Racial and ethnic disparities in birth outcomes: a life-course perspective

Lu, Michael C.; Halfon, Neal

doi:10.1023/a:1022537516969

Cited by 979Health disparities and outcomesMaternal and Neonatal HealthcareRacial and Ethnic Identity Research

Racial and ethnic disparities in birth outcomes: a life-course perspective

Lu, Michael C., Halfon, Neal·2003·Maternal and Child Health Journal

DOI 10.1023/a:1022537516969

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Abstract

Background In the United States, Black infants have significantly worse birth outcomes than do White infants. The cause of these persisting racial disparities remains unexplained. Most extant studies focus on differential exposures to protective and risk factors during pregnancy, such as current socioeconomic status, maternal risky behaviors, prenatal care, psychosocial stress, or perinatal infections. These risk factors during pregnancy, however, do not adequately account for the disparities.Methods We conducted a literature review for longitudinal models of health disparities, and presented a synthesis of two leading models, using a life-course perspective. Traditional risk factors during pregnancy are then reexamined within their life-course context. We conclude with a discussion of the limitations and implications of the life-course perspective for future research, practice, and policy development.Results Two leading longitudinal models of health disparities were identified and discussed. The early programming model posits that exposures in early life could influence future reproductive potential. The cumulative pathways model conceptualizes decline in reproductive health resulting from cumulative wear and tear to the body's allostatic systems. We propose a synthesis of these two models, using the life-course perspective. Disparities in birth outcomes are the consequences of differential developmental trajectories set forth by early life experiences and cumulative allostatic load over the life course.Conclusions Future research on racial disparities in birth outcomes needs to examine differential exposures to risk and protective factors not only during pregnancy, but over the life course of women. Eliminating disparities requires interventions and policy development that are more longitudinally and contextually integrated than currently prevail.

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BackgroundMethodInfluential
Ethno-racial inequalities on adverse birth and neonatal outcomes: a nationwide, retrospective cohort study of 21 million Brazilian newborns
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“The life course theory recognizes the vital role of social, economic, and environmental factors in influencing health outcomes, including health inequities (Lu & Halfon, 2003).”

Authors: Lu, M. C., & Halfon, N.
Affiliations: University of California, Los Angeles (US)
Corresponding author: Lu, Michael C.
ORCID: Lu, Michael C.
Halfon, Neal
Venue: Maternal and Child Health Journal
Publisher: Springer Science and Business Media LLC
Published: 2003-03
Volume: 7
Issue: 1
Pages: 13-30
ISSN: 1092-7875 (ISSN-L)
1573-6628
DOI: 10.1023/a:1022537516969
OpenAlex: W1577991876
Cited by: 979
References: 132
Citations by year: 2026: 17 · 2025: 49 · 2024: 40 · 2023: 39 · 2022: 49 · 2021: 51 · 2020: 58 · 2019: 44 · 2018: 44 · 2017: 61 · 2016: 59 · 2015: 57 · 2014: 56 · 2013: 58 · 2012: 43
FWCI: 1.81
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Maternal and Child Health Journal (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
U.S. Public Health Service (5U93MC00099)
National Institute on Minority Health and Health Disparities
Maternal and Child Health Bureau
Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD001281, HD01281-03)
Topics: Social Sciences › Health › Health disparities and outcomes
Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords: racial disparities, ethnic disparities, birth outcomes, life course perspective, allostatic load, early life exposure, reproductive health, Black infants, health disparities, developmental trajectories
MeSH terms: Black or African American, Female, Health Services Accessibility, Humans, Infant Mortality, Infant, Newborn, Longitudinal Studies, Maternal Welfare, Models, Theoretical, Pregnancy, Pregnancy Outcome, Quality of Health Care, Risk Factors, Risk-Taking, Socioeconomic Factors, United States, Health Behavior, Life Tables, Women's Health, White People, Racial Groups

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Racial and ethnic disparities in birth outcomes: a life-course perspective

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