rankings data, the percentage of infants born with low birth weight is two times higher among non-Hispanic Black women than among non-Hispanic white women.

According to the American Public Health Association, effective tools for reducing disparities in low birth weight include “educating the public and health care providers, broadening access to quality health care services, promoting healthier physical and social environments, supporting innovative research, and advocating for efforts to address racial and social inequalities.”

Eliminating health disparities, achieving health equity and attaining health literacy to improve the health and well-being of all is a Healthy People 2030 overarching goal. Healthy People 2030 has several objectives related to pregnancy and childbirth, including:

• Reducing preterm births.
• Reducing infant mortality.

Alhusen, Jeanne L., Kelly M. Bower, Elizabeth Epstein, and Phyllis Sharps. “Racial Discrimination and Adverse Birth Outcomes: An Integrative Review.” Journal of Midwifery & Women’s Health 61, no. 6 (November 2016): 707–20. https://doi.org/10.1111/jmwh.12490.

David, Richard J., and James W. Collins. “Differing Birth Weight among Infants of U.S.-Born Blacks, African-Born Blacks, and U.S.-Born Whites.” New England Journal of Medicine 337, no. 17 (October 23, 1997): 1209–14. https://doi.org/10.1056/NEJM199710233371706.

Hill, Latoya, Samantha Artiga, and Usha Ranji. “Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them.” Issue Brief. KFF, November 1, 2022. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/.

Kowlessar, Niranjana M., H. Joanna Jiang, and Claudia Steiner. “Hospital Stays for Newborns, 2011.” HCUP Statistical Brief #163. Rockville, MD: Agency for Healthcare Research and Quality, October 2013. https://pubmed.ncbi.nlm.nih.gov/24308074/.