High-income Black mothers and their newborns have worse health outcomes than their less-wealthy white peers. So what’s going on?

Parental income and race appear to play an important role in infant mortality.

That’s the conclusion of a research paper distributed this week by the National Bureau of Economic Research, a nonprofit organization based in Cambridge, Mass. The study, titled “Maternal and Infant Health Inequalities,” looked at data from birth records in California from 2007 to 2016.

Researchers collected data from the California Department of Health Care Access and Information, a department within the California Health and Human Services Agency, and from Internal Revenue Service tax records.

Babies born into low-income families experience higher mortality rates in the first year of life compared to those born into the highest-income households, the paper found. Maternal mortality rates are also greatest among mothers with the lowest incomes.

Infant and maternal health are best for non-Hispanic white families and worst for non-Hispanic black families. The gap between the two groups is greater than the difference in income across races.

‘The health of babies and mothers in Black families at the top of the income distribution appears to be worse than that of white families at the bottom of the income distribution.’

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– ‘Maternal and Infant Health Inequalities’ Report

“Indeed, infant and maternal health in black families at the top of the income distribution is worse than white families at the bottom of the income distribution,” the researchers wrote.

That means even the highest-income black mothers and their newborns experience worse infant and maternal mortality rates than their lowest-income white counterparts.

The findings show deep racial biases in the US health care system and elsewhere, Maya Rossin-Slater, one of the paper’s authors and a professor of health policy at Stanford University, said in a statement.

“We hear stories like Serena Williams and tend to think she’s amazing, but our data shows that’s not true,” she added, referring to the tennis star’s account in a 2018 Vogue story in which she had complications after giving birth, and struggled. to get the medical staff to listen to her concerns.

Black women are three times more likely to die during pregnancy than their white counterparts, according to the Centers for Disease Control and Prevention.

But the quality of health care is not the only factor that explains the disparity, Rossin-Slater said. Resources like paid family leave, unequal access among different socio-economic groups, also affect the well-being of mothers and babies, he said.

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“The stark inequities by income and race in California are particularly striking because the state has one of the most generous social safety-net systems in the US, and is also well-known for its efforts to improve maternal and child-health outcomes and overcome racial disparities,” added the newspaper’s authors, which came from Stanford University, New York University, Columbia University, University of Michigan and the US Census Bureau.

The US has higher infant mortality and maternal mortality rates than other rich countries. In fact, the US infant mortality rate ranks 33rd out of 38 countries included in the Organization for Economic Co-operation and Development’s infant mortality report for 2021. For every 1,000 live births, there will be 5.4 deaths in the US in 2021.

But the US ranks first in the world in terms of scientific progress in healthcare, according to the World Index of Healthcare Innovation in 2020. The US ranks fourth, after Switzerland, Germany and the Netherlands. It fared high in categories such as quality, choice, and science and technology, but scored low in fiscal sustainability, ahead of only Japan.

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The researchers also found that lower-income mothers were more likely to have normal-weight babies compared to mothers in the highest income bracket. (Low birth weight can indicate serious health problems.) Mothers in the highest income bracket are also older, and sometimes more likely to have singleton births, meaning they give birth to more than one child.

Non-singleton births — twins or triplets, for example — typically have lower birth weights and are more likely to occur during pregnancies assisted by fertility treatment, the authors said. Studies show that people who use fertility treatment are disproportionately older and wealthier, due to the high cost.

While children born into households at the highest level have worse birth outcomes than those born at the bottom of the income distribution, they still have lower mortality rates.


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