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Civil Rights, Culture, Discrimination, Gender, Health Care, Health Disparities, Inequality, Mental Health, Politics, Public Health, Public Policy, Racial Discrimination, Racial Disparities, Social Justice, Society, Women's Health

Research Shows The Effects Of Discrimination Could Last A Lifetime

Environmental-factors-may-explain-some-racial-disparities-in-childbirth

Increased levels of depression as a result of discrimination could contribute to low birth weight babies, a new study finds, adding to a growing line of research that suggests the adverse effects of discrimination may contribute to persistent racial disparities in health.

Given the well-documented relationship between low birth weight and the increased risk of health problems throughout one’s lifespan, identifying and reducing potential contributors to low birth weight is thought to be a key step to addressing later-life disparities in conditions such as heart disease, diabetes and cancer. Now, research from Yale University sheds light on one possible causal factor. The findings, published in the Annals of Behavioral Medicine, suggest that chronic, everyday instances of discrimination against pregnant, urban women of color may play a significant role in contributing to low birth weight babies — and potentially to the striking racial disparities that persist across a multitude of health outcomes.

Twice as many black women give birth to low birth weight babies than white or Latina women in the U.S.  Reasons for this disparity are, as yet, unclear. But initial evidence suggests a link may exist between discrimination experienced while pregnant and the incidence of low birth weight.  In addition, experiences of discrimination have also been linked to depression, which causes physiological changes that can have a negative effect on a pregnancy.

In this latest study, Dr. Valerie Earnshaw, Ph.D., and her colleagues at Yale’s Center for Interdisciplinary Research on AIDS (CIRA) interviewed 420 black and Latina women between the ages of 14 and 21. The women were interviewed during the second and third trimesters of their pregnancies, and again at six and 12 months after their babies had been born. The researchers measured women’s reported experiences of discrimination, as well as their depressive symptoms, pregnancy distress and pregnancy symptoms.

Overall, women reported relatively low levels of everyday discrimination.  However, the results revealed a very clear, negative impact of discrimination, which was consistent across the participants, regardless of age, ethnicity or type of discrimination reported.  Women reporting greater levels of discrimination were more prone to depressive symptoms, and ultimately went on to have babies with lower birth weights than those reporting lower levels of discrimination, the researchers found.

Other research shows similar relationships between racial discrimination and poor birth outcomes, particularly among African American women. However, this is a complex relationship due to the multiple pathways through which racism impacts health. For example, studies show that the increased poverty rate among racial minorities also contributes to racial disparities in poor birth outcomes. Other factors, including an increased risk of inadequate prenatal care among minority women, as well as higher rates of chronic disease, also significantly influence birth outcomes.

However, given that racial discrimination increases stress, and stress is independently associated with poor birth outcomes, it seems likely that racial discrimination is a significant contributor to racial disparities in adverse pregnancy outcomes including preterm birth and low birthweight deliveries.

These findings have important implications for healthcare providers who work with pregnant teens and young women during the prenatal period, said Dr. Earnshaw, noting that providers have a window of opportunity to intervene and reduce the potential impacts of discrimination on the pregnancy and future health of the child.

“Given the associations between birth weight and health across the life span, it is critical to reduce discrimination directed at urban youth of color so that all children are able to begin life with greater promise for health,” the study concluded. “In doing so, we have the possibility to eliminate disparities not only in birth weight, but in health outcomes across the lifespan.”

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