Regions of the state with combined high poverty rates and concentrated African-American populations have higher percentages of low birth weight babies, according to data from the U.S. Census and the Missouri Department of Health and Senior Services.
The data indicates that geography, race and poverty – and the resulting chronic stress those factors cause – can combine to create lower health outcomes for infants.
More than 10 percent of all babies born in St. Louis and the Bootheel region between 2010 and 2016 weighed less than 5 and a half pounds, the cutoff for what’s considered a healthy birth weight, according to data from the Missouri Information for Community Assessment.
“The two things that bind these regions together are race and poverty,” said Christopher Prener, a sociology professor at Saint Louis University. Prener and his students have been studying the relationship between low birth weights, income levels and race across Missouri.
While south central Missouri has a high rate of poverty, and Kansas City has a large percentage of African-Americans, babies with low birth rates largely are found in areas where the two factors overlap, he said.
Some babies with low birth weights are carried for a full nine months. But most are born premature, before they’ve had time to grow to a larger size. Babies with low birth weight are more likely to develop health problems or die before their first birthday, according to the March of Dimes.
Nearly 14 percent of black babies are born with low birth weight. That’s nearly double the rate for white women.
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“We don’t think in the U.S. this is a story about access to care, or necessarily health insurance,” said Prener. “It’s about other factors in society that seem to be driving this gap.”
African women who immigrate to the United States tend to deliver babies with weights similar to white babies. But African-American women in higher income brackets still have smaller babies than their white peers.
Factors such as nutrition and access to hospitals are associated with low birth weight, especially in developing countries. In the United States, though, public health officials have begun to focus on how socioeconomic factors and resulting stress can result in low birth weights.
“It’s definitely a double jeopardy,” said Cathy McElderry, Southeast Missouri State University social work professor, of the combined pressures of racism and poverty.
“One of the variables we’re beginning to look at in terms of social determinants is the role of chronic stress,” McElderry said. “Many African-Americans live not only in the stress of poverty but also the stress of a racialized society.”
The more stress a woman experiences while pregnant, the more likely it is she’ll have prenatal health problems, said McElderry. Stress hormones are naturally high during pregnancy. If a woman goes into a pregnancy with already high stress levels, she’s more likely to have baby prematurely or with a low birth weight.
“When we’re under chronic stress, we know that our bodies don’t function at full capacity. What the mother experiences, the infant is likely to experience as well,” she said.
Ensuring that black American women have better pay and social and emotional support, along with prenatal care, would help them have healthier babies, McElderry said.
“I think we’ve done a lot medically but we haven’t done as much on the social frontier as we need to do,” she said.
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