Disparate Beginnings

Profound disparities exist among families who experience adverse infant health outcomes (i.e. preterm birth and low birth weight), yet much is still unclear regarding the factors that predict disparate outcomes. In order to address this gap, the current study takes a more nuanced approach compared to existing research by applying three key theoretical models (Critical Race Theory, Intersectionality, and Ecosocial Theory) to create an overarching analysis of how social determinants of health interact in a dynamic way to predict which families are at the greatest risk of experiencing poor outcomes. In order to examine the role that social determinants play in predicting risk, this study implements a secondary analysis of data from the Pregnancy Risk Assessment Monitoring System (PRAMS). Results of the study indicate three distinct risk types among women in the sample: low-, moderate- and high-risk women. Within the three risk groups, racial disparities are particularly notable, with 76% of the sample’s African American mothers falling into the “high-risk” category. Although racial disparities have long been noted, the findings from this study’s intersectional analysis help to better understand how determinants of health intersect to create an overarching risk profile, which can be used to help promote social services that may reduce the current gap in infant health outcomes.