The DOI matches its Crossref record; 25 of the 28 references it cites were found in a registry or an index.
Separate and unequal: Structural racism and infant mortality in the US
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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“State-level racism has been established as an important predictor of Black individuals' health and healthcare, and [13,15] obesity risk may be impacted by structural racism.”
From Intersections of Structural State-Level Racism and Neighborhood Deprivation on Nutrition and Obesity for Black Adolescents (2025) · cites this paper as [13]
In the citing paper
“Structural racism operates at multiple geospatial levels [10,13], including the state-level.”
From Intersections of Structural State-Level Racism and Neighborhood Deprivation on Nutrition and Obesity for Black Adolescents (2025) · cites this paper as [13]
Citations
Cites
Social conditions as fundamental causes of disease.
Link, B. G., & Phelan, J. (1995) · Journal of Health and Social Behavior · doi:10.2307/2626958 · Cited by 5,722
Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health
Williams, D. R., & Collins, C. (2001) · Public Health Reports · doi:10.1093/phr/116.5.404 · Cited by 3,153
Socioeconomic Status and Health: What We Know and What We Don't
ADLER, N. E., & OSTROVE, J. M. (1999) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1999.tb08101.x · Cited by 1,643
(1992) · PubMed · Cited by 1,389
Is Racism a Fundamental Cause of Inequalities in Health?
Phelan, J. C., & Link, B. G. (2015) · Annual Review of Sociology · doi:10.1146/annurev-soc-073014-112305 · Cited by 1,363
Infant mortality statistics from the 2001 period linked birth/infant death data set.
Mathews, T. J., Menacker, F., & MacDorman, M. F. (2003) · PubMed · Cited by 967
Achieving health equity: from root causes to fair outcomes
Marmot, M. G. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61385-3 · Cited by 936
Infant Mortality Statistics from the 1999 Period: Linked Birth/Infant Death Data Set
Mathews, T. J., MacDorman, M. F., & Menacker, F. (2002) · PsycEXTRA Dataset · doi:10.1037/e558952006-001 · Cited by 840
Systemic racism and U.S. health care
Feagin, J., & Bennefield, Z. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.09.006 · Cited by 819
Democratic Contraction? Political Consequences of Felon Disenfranchisement in the United States
Uggen, C., & Manza, J. (2002) · American Sociological Review · doi:10.1177/000312240206700601 · Cited by 497
Krieger, N. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.2.194 · Cited by 397
Structural racism and myocardial infarction in the United States
Lukachko, A., Hatzenbuehler, M. L., & Keyes, K. M. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.07.021 · Cited by 353
Increasing mortality during the expansions of the US economy, 1900–1996
Granados, J. A. T. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyi141 · Cited by 339
Revisiting Robinson: The perils of individualistic and ecologic fallacy
Subramanian, S. V., Jones, K., Kaddour, A., & Krieger, N. (2009) · International Journal of Epidemiology · doi:10.1093/ije/dyn359 · Cited by 322
Closing the Black-White Gap in Birth Outcomes: A Life-course Approach
Lu, M. C. (2010) · PubMed · doi:10.17615/m0w8-vx83 · Cited by 258
Black Lives Matter: A Commentary on Racism and Public Health
Jee-Lyn García, J., & Sharif, M. Z. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302706 · Cited by 246
Last hired, first fired? Black-white unemployment and the business cycle
Couch, K. A., & Fairlie, R. (2010) · Demography · doi:10.1353/dem.0.0086 · Cited by 180
Socioeconomic domains and associations with preterm birth
Messer, L. C., Vinikoor, L. C., Laraia, B. A., Kaufman, J. S., Eyster, J. T., Holzman, C., Culhane, J. F., Elo, I. T., Burke, J. G., & O'Campo, P. J. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.06.009 · Cited by 127
Phuong, D., Finch, B. K., Basurto‐Dávila, R., Bird, C. E., Escarce, J. J., & Lurie, N. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.06.018 · Cited by 126
INCARCERATION AND THE HEALTH OF THE AFRICAN AMERICAN COMMUNITY1
Schnittker, J., Massoglia, M., & Uggen, C. (2011) · Du Bois Review: Social Science Research on Race · doi:10.1017/s1742058x11000026 · Cited by 111
Krieger, N. (2008) · American Journal of Public Health · doi:10.2105/ajph.98.supplement_1.s20 · Cited by 64
Siddiqi, A., Jones, M. K., Bruce, D. J., & Erwin, P. C. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.07.013 · Cited by 32
RACIAL DIFFERENCES IN THE RELATIONSHIP BETWEEN INFANT MORTALITY AND SOCIOECONOMIC STATUS
Goza, F., Stockwell, E. G., & Balistreri, K. S. (2006) · Journal of Biosocial Science · doi:10.1017/s0021932006001581 · Cited by 24
Sidebar: Economic Conditions and Health Behaviors: Are Recessions Good for Your Health?
Ruhm, C. J. (2009) · North Carolina Medical Journal · doi:10.18043/ncm.70.4.328 · Cited by 21
Orsini, C., & Avendaño, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0123501 · Cited by 7
Cited by
Sorted by citations
How Structural Racism Works — Racist Policies as a Root Cause of U.S. Racial Health Inequities
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Social and Structural Determinants of Health Inequities in Maternal Health
Crear-Perry, J., Correa‐de‐Araujo, R., Johnson, T. L., McLemore, M. R., Neilson, E., & Wallace, M. E. (2020) · Journal of Women s Health · doi:10.1089/jwh.2020.8882 · Cited by 908
Self-citationPhysician–patient racial concordance and disparities in birthing mortality for newborns
Greenwood, B. N., Hardeman, R. R., Huang, L., & Sojourner, A. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1913405117 · Cited by 772
Measuring structural racism: a guide for epidemiologists and other health researchers
Adkins-Jackson, P. B., Chantarat, T., Bailey, Z. D., & Ponce, N. A. (2022) · American Journal of Epidemiology · doi:10.1093/aje/kwab239 · Cited by 417
Krieger, N. (2020) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-040119-094017 · Cited by 411
Metadata
- 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
- Venue
- Health & Place
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 45
- Pages
- 140-144
- ISSN
- 1353-8292 (ISSN-L)
- 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
- 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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