A Tale of Two Generations: Maternal Skin Color and Adverse Birth Outcomes in African American Women
Jaime Slaughter-Acey, PhD, MPH
Division of Epidemiology and Community Health
Abstract: Most empirical research fails to recognize the multidimensional nature of race, a social construct, and thus, its intersection with sociopolitical context. In response, we examined how sociopolitical context (marked by generational cohort) and skin color interacted to influence rates of preterm delivery (PTD) in sample of Black American women. Data from the 2009-2011 Life-course Influences on Fetal Environments Study comprised of 1410 AA women, age 18-45 years, residing in Metropolitan Detroit, MI were analyzed. Inconsistent with expectation, descriptive results showed similar PTD rates by generation, Generation X (born 1964-1983) vs. Millennial (born 1984-1993): 16.3% vs. 16.1%. Yet, within each generation, PTD rates varied by women’s self-reported skin tone. Poisson regression models confirmed a significant interaction between generational cohort and self-reported skin tone predicting PTD (P < 0.01). Results suggested a salubrious association between light brown skin tone (as compared to medium and dark brown skin) and PTD for AA women in Generation X; however, Millennials with medium and dark brown skin experienced lower PTD rates than their light brown Millennial counterparts. Similar results were found for low birthweight. Future research should consider sociopolitical context and the salience of skin tone bias when investigating racial health disparities, including those in perinatal health.
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