Cited by 243Racial and Ethnic Identity ResearchHealth disparities and outcomesMaternal and Neonatal Healthcare

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Separate and unequal: Structural racism and infant mortality in the US

Wallace, Maeve, Crear-Perry, Joia, Richardson, Lisa, Tarver, Meshawn, Theall, Katherine·2017·Health & Place

DOI 10.1016/j.healthplace.2017.03.012

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Abstract

We examined associations between state-level measures of structural racism and infant mortality among black and white populations across the US. Overall and race-specific infant mortality rates in each state were calculated from national linked birth and infant death records from 2010 to 2013. Structural racism in each state was characterized by racial inequity (ratio of black to white population estimates) in educational attainment, median household income, employment, imprisonment, and juvenile custody. Poisson regression with robust standard errors estimated infant mortality rate ratios (RR) and 95% confidence intervals (CI) associated with an IQR increase in indicators of structural racism overall and separately within black and white populations. Across all states, increasing racial inequity in unemployment was associated with a 5% increase in black infant mortality (RR=1.05, 95% CI=1.01, 1.10). Decreasing racial inequity in education was associated with an almost 10% reduction in the black infant mortality rate (RR=0.92, 95% CI=0.85, 0.99). None of the structural racism measures were significantly associated with infant mortality among whites. Structural racism may contribute to the persisting racial inequity in infant mortality.

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Authors: Wallace, M., Crear-Perry, J., Richardson, L., Tarver, M., & Theall, K.
Affiliations: Tulane University (US)
Institute of Women and Ethnic Studies (US)
Corresponding author: Wallace, Maeve
ORCID: Crear-Perry, Joia
Richardson, Lisa
Theall, Katherine
Venue: Health & Place
Publisher: Elsevier BV
Published: 2017-05
Volume: 45
Pages: 140-144
ISSN: 1353-8292 (ISSN-L)
DOI: 10.1016/j.healthplace.2017.03.012
OpenAlex: W2598043244
Cited by: 243
References: 28
Citations by year: 2026: 18 · 2025: 19 · 2024: 46 · 2023: 37 · 2022: 41 · 2021: 43 · 2020: 21 · 2019: 12 · 2018: 4 · 2017: 1
FWCI: 26.60
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Health & Place (publishedVersion)
PubMed (publishedVersion)
Funders: W.K. Kellogg Foundation (P3032230)
Frost Foundation
Topics: Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: structural racism, infant mortality, racial inequity, racial disparities, unemployment, educational attainment, household income, incarceration, juvenile custody, United States
MeSH terms: Black or African American, Education, Female, Humans, Income, Infant, Infant Mortality, Infant, Newborn, Male, United States, White People, Health Status Disparities, Racism

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Separate and unequal: Structural racism and infant mortality in the US

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