The effects of racial density and income incongruity on pregnancy outcomes

This study shows that living in a better area reduces the risk of adverse pregnancy outcomes but, among African–American women, living in an area in which they are in a racial minority may increase the risk. Using the 1991 cohort of single infants born to African–American women in Chicago, we measured census tract socioeconomic status and defined women as having “positive income incongruity” if they lived in wealthier tracts than the average African–American woman of comparable education and marital status. We examined whether or not the effect of positive income incongruity differed according to whether or not African–American women lived in predominantly black, or mixed tracts. Among the women living in predominantly black census tracts, positive income incongruity was associated with a lower risk of low birth weight (odds ratio (OR)=0.91) and preterm delivery (OR=0.83). These effects were modest, but statistically significant for gestation (p-value=0.01). In contrast, among the women living in mixed tracts positive income incongruity was not associated with low birth weight (OR=1.04) or preterm delivery (OR=1.11). In mixed areas the expected benefits of positive income incongruity are completely offset by the racial density effect, suggesting that the positive effects of a better socioeconomic context may be countered for minority women by the adverse effects of racism or racial stigma.