Racist policies and practices that restrict Black workers from employment may drive racial inequities in birth outcomes among workers. In the United States, Black infants are 50% more likely to be born prematurely than white infants, and they are 2.3 times as likely to die before their first birthday. Health equity experts at the University of Minnesota School of Public Health (SPH) are working to explain why these pervasive inequities persist.

A new study, led by postdoctoral fellow Bert Chantarat, Ph.D., from the SPH Center for Antiracism Research and Health Equity (CARHE), looked at the association between structural racism and low birth weights for Black birthing people in 635 U.S. labor markets. 

“The stress and disadvantage of structural racism builds up in a person’s body over the course of their lifetime,” said study co-author and CARHE director, Associate Professor, and Blue Cross Endowed Professor of Health and Racial Equity Rachel Hardeman. “Inequities that Black birthing people face searching for jobs and at work are bad for them and their infants.”

Structural racism impacts the lives of Black people in ways that intersect economics, geography, history, and culture including labor markets. The researchers defined labor markets as geographic areas where workers live, search for jobs, and commute to work. The extent of structural racism in labor markets was measured by looking at different probabilities of employment for equally qualified white and Black workers using data from the U.S. Census Bureau’s American Community Survey. The national survey asks Americans about various information including their educational attainment, employment status, and the type of work they do.

Data on newborn birth weight came from the U.S. birth records which allows researchers to compare the risk for Black workers from various nativity groups living and working in specific regions of the U.S. 

The researchers found: 

• For U.S.-born Black pregnant people, living in racist labor markets was associated with low birth weight specifically in the southern regions of the U.S. 
• However, there were not statistically significant increases in risk for Caribbean-born or African-born Black pregnant people, which reinforces that racism, not race, is the risk factor. 

“Not having access to health-promoting resources that generally come from work or feeling extra stress landing a high-quality job because you’re Black can affect your health, as well as your infant’s health” said Chantarat. “If we want to truly eliminate birth inequities, we need to get rid of the system that places equally qualified workers into different employment because of their race”.

Work policies to ensure equal employment access and workplace inclusion are viable solutions to birth inequities. However, “one-size-fit-all” solutions may not be sufficient. Future research and policy recommendations must factor in the local, historical, and cultural context of different communities.