Geronimus A T
Department of Public Health Policy and Administration, University of Michigan, Ann Arbor 48109-2029.
Ethn Dis. 1992 Summer;2(3):207-21.
Observed variation between populations in fertility-timing distributions has been thought to contribute to infant mortality differentials. This hypothesis is based, in part, on the belief that the 20s through early 30s constitute "prime" childbearing ages that are low-risk relative to younger or older ages. However, when stratified by racial identification over the predominant first child-bearing ages, maternal age patterns of neonatal mortality vary between groups. Unlike non-Hispanic white infants, African-American infants with teen mothers experience a survival advantage relative to infants whose mothers are older. The black-white infant mortality differential is larger at older maternal ages than at younger ages. While African Americans and non-Hispanic whites differ on which maternal ages are associated with the lowest risk of neonatal mortality, within each population, first births are most frequent at its lowest-risk maternal ages. As a possible explanation for racial variation in maternal age patterns of births and birth outcomes, the "weathering hypothesis" is proposed: namely, that the health of African-American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage.
不同人群生育时间分布的观察差异被认为是导致婴儿死亡率差异的原因之一。这一假设部分基于这样一种观点,即20多岁到30岁出头是“最佳”生育年龄,相对于更年轻或更年长的年龄而言风险较低。然而,在主要的首次生育年龄范围内按种族划分时,新生儿死亡率的产妇年龄模式在不同群体之间存在差异。与非西班牙裔白人婴儿不同,青少年母亲所生的非裔美国婴儿相对于母亲年龄较大的婴儿具有生存优势。产妇年龄较大时,黑白婴儿死亡率差异比年龄较小时更大。虽然非裔美国人和非西班牙裔白人在哪些产妇年龄与最低新生儿死亡风险相关方面存在差异,但在每个人口中,首次生育在其最低风险产妇年龄时最为频繁。作为出生产妇年龄模式和出生结局种族差异的一种可能解释,有人提出了“累积劣势假说”:即非裔美国女性的健康状况可能在成年早期就开始恶化,这是累积社会经济劣势的生理后果。