ArticleJournal of racial and ethnic health disparities2026
The Association Between Structural Disadvantage and Adverse Birth Outcomes: Analyzing Preterm Birth and Low Birth Weight Using the Structural Racism Effect Index.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Neighborhood Disadvantage and Dementia Risk Among Older Patients With Kidney Failure: Differences by Race/Ethnicity and Urbanicity.Kidney medicine · 2026Article
- Multidimensional predictors of preterm birth risk among black and white primiparous women in the U.S.: insights from machine learning.BMC pregnancy and childbirth · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Patterns of risk for adverse birth outcomes, including low birth weight and preterm birth, are influenced by structural disadvantage. The Structural Racism Effect Index (SREI) measures these disadvantages across nine different domains, including education, income, housing, and employment. This study examines the association between structural disadvantage, as measured by the SREI, and adverse birth outcomes in the USA. Using the National Center for Health Statistics' 2020 natality file, modified Poisson regression models with robust variance adjusted for maternal age, education, prenatal care initiation, previous preterm birth, and payment source estimated the relative risks of low birth weight and preterm birth associated with exposure to level of SREI at the maternal county of residence. Among 2,376,030 birth records, higher SREI scores were significantly associated with increased risks of adverse outcomes. Medium and high SREI levels were linked to 7.4% (95% CI 6.3-8.5%) and 18.8% (95% CI 16.9-20.8%) higher risks for preterm birth, respectively, and 6.1% (95% CI 4.9-7.2%) and 17.0% (95% CI 15.8-18.2%) higher risks for low birth weight, respectively, compared to low SREI scores. Stratified analyses revealed that the impact of SREI on adverse birth outcomes varied significantly by maternal race, highlighting differential effects across racial groups. Cuzick's test for linear trend confirmed the dose-response relationship between the extent of structural disadvantage and the likelihood of adverse birth outcomes.
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