But drill down on America’s premature birth problem—the absolute worst in the industrialized world—and the real problem becomes clear. About 10.5 percent of white children were born before 37 weeks gestation in 2012, the most recent data available (pdf). But about 11.7 percent of Latino children, 13.6 percent of Native American babies, 10.3 percent of Asian kids and a tragic 16.8 percent of black infants arrived too soon.
The tenacity of those gaps has spawned decades of research, said Dr. Diane L. Rowley, a professor at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health.
Public health researchers and doctors spent years attributing the disproportionate numbers of preterm minority children to elevated poverty, gaps in insurance coverage and limited access to quality prenatal care, said Rowley. But over time, the studies revealed something more complex.
Black women up and down the income and education ladder disproportionately deliver their children too early.
“The research was at first just suggesting, but it’s well-established today, something about living in the United States, something beyond poverty or health insurance coverage and health care access is helping to shape pregnancy outcomes,” Rowley said. “And that something is racism.”
In short, the research concludes, racism—the psychological and physical strain that it causes—is prompting some children to be born too soon. Poverty and health care access matter, but so, too, do social conditions.
Long-time public health specialists like Rowley know that racism—whether it exists, when and how it is perceived and how it shapes lives—is not only controversial; it’s difficult to measure.
Enter the researchers at Emory University.
In September, Corwin, the dean of research at Emory’s School of Nursing, and a team of researchers closely tracked the pregnancies of more than 100 women during the last three months of their pregnancies. They found that women of all races and ethnicities who are poor during their pregnancies are more likely to suffer from chronic stress, a biologically detectable condition. The same is also true, she said, of middle-class black women and second- and later-generation Latinas.
Chronic stress, the team extrapolated, is the reason some 30,000 more African-American babies are born prematurely each year than any other group.