Low Birthweight Racial Disparity

Low Birthweight Racial Disparity in United States

United States

Significant and persistent racial and ethnic disparities exist in birth outcomes such as low birthweight, preterm birth and infant mortality. Socioeconomic status does not solely explain racial disparities in low birthweight, as rates are higher among Black mothers even after controlling for socioeconomic status. The role of genetics has been dismissed by research, since low birthweight rates are much lower among African-born infants than Black infants 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 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 birthweight infants (weighing less than 2,500 grams at birth) are at increased risk of a number of short- and long-term complications. Low birthweight and preterm birth are leading causes of infant mortality. The average hospital cost is estimated to be $27,200 for a low birthweight infant and $76,700 for a very low birthweight infant, compared with $3,200 for all newborns.

The percentage of infants born with low birthweight is two times higher among non-Hispanic Black mothers than among non-Hispanic white mothers.

According to the American Public Health Association, effective tools for reducing disparities in low birthweight 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 pregnancy and childbirth objectives, including reducing preterm births.

Alhusen, Jeanne L., Kelly M. Bower, Elizabeth Epstein, and Phyllis Sharps. 2016. “Racial Discrimination and Adverse Birth Outcomes: An Integrative Review.” Journal of Midwifery & Women’s Health 61 (6): 707–20. https://doi.org/10.1111/jmwh.12490.

David, Richard J., and James W. Collins. 1997. “Differing Birth Weight among Infants of U.S.-Born Blacks, African-Born Blacks, and U.S.-Born Whites.” New England Journal of Medicine 337 (17): 1209–14. https://doi.org/10.1056/NEJM199710233371706.

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

Matthews, T. J., Marian F. MacDorman, and Marie E. Thoma. 2015. “Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.” National Vital Statistics Reports 64 (9): 1–30.

Rubin, Lewis P. 2016. “Maternal and Pediatric Health and Disease: Integrating Biopsychosocial Models and Epigenetics.” Pediatric Research 79 (1–2): 127–35. https://doi.org/10.1038/pr.2015.203.