Infant Mortality Differences Between Whites and African Americans: the Effect of Maternal Education

Overview

Journal Am J Public Health

Specialty Public Health

Date 1998 Apr 29

PMID 9551012

Citations 15

Authors

I Hertz-Picciotto

Affiliations

Soon will be listed here.

Abstract

Objectives: Despite decreasing infant mortality in North Carolina, the gap between African Americans and Whites persists. This study examined how racial differences in infant mortality vary by maternal education.

Methods: Data came from Linked Birth and Infant Death files for 1988 through 1993. Multiple logistic regression models adjusted for confounders.

Results: Infant mortality risk ratios comparing African Americans and Whites increased with higher levels of maternal education. Education beyond high school reduced risk of infant mortality by 20% among Whites but had little effect among African Americans.

Conclusions: Higher education magnifies racial differences in infant mortality on a multiplicative scale. Possible reasons include greater stress, fewer economic resources, and poorer quality of prenatal care among African Americans.

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References

Hertz-Picciotto I . Comparisons of infant mortality using a percentile-based method of standardization for birthweight or gestational age. Epidemiology. 1998; 9(1):61-7. DOI: 10.1097/00001648-199801000-00009. View

Hertz-Picciotto I . Relationship of education to the racial gap in neonatal and postneonatal mortality. Arch Pediatr Adolesc Med. 1997; 151(8):787-92. DOI: 10.1001/archpedi.1997.02170450037005. View

Schramm W . Prenatal participation in WIC related to Medicaid costs for Missouri newborns: 1982 update. Public Health Rep. 1986; 101(6):607-15. PMC: 1477679. View

Buescher P, Smith C, Holliday J, Levine R . Source of prenatal care and infant birth weight: the case of a North Carolina county. Am J Obstet Gynecol. 1987; 156(1):204-10. DOI: 10.1016/0002-9378(87)90239-0. View

Rosner B, Spiegelman D, Willett W . Correction of logistic regression relative risk estimates and confidence intervals for measurement error: the case of multiple covariates measured with error. Am J Epidemiol. 1990; 132(4):734-45. DOI: 10.1093/oxfordjournals.aje.a115715. View

Lobel M, Dunkel-Schetter C, Scrimshaw S . Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol. 1992; 11(1):32-40. DOI: 10.1037//0278-6133.11.1.32. View

Schoendorf K, Hogue C, Kleinman J, Rowley D . Mortality among infants of black as compared with white college-educated parents. N Engl J Med. 1992; 326(23):1522-6. DOI: 10.1056/NEJM199206043262303. View

McGrady G, Sung J, Rowley D, Hogue C . Preterm delivery and low birth weight among first-born infants of black and white college graduates. Am J Epidemiol. 1992; 136(3):266-76. DOI: 10.1093/oxfordjournals.aje.a116492. View

Buescher P, Larson L, Nelson Jr M, Lenihan A . Prenatal WIC participation can reduce low birth weight and newborn medical costs: a cost-benefit analysis of WIC participation in North Carolina. J Am Diet Assoc. 1993; 93(2):163-6. DOI: 10.1016/0002-8223(93)90832-6. View

10.

Weinberg C . Toward a clearer definition of confounding. Am J Epidemiol. 1993; 137(1):1-8. DOI: 10.1093/oxfordjournals.aje.a116591. View

11.

Buescher P, Taylor K, Davis M, Bowling J . The quality of the new birth certificate data: a validation study in North Carolina. Am J Public Health. 1993; 83(8):1163-5. PMC: 1695166. DOI: 10.2105/ajph.83.8.1163. View

12.

Hedegaard M, Henriksen T, Sabroe S, Secher N . Psychological distress in pregnancy and preterm delivery. BMJ. 1993; 307(6898):234-9. PMC: 1678180. DOI: 10.1136/bmj.307.6898.234. View

13.

James S . Racial and ethnic differences in infant mortality and low birth weight. A psychosocial critique. Ann Epidemiol. 1993; 3(2):130-6. DOI: 10.1016/1047-2797(93)90125-n. View

14.

Kotelchuck M . An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. Am J Public Health. 1994; 84(9):1414-20. PMC: 1615177. DOI: 10.2105/ajph.84.9.1414. View

15.

Singh G, Yu S . Infant mortality in the United States: trends, differentials, and projections, 1950 through 2010. Am J Public Health. 1995; 85(7):957-64. PMC: 1615523. DOI: 10.2105/ajph.85.7.957. View

16.

Greenland S . Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology. 1995; 6(4):356-65. DOI: 10.1097/00001648-199507000-00005. View

17.

Greenland S . Avoiding power loss associated with categorization and ordinal scores in dose-response and trend analysis. Epidemiology. 1995; 6(4):450-4. DOI: 10.1097/00001648-199507000-00025. View

18.

Herman A . Toward a conceptualization of race in epidemiologic research. Ethn Dis. 1996; 6(1-2):7-20. View

19.

Polednak A . Segregation, discrimination and mortality in U.S. blacks. Ethn Dis. 1996; 6(1-2):99-108. View

20.

Collins Jr J, Herman A, David R . Very-low-birthweight infants and income incongruity among African American and white parents in Chicago. Am J Public Health. 1997; 87(3):414-7. PMC: 1381014. DOI: 10.2105/ajph.87.3.414. View