Using Index of Concentration at the Extremes as Indicators of Structural Racism to Evaluate the Association with Preterm Birth and Infant Mortality—California, 2011–2012
Racism plays a key role in perpetuating the health inequities we see in birth outcomes among Black women in California today, including preterm birth and infant death before 1 year of age. Research has suggested that higher levels of racial segregation are associated with worse birth outcomes, but few studies have looked at how race and income segregation together may drive health disparities.
Findings from a recent article published in the Journal of Urban Health, and authored by Preterm Birth Initiative Postdoctoral Research Fellow Brittany Chambers, supports that structural racism has profound effects on Black women's birth outcomes.
Black women in California live in neighborhoods with more extreme variations in race and income concentrations compared to California residents as a whole, and the purpose of the study was to determine if local measures of race and income disparities—as markers for structural racism—are associated with preterm birth and infant mortality experienced by these women. The study found that zip codes that harbor greater racial and economic segregation, as well as racial segregation alone, were associated with greater preterm birth and infant mortality rates. In contrast, zip codes that included greater income extremes were only associated with preterm birth.
This study is first of its kind to examine measures of structural racism at the zip-code level and among a sample solely of Black women using The Index of Concentration at the Extremes (ICE). ICE is a study method that evaluates the extent to which a neighborhood’s residents are concentrated into groups at the extremes of deprivation and privilege, and ICE is used to reveal how stark racial and economic differences between neighborhoods are linked to health disparities.
Read the full study from The Journal of Urban Health, June 2018, here: Using Index of Concentration at the Extremes as Indicators of Structural Racism to Evaluate the Association with Preterm Birth and Infant Mortality—California, 2011–2012