A recent study reveals that over half of Black and Hispanic infants are born in neighborhoods with minimal opportunities. Babies in these low-opportunity areas face a 16-percent higher risk of being born prematurely. This research highlights the public health impacts of structural racism and historical discriminatory practices, including redlining and excessive exposure to pollutants, which still influence neighborhood conditions today.
This study indicates that living in areas with limited educational, health, environmental, and socioeconomic resources may heighten the chances of preterm births and exacerbate the racial disparities in preterm delivery rates in the Commonwealth.
Preterm birth, defined as a live birth occurring before 37 weeks of pregnancy, ranks as the second leading cause of infant mortality in the U.S. It disproportionately impacts Black and Hispanic individuals giving birth. While individual factors like poverty, age, and health can affect these disparities, researchers suggest that larger structural issues may contribute significantly to the racial disparities in this common birth complication.
A study conducted by the Boston University School of Public Health (BUSPH) analyzed preterm births in Massachusetts, where about 1 in 11 live births are premature. The findings indicated that the social characteristics of a birthing parent’s neighborhood correlate with their risk of experiencing early delivery.
As published in JAMA Network Open, it was found that over half of Black and Hispanic infants are born into neighborhoods characterized by very low opportunities, with those born in such areas facing a 16-percent increased risk of preterm birth. Researchers evaluated neighborhood opportunity levels using the Childhood Opportunity Index (COI), a comprehensive measure based on 44 indicators within census tracts assessing various educational, health, environmental, and socioeconomic aspects.
The study underscores the health ramifications of structural racism and longstanding discriminatory actions—like redlining and inequitable exposure to pollutants—that shape contemporary neighborhood conditions. The COI effectively illustrates both historical and ongoing structural racism, as social opportunity tied to neighborhood conditions is unevenly distributed across racial and ethnic lines, according to the researchers.
“Our research indicates that a neighborhood’s social context can affect health outcomes in children even before they are born, potentially driving ongoing racial and ethnic disparities in preterm births,” stated Dr. Candice Belanoff, the study’s lead author and a clinical associate professor of community health sciences at BUSPH. “This effect persists even when adjusting for factors such as maternal health and individual social standing.”
Dr. Belanoff and her colleagues from BUSPH, Simmons SSW, the University of Illinois at Chicago (UIC), and Brandeis University analyzed birth certificate data for over 260,000 singleton infants born in the Boston, Springfield, and Worcester metro areas from February 2011 to December 2015, exploring the connection between neighborhood opportunities and preterm births.
The study found that the rate of preterm births was highest among Black infants at 8.4 percent, followed by Hispanic infants at 7.3 percent, and both Asian or Pacific Islander and White infants at 5.8 percent. Black and Hispanic infants were approximately 54 percent more likely to be born into neighborhoods with very low opportunities compared to White infants (11.8 percent) and Asian or Pacific Islander infants (19.6 percent). These same groups were also less likely to be born into neighborhoods with high opportunities, with only 6 percent of Black infants and 6.7 percent of Hispanic infants in such areas.
“Many lower opportunity neighborhoods are vibrant cultural centers filled with community activism and strength. However, they still experience economic exclusion, proximity to environmental toxins, and generally have fewer resources to support flourishing lives,” emphasizes Dr. Belanoff.
“To effectively narrow or close the racial and ethnic gaps in birth outcomes, it is crucial to look beyond individual factors,” asserts Dr. Joanna Almeida, the study’s senior author, and professor at Simmons SSW. “We must tackle the unequal distribution of resources and access to opportunity within neighborhoods to bring about changes in racial and ethnic disparities regarding preterm birth.”
