New research from the University of Minnesota School of Public Health (SPH) links the stress of living in an over-policed neighborhood with higher odds of preterm birth for both Black and white birthing people — but most severely for Black residents. Preterm birth, defined as birth before 37 weeks of gestation, raises the risk of long-term health problems for babies.

The study, led by Rachel Hardeman, associate professor and director of the SPH Center for Antiracism Research and Health Equity (CARHE), was published in the Journal of the American Medical Association (JAMA) Open Network. Hardeman is a national expert in racial reproductive health disparities, including the role of over-policing in Black birth disparities.

A growing body of research reveals the physiological harms of police encounters, particularly for Black people. This study adds to that research, showing how racist policing practices hurt birthing people and their babies.

“Racism is a fundamental cause of health inequity, which means we have to apply antiracism to institutions that affect the fundamentals of our lives and communities,” said Hardeman. “Our research focused on residents of Minneapolis and found that U.S.-born Black birthing people and their babies were hit the hardest by over-policing, which is a form of structural racism.”

Hardeman’s study team examined medical record data of 745 white, 121 U.S.-born Black, and 193 non–U.S.-born Black Minneapolis residents who gave birth to single babies at a large health system between Jan. 1 and Dec. 31, 2016. The researchers then looked at where the residents lived in Minneapolis and determined if they were in neighborhoods that had high police contact, defined as areas within the highest statistical quarter of police activity in the city.

The research found:

• In high police-contact neighborhoods, all birthing people had higher odds of preterm birth, indicating that the stress of over-policing is harmful regardless of race. 
• White birthing people living in high police contact neighborhoods experienced a 90% higher chance of preterm birth compared to residents in low-contact areas.
• U.S.-born Black birthing people in high-contact areas experienced a 100% higher chance of preterm birth compared to residents in low-contact areas. 
• Foreign-born Black birthing people in high-contact areas showed only a 10% higher chance for preterm birth. This is explained by what researchers call the “immigrant paradox,” which states that Black immigrants who didn’t grow up weathering structural racism have far better health outcomes than Black individuals who were born and raised in America. 
• The researchers also found that Black neighborhoods are disproportionately over-policed compared to white neighborhoods.

“Our results show that over-policing is bad for everyone, but that the burden is not shared equally,” said Hardeman. “The difference between U.S.-born and non-U.S.-born Black birthing people also reveals that racism — and not race — creates health inequities between Black people and their white counterparts.”

If the cause of higher preterm birth rates among U.S. and non-U.S.-born Black birthing people was purely biological due to their race, both groups would have had similar results. Instead, the research shows that non-U.S.–born Black birthing people have far healthier pregnancies and babies than their U.S.-born counterparts, proving that the difference is whether or not they experienced long-term exposure to over-policing structural racism. 

“Racism is a fixable problem,” said Hardeman. “Community health needs to be a priority for public safety reform, and the voices and needs of Black, Indigenous, and people of color need to be prioritized.”

Funding for this study was provided from the Institute for Diversity, Equity, and Advocacy at the University of Minnesota. Additional support by the Minnesota Population Center, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant No: P2C HD041023). Medical record data was provided by the University of Minnesota’s Best Practices Informatics Consulting Group.

About the Center for Antiracist Research for and Health Equity
The SPH Center for Antiracism Research for Health Equity (CARHE), supported by Blue Cross and Blue Shield of Minnesota, uses revolutionary antiracist research techniques to explore how systems, policies, social structures and historical influences create the conditions for health inequities. In its pursuit to address and uproot structural racism’s impact on health and healthcare, CARHE produces antiracist research findings, changes the narrative around race and racism, produces equitable policy solutions, and influences community interventions.