Healthy Birth Outcomes: Eliminating Racial and Ethnic Disparities
Selected Research

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This page features selected research efforts that seek to understand and identify ways to eliminate racial and ethnic disparities in birth outcomes.

• The American Medical Association offers resources on eliminating health disparities.



• "You Learn to Go Last": Perceptions of Prenatal Care Experiences among African-American Women with Limited Incomes (November 2012). Authors: Trina C. Salm Ward, Mary Mazul, Emmanuel M. Ngui, Farrin D. Bridgewater, Amy E. Harley.



• Where health disparities begin: The role of social and economic determinants - and why current policies may make matters worse (October 2011). Authors: Steven H. Woolf and Paula Braveman.



• Reducing low birthweight through home visitation (February 2009). As part of a larger randomized control trial, this study examined the effects of home visitation services on low birthweight (LBW) deliveries. The study found that the risk of delivering LBW babies was significantly lower for participants in the group receiving prenatal home visits with a focus on social support, health education, and better access to services, suggesting that this approach holds promise for reducing LBW deliveries among at-risk women and adolescents.



• Primary care interventions to promote breastfeeding: U.S. Preventive Services Task Force recommendation statement (October 2008). There is convincing evidence that breastfeeding provides substantial health benefits for children, and adequate evidence that breastfeeding provides moderate benefits for mothers. The promotion and support of breastfeeding may be accomplished through interventions over the course of pregnancy, around the time of delivery, and after birth while breastfeeding is under way. Interventions may include breastfeeding education for mothers and families, direct support of mothers during breastfeeding observations, and the training of health professional staff about breastfeeding and techniques for breastfeeding support. Evidence suggests that interventions including both prenatal and postnatal components may be the most effective at increasing breastfeeding duration. Many successful programs include peer support, prenatal breastfeeding education, or both.



• Impact of Prenatal Care Coordination on Birth Outcomes in Wisconsin (Slides; PDF,162 KB). Julie A. Willems Van Dijk, August 13, 2008.
  
  
• Advancing health disparities research within the health care system: A conceptual framework (December 2006). Authors: Amy M. Kilbourne, Galen Switzer, Kelly Hyman, Megan Crowley-Matoka, and Michael J. Fine.



• Recommendations to improve preconception health and health care - United States (April 2006): Improving one's health before pregnancy is essential to improve birth outcomes. The Centers for Disease Control and Prevention has outlined ten recommendations for improving women's preconception health and thereby improve birth outcomes, including emphasizing the importance of personal responsibility; increasing public awareness, risk assessment, education and counseling on the importance of behaviors that affect preconception health; increasing interventions for women with identified risks; providing interconception interventions for women with adverse outcomes; expanding health insurance coverage; and increasing public health surveillance and research to monitor preconception health.



• Social sources of racial disparities in health (May 2005). Authors: David R. Williams and Pamela Braboy Jackson.



• The Community Guide: Prevention of birth defects (June 2004): Folate taken before pregnancy and in the first two months of gestation can help prevent major birth defects of a baby's brain and spine. The Task Force on Community Preventive Services recommends community-wide campaigns to increase the use of supplements containing folic acid by women of childbearing age and folic acid fortification of food products.



• Racial and ethnic disparities in birth outcomes: A life-course perspective.  (Michael C. Lu and N. Halfon, Maternal Child Health Journal, Vol. 7, No. 1, pages 13-30, March 2003).  Abstract and information on accessing the full article.
  
  
• Neonatal health care costs related to smoking during pregnancy - Abstract (January 2002). This study confirms the adverse effects of smoking. Among mothers who smoke, smoking adds over $700 per mother in neonatal costs. The smoking-attributable neonatal costs in the U.S. represent almost $367 million in 1996 dollars; these costs vary from less than a million dollars in smaller states to more than $23 million in New York. These costs are highly preventable since the adverse effects of maternal smoking occur in the short run and can be avoided by even a temporary cessation of maternal smoking. These cost estimates can be used by managed care plans, state and local public health officials, and others to evaluate alternative smoking cessation programs.

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Last Revised:  December 17, 2012