African American Unemployment and the Disparity in Periviable Births

Ralph Catalano, Deborah Karasek, Tim Bruckner, Joan A. Casey, Katherine Saxton, Collette N. Ncube, Gary M. Shaw, Holly Elser, Alison Gemmill

Research output: Contribution to journalArticlepeer-review


Periviable infants (i.e., born before 26 complete weeks of gestation) represent fewer than.5% of births in the US but account for 40% of infant mortality and 20% of billed hospital obstetric costs. African American women contribute about 14% of live births in the US, but these include nearly a third of the country’s periviable births. Consistent with theory and with periviable births among other race/ethnicity groups, males predominate among African American periviable births in stressed populations. We test the hypothesis that the disparity in periviable male births among African American and non-Hispanic white populations responds to the African American unemployment rate because that indicator not only traces, but also contributes to, the prevalence of stress in the population. We use time-series methods that control for autocorrelation including secular trends, seasonality, and the tendency to remain elevated or depressed after high or low values. The racial disparity in male periviable birth increases by 4.45% for each percentage point increase in the unemployment rate of African Americans above its expected value. We infer that unemployment—a population stressor over which our institutions exercise considerable control—affects the disparity between African American and non-Hispanic white periviable births in the US.

Original languageEnglish (US)
Pages (from-to)840-848
Number of pages9
JournalJournal of Racial and Ethnic Health Disparities
Issue number3
StatePublished - Jun 2022


  • African American
  • Disparities
  • Periviable birth
  • Unemployment

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health


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