The hidden role of racial discrimination on adverse birth outcomes: a strategic plan for Delaware

Sarzynski, AndreaBlack women experience an infant mortality rate more than double that of White women. The causes underlying this inequity are not well understood. Research indicates a relationship between psychological stress and adverse birth outcomes. Further, racial discrimination has been linked with psychological stress and is thought to contribute to higher rates of infant mortality among Black women. The purpose of this thesis is to explore the relationship between racial discrimination and adverse birth outcomes using a publicly available dataset, which includes characteristics of parents and birth outcomes from 2004-2009. Two approaches were used to explore racial discrimination. First, birth outcomes were assessed relative to the race of both parents. Second, birth outcomes were assessed relative to chronic hypertension. The major findings of this study were that in the college-educated population, there are persistent gaps in infant mortality between same race Black parents and biracial parents compared to same race White parents. This study also found that chronic hypertension was a contributor to adverse birth outcomes, but may not explain the effect that discrimination can have. When considered in the context of the existing literature, and a comparative institutional analysis, the findings suggest that policy interventions may need to more explicitly address the role of racial discrimination in adverse birth outcomes. Implications for Delaware's efforts to close the gap in Black-White birth outcomes are discussed. Finally, it is recommended that additional research is needed to better understand the role of racial discrimination in adverse birth outcomes, including approaches to systematically measure its effects on health.University of Delaware, School of Public Policy and AdministrationM.A