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Soc Sci Med. 2018 Feb;199:49-55. doi: 10.1016/j.socscimed.2017.04.019. Epub 2017 Apr 13.

Area racism and birth outcomes among Blacks in the United States.

Author information

1
Department of Human Development and Family Studies, Auburn University, College of Human Sciences, United States. Electronic address: david.chae@auburn.edu.
2
Department of Family, Population, and Preventive Medicine, Stony Brook University, Health Sciences Center, United States.
3
Department of Human Development and Family Studies, Auburn University, College of Human Sciences, United States.
4
Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, United States.
5
Department of Behavioral Sciences and Health Education, Emory University, Rollins School of Public Health, United States.
6
Department of Epidemiology and Biostatistics, University of Maryland, College Park, School of Public Health, United States.
7
University of Pennsylvania, The Wharton School, United States.
8
Department of Epidemiology, Emory University, Rollins School of Public Health, United States.

Abstract

There is increasing evidence that racism is a cause of poor health outcomes in the United States, including adverse birth outcomes among Blacks. However, research on the health consequences of racism has faced measurement challenges due to the more subtle nature of contemporary racism, which is not necessarily amenable to assessment through traditionally used survey methods. In this study, we circumvent some of these limitations by examining a previously developed Internet query-based proxy of area racism (Stephens-Davidowitz, 2014) in relation to preterm birth and low birthweight among Blacks. Area racism was measured in 196 designated market areas as the proportion of total Google searches conducted between 2004 and 2007 containing the "n-word." This measure was linked to county-level birth data among Blacks between 2005 and 2008, which were compiled by the National Center for Health Statistics; preterm birth and low birthweight were defined as <37 weeks gestation and <2500 g, respectively. After adjustment for maternal age, Census region, and county-level measures of urbanicity, percent of the Black population, education, and poverty, we found that each standard deviation increase in area racism was associated with relative increases of 5% in the prevalence of preterm birth and 5% in the prevalence of low birthweight among Blacks. Our study provides evidence for the utility of an Internet query-based measure as a proxy for racism at the area-level in epidemiologic studies, and is also suggestive of the role of racism in contributing to poor birth outcomes among Blacks.

KEYWORDS:

African Americans; Big data; Birth outcomes; Racism; USA

PMID:
28454665
PMCID:
PMC5640467
DOI:
10.1016/j.socscimed.2017.04.019
[Indexed for MEDLINE]
Free PMC Article

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