ArticleSocial science & medicine (1982)2023
Investigating the impact of structural racism on black birthing people - associations between racialized economic segregation, incarceration inequality, and severe maternal morbidity.
Article in Social science & medicine (1982), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Structural racism as a fundamental cause of health inequities: a scoping review.International journal for equity in health · 2025Pooled it
- Postpartum Health Disparities During the Birth Hospitalization in the United States: A Scoping Review.Journal of racial and ethnic health disparities · 2026Article
- Structural Racism, Geographies of Opportunity, and Maternal Health Inequities: A Dynamic Conceptual Framework.Journal of racial and ethnic health disparities · 2026Article
- Judge Me Not: Exploring Black Mothers' Perceptions of Maternal Health Care Services and Structural Racism in South Carolina.Journal of racial and ethnic health disparities · 2026Article
- Challenges in estimating effects of hypothetical interventions on resources patterned by structural racism: an example in a rural North Carolina Medicaid population.American journal of epidemiology · 2026Article
- Postpartum severe maternal morbidity: A longitudinal analysis of the association with economic segregation and neighborhood deprivation in Georgia, USA 2016-2022.Social science & medicine (1982) · 2026Article
- Neighbourhood Socioeconomic Disadvantage and Severe Maternal Morbidity: Secondary Analysis of a Prospective Cohort.BJOG : an international journal of obstetrics and gynaecology · 2025Observational
- A Standard Measure of Structural Racism, Do We Have One? Can We Have One? A Narrative Review of Commonly Used Measures and Domains of Use.Journal of racial and ethnic health disparities · 2025Review
- The impact of neighborhood-level racial and economic segregation on low-risk cesarean delivery among Black, White, and Biracial (Black/White) individuals.BMC pregnancy and childbirth · 2025Article
- Accelerating birth equity using collaborative systems mapping.Health research policy and systems · 2025Article
- The Impact of Neighborhood-level Racial and Economic Segregation on Low-Risk Cesarean Delivery among Black, White, and Biracial (Black/White) Individuals.Research square · 2025Article
- Comparative Measurements: Ethnic Enclaves and Severe Maternal Morbidity in Asian, Black, and Hispanic Neighborhoods in California.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Reframing obstetric care through a trauma-informed lens: A narrative review of trauma-informed principles and clinical applications.Pregnancy (Hoboken, N.J.) · 2025Review
- Child abuse and experiences of discrimination are linked to fear of childbirth among younger patients in the US: a cohort study.BMC pregnancy and childbirth · 2025Article
- Article
- Linking Adverse Experiences to Pregnancy and Birth Outcomes: A Life Course Analysis of Racial and Ethnic Disparities Among Low-Income Women.Journal of racial and ethnic health disparities · 2024Article
- Structural gendered racism and preterm birth inequities in the United States.Social science & medicine (1982) · 2024Article
- Neighborhood Deprivation and Severe Maternal Morbidity in a Medicaid Population.American journal of preventive medicine · 2024Article
- The social determinants of mental health and disorder: evidence, prevention and recommendations.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Structural Racism, Mass Incarceration, and Racial and Ethnic Disparities in Severe Maternal Morbidity.JAMA network open · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Black birthing people are twice as likely to experience severe maternal morbidity (SMM) as their white counterparts. Structural racism provides a framework for understanding root causes of perinatal health disparities. Our objective was to investigate associations between measures of structural racism and severe maternal morbidity (SMM) among Black birthing people in the US. We linked delivery hospitalizations for Black birthing people in the National Inpatient Sample (2008-2011) with data from the American Community Survey 5-year estimates and the Vera Institute of Justice Incarceration Trends datasets (2008-2011). Structural racism measures included the Index of Concentration at the Extremes for race and income (i.e., racialized economic segregation) and Black-white incarceration inequality, assessed as quintiles by hospital county. Multilevel logistic regression assessed the relationship between these county-level indicators of structural racism and SMM. Black birthing people delivering in quintiles 5 (concentrated deprivation; OR = 1.45, 95% CI = 1.16-1.81) and 3 (OR = 1.27, 95% CI = 1.04-1.56) experienced increased odds of SMM compared to those in quintile 1 (concentrated privilege). After adjusting for individual characteristics, obstetric comorbidities, and hospital characteristics the odds of SMM remained elevated for Black birthing people delivering in quintiles 5 (aOR = 1.32, 95% CI = 1.02-1.71) and 3 (aOR = 1.24, 95% CI = 1.02-1.51). Delivering in the quintile with the highest incarceration inequality (Q5) was not significantly associated with SMM (aOR = 0.95, 95% CI = 0.72-1.25) compared to those delivering in counties with the lowest incarceration inequality (Q1). In this national-level study, racialized economic segregation was associated with SMM among Black birthing people. Our findings highlight the need to promote maternal and perinatal health equity through actionable policies that prioritize investment in communities experiencing deprivation.
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