Mark Nicholas D E
Department of Sociology, New York University, Puck Building 4th Floor, 295 Lafayette Street, New York, NY, 10012-9605, USA.
SSM Popul Health. 2021 Jun 1;15:100806. doi: 10.1016/j.ssmph.2021.100806. eCollection 2021 Sep.
This paper uses birth certificate data to provide novel estimates of the age-specific risk of a low birth weight birth (LBW, an infant born weighting <2500 g) for U.S.-born non-Hispanic Black and White mothers, and finds that patterns vary markedly over space and time. Notably, risk of an LBW birth for Black mothers increased much more steeply with age in 1991-94 than in 2014-17. This decline in LBW risks among older Black mothers led to a decline in the Black-White LBW gap of more than half a percentage point. Both patterns and changes were regional; while age gradients on the Black-White LBW gap were lowest in the South in 1991-94, by 2014-17 they had increased in the South and declined in the rest of the country. These descriptive data allow a new examination of hypotheses regarding the causes of age-specific racial LBW gaps. Research has found that racial disparities in a number of health outcomes, including LBW, increase with age, leading some to speculate that this increase is due to the cumulative effects of exposure to disadvantage. The large degree of variability in Black-White LBW disparities suggests that age-specific causes may also play a role. A series of counterfactual trend analyses explore the roles of two specific mechanisms, smoking and hypertension, and compares these to a more fundamental indicator of socioeconomic status: education.
本文利用出生证明数据，对美国出生的非西班牙裔黑人和白人母亲生出低体重儿（LBW，出生体重<2500克的婴儿）的特定年龄风险进行了新的估计，并发现不同地区和不同时期的模式差异显著。值得注意的是，1991 - 1994年期间，黑人母亲生出低体重儿的风险随年龄增长的幅度比2014 - 2017年期间大得多。年长黑人母亲的低体重风险下降导致黑人与白人之间的低体重差距缩小了超过0.5个百分点。这些模式和变化都具有地区性；1991 - 1994年期间，南方黑人和白人在低体重差距方面的年龄梯度最低，但到2014 - 2017年，南方的这一梯度上升，而美国其他地区则下降。这些描述性数据有助于对关于特定年龄种族低体重差距成因的假设进行新的审视。研究发现，包括低体重在内的许多健康结果方面的种族差异会随着年龄增长而增加，这使得一些人推测这种增加是由于长期处于不利环境的累积影响。黑人和白人在低体重方面的差异存在很大程度的变异性，这表明特定年龄的成因可能也起到了作用。一系列反事实趋势分析探讨了吸烟和高血压这两种特定机制所起的作用，并将其与社会经济地位的一个更基本指标：教育程度进行比较。
