ArticleAnnals of epidemiology2023
Political representation and perinatal outcomes to Black, White, and Hispanic people in Georgia: a cross-sectional study.
Article in Annals of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.
- Interpersonal, Community/Environmental, and Societal Risk and Protective Factors for Gestational Diabetes and Hypertensive Disorders of Pregnancy Among Black Women in the United States: A Systematic Review.Maternal and child health journal · 2026Pooled it
- CVD Environmental Health Disparities Tool: systematic evidence mapping of psychosocial stressors, environmental exposures, and cardiovascular diseases to inform disparities research and action.Environmental health : a global access science source · 2026Review
- Ecological Impacts of Structural Racism on Health Disparity Through Its Determinants and Mediating Factors: A Case Study on Low Birthweight in Three Race/Ethnicity Groups in the United States.International journal of environmental research and public health · 2025Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
purposeOur goal was to estimate differences in perinatal outcomes by racial differences in political representation, a measure of structural racism.
methodsWe gathered data on the racial composition of county-level elected officials for all counties in Georgia (n = 159) in 2022. We subtracted the percent of non-White elected officials from the percent of non-White residents to calculate the "representation difference," with greater positive values indicating a larger disparity. We linked this to data from 2020-2021 birth certificates (n = 238,795) on outcomes (preterm birth, <37 weeks, low birthweight birth <2500 g, birthweight, hypertensive disorders of pregnancy, cesarean delivery). We fit log binomial and linear models with generalized estimating equations, stratified by individual race/ethnicity and including individual and county covariates.
resultsMedian representation difference was 17.5% points (interquartile range: 17.2). A 25-percentile point increase in representation difference was associated with a greater risk of hypertensive disorders of pregnancy [White: adjusted risk ratio (RR): 1.12, 95% confidence interval (CI): (1.05, 1.2), Black: 1.06, 95% CI: (0.95, 1.17), other: 1.14, 95% CI: (1.0, 1.3), Hispanic: 1.19, 95% CI: (1.07, 1.32)] and lower mean birthweight for Black birthing people [adjusted beta -15.3, 95% CI: (-25.5, -7.4)].
conclusionsParity in political representation may be associated with healthier environments.
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Registered trials
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