Document Detail

Racial and ethnic disparities in birth outcomes: a life-course perspective.
MedLine Citation:
PMID:  12710797     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In the United States, Black infants have significantly worse birth outcomes than do White infants. The cause of these persisting racial disparities remains unexplained. Most extant studies focus on differential exposures to protective and risk factors during pregnancy, such as current socioeconomic status, maternal risky behaviors, prenatal care, psychosocial stress, or perinatal infections. These risk factors during pregnancy, however, do not adequately account for the disparities. METHODS: We conducted a literature review for longitudinal models of health disparities, and presented a synthesis of two leading models, using a life-course perspective. Traditional risk factors during pregnancy are then reexamined within their life-course context. We conclude with a discussion of the limitations and implications of the life-course perspective for future research, practice, and policy development. RESULTS: Two leading longitudinal models of health disparities were identified and discussed. The early programming model posits that exposures in early life could influence future reproductive potential. The cumulative pathways model conceptualizes decline in reproductive health resulting from cumulative wear and tear to the body's allostatic systems. We propose a synthesis of these two models, using the life-course perspective. Disparities in birth outcomes are the consequences of differential developmental trajectories set forth by early life experiences and cumulative allostatic load over the life course. CONCLUSIONS: Future research on racial disparities in birth outcomes needs to examine differential exposures to risk and protective factors not only during pregnancy, but over the life course of women. Eliminating disparities requires interventions and policy development that are more longitudinally and contextually integrated than currently prevail.
Michael C Lu; Neal Halfon
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Maternal and child health journal     Volume:  7     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-24     Completed Date:  2003-06-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  13-30     Citation Subset:  IM    
Department of Obstetrics & Gynecology, Center for Healthier Children, Families, and Communities, UCLA School of Medicine, Los Angeles, California, USA.
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MeSH Terms
African Americans / psychology,  statistics & numerical data*
Continental Population Groups*
European Continental Ancestry Group / psychology,  statistics & numerical data
Health Behavior / ethnology
Health Services Accessibility
Infant Mortality
Infant, Newborn
Life Tables*
Longitudinal Studies
Maternal Welfare / ethnology
Models, Theoretical*
Pregnancy Outcome / ethnology*
Quality of Health Care
Risk Factors
Socioeconomic Factors
United States / epidemiology
Women's Health*
Grant Support
5U93MC00099//PHS HHS; HD01281-03/HD/NICHD NIH HHS
Comment In:
Matern Child Health J. 2003 Mar;7(1):5-11   [PMID:  12710796 ]
Matern Child Health J. 2003 Sep;7(3):151-6   [PMID:  14509410 ]

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