Racially motivated hate crime exposure and birth outcomes: Analysis of US vital statistics data 1995-2020.

Exposure to racially motivated hate crime represents a salient form of structural and interpersonal racism that is associated with detrimental mental and physical health. Although prior research shows that stress during pregnancy can influence birth outcomes, empirical evidence linking hate crime exposure to adverse birth outcomes remains limited. Using National Vital Statistics Birth Data from 1995 to 2020 linked to county-level hate crime data, we use linear probability models and leverage variation in the timing of hate crimes in the county to examine the association between maternal exposure to a hate crime targeting her own race during pregnancy and the likelihood of preterm birth or low birth weight among Black, Asian, and Hispanic mothers, compared with White mothers as the reference group. Hate crime exposure is associated with a higher likelihood of preterm birth, though not with low birth weight; this association is stronger among Black and Asian than White mothers. When stratified by maternal education, the relationship between hate crime exposure and the likelihood of preterm birth is significantly larger among Black and Hispanic mothers with at least some college education than similar White mothers. Hate crime, as a marker of the racialized social environment, may contribute to racial disparities in birth outcomes. Policies reducing hate crime and its health effects may improve maternal and infant health and narrow inequities at birth.