Structural Racism and Adverse Birth Outcomes in the US South: A Multigenerational Perspective (5R01MD016046-02)

Project Description

Chronic material deprivation and the ‘wear and tear’ of everyday discrimination are key social factors thought to contribute to Black women’s poor birth outcomes. These processes are embedded within structural racism, which is the larger system of policies, practices, ideologies, and institutions that reinforces racial inequality by creating differential access to resources and opportunities. To date, however, most research on structural racism and poor birth outcomes considers maternal exposure to only one or two dimensions of structural racism, at a single point in time, thereby underestimating its contribution to Black women’s birth outcomes. The goal of this project is to examine the effects of multigenerational exposure to structural racism on birth outcomes among Black women in the US South. 


Aims

  1. Quantify Black women’s exposure to four dimensions of structural racism in South Carolina.
  2. Examine the association between four dimensions of structural racism and adverse birth outcomes both within and across generations of Black mothers in South Carolina.

GRANT INFORMATION

2025

Kappelman AL, Ro A, Admon L, Needham BL, Fleischer NL. Black/White disparities in low birth weight across maternal trajectories of social mobility in South Carolina. Social Science & Medicine. 2025. doi: 10.1016/j.socscimed.2025.117675.

2024

Ali T, Allgood KL, Needham B, Ro A, Hirschtick JL, Fleischer NL. Policies and indicators to operationalize structural racism for quantitative health research. American Journal of Epidemiology. 2024. doi: 10.1093/aje/kwae250.


2023

Buxton MA, Fleischer NL, Ro A, O'Neill MS. Structural racism, air pollution and the association with adverse birth outcomes in the United States: the value of examining intergenerational associations. Frontiers in Epidemiology. 2023. doi: 10.3389/fepid.2023.1190407.


2022

Needham BL, Ali T, Allgood KL, Ro A, Hirschtick JL, Fleischer NL. Institutional Racism and Health: a Framework for Conceptualization, Measurement, and Analysis. J Racial Ethn Health Disparities. 2022. doi: 10.1007/s40615-022-01381-9.


2019

Fleischer NL, Abshire C, Margerison CE, Nitcheva D, Smith MG. The South Carolina Multigenerational Linked Birth Dataset: Developing Social Mobility Measures Across Generations to Understand Racial/Ethnic Disparities in Adverse Birth Outcomes in the US South. Matern Child Health J. 2019. doi: 10.1007/s10995-018-02695-z.

2024

AL Kappelman, A Ro, NL Fleischer. Black/White disparities in intergenerational trajectories of maternal education and adverse birth outcomes in South Carolina. Oral presentation at: Annual Meeting of the Interdisciplinary Association for Population Health Science; Septemeber 2024; St. Louis, MO.

MP Huynh, WJ Lee, NL Fleischer, AL Kappelman, Y Xie, A Ro. Differences in the Relationship Between Voter Registration and Birth Outcomes by Race in South Carolina. Poster presentation at: Annual Meeting of the Society for Epidemiologic Research; June 2024; Austin, TX.

AL Kappelman. Chutes and Ladders: Racial Disparities in Maternal Trajectories of Social Mobility and Adverse Birth Outcomes in South Carolina. Seminar presentation at: the University of Michigan Center for Social Epidemiology and Population Health; January 2024; Ann Arbor, MI.


2023

AL Kappelman. An exploration of the intergenerational persistence of health and social status contributing to racial disparities in birth outcomes in South Carolina. Seminar presentation at: the University of Michigan Center for Social Epidemiology and Population Health; November 2023; Ann Arbor, MI.