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Socioeconomic Gradients in Infant Health Across Race and Ethnicity

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Abstract

The objective of this study was to examine socioeconomic (SES) gradients in infant health across a number of racial and ethnic groups in the United States. The study was based on data from a new nationally representative sample of children born in the US in 2001 (N = 8,650). The data include oversamples of several minority groups and a rich set of socioeconomic indicators, as well as demographic, health, and health behavior characteristics. Proportion of low birth weight (LBW) and small for gestational age (SGA) (and 95% CIs) across categories of several indicators of SES (maternal education, income, income adjusted for family size, and wealth) was presented for the full sample of children and disaggregated by race/ethnicity: non-Hispanic white, non-Hispanic black, Hispanic, Asian/Pacific Islander (A/PI), and American Indian/Alaskan Native (AI/AN). A graded relationship was found between all measures of SES and infant health for white mothers, and between adjusted income and LBW for Asian and Hispanic mothers. There was no relationship between any indicator of SES and either LBW or SGA for either black or AI/AN mothers. The finding that some minority racial/ethnic groups do not reap the same health benefits from higher levels of SES as do whites suggests that approaches to reducing health disparities must address not only the structural barriers that lead some minority groups to have fewer resources but also barriers that prevent these groups from taking advantage of those resources to improve the health of their families.

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Notes

  1. Sampling was done within primary sampling units (PSUs), which were stratified by region, median household income, proportion minority, and whether in a metro area. The core sample is representative of each of the main racial/ethnic groups (non-Hispanic white, non-Hispanic black, Hispanic), while the oversamples were intended to be representative of A/PI and AI/AN. The response rate for completed parent baseline interviews was approximately 75% of eligible cases. Response rates were also calculated by race/ethnicity (ranging from 63% for Chinese to 80% for non-Hispanic black) and by region of residence (ranging from 68% in the Northeast to 77% in the Midwest).

  2. All unweighted sample sizes have been rounded to the nearest 50, as required by the National Center for Education Statistics to protect subject confidentiality.

  3. The following numbers of cases were dropped because of exclusion criteria: 1,700 multiple birth cases; 150 cases for whom the main respondent was not the biological mother; and 150 cases that were missing data on birth weight or race/ethnicity. For the SGA analyses only, another 150 cases were dropped because of missing data on gestational age.

  4. Though the Kessner adequacy scale has been critiqued and a more valid scale is available [39], it is used here because of convenience (variable was constructed in the ECLS-B) and because it is not a primary variable of interest in these analyses.

  5. Medical risk factors include: anemia, cardiac disease, acute or chronic lung disease, diabetes, genital herpes, oligohydramnios, hemoglobinopathy, pre-existing or gestational hypertension, eclampsia, incompetent cervix, previous ≥4000 gm infant, previous preterm or small for gestational age infant, renal disease, RH sensitization, uterine bleeding, or other risk factor.

  6. The statistical results for Fig. 3 are not presented, but are available upon request from the author.

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Acknowledgements

This work has been supported by a grant from the National Poverty Center at the University of Michigan. Any opinions expressed are those of the author. I would like to thank Julien Teitler, Nancy Reichman, and Matt Davis for their advice and suggestions.

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  1. School of Social Work, Rutgers University, 536 George Street, New Brunswick, NJ, 08901, USA

    Lenna Nepomnyaschy

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Nepomnyaschy, L. Socioeconomic Gradients in Infant Health Across Race and Ethnicity. Matern Child Health J 13, 720–731 (2009). https://doi.org/10.1007/s10995-009-0490-1

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