How much does race still matter around here?
A lot, if you look in our maternity wards. Every year, about 11,000 babies delivered in the Boston metropolitan area are born underweight. That’s a little below the national average, but it’s still alarming, given the lifelong health problems that can plague these babies.
A woman’s education level is a huge factor in whether she’ll have a small baby. The better educated she is, the more likely she is to understand the importance of good nutrition, to live in a safer, less polluted neighborhood, and to live a more affluent, less stressful life – all of which make it less likely that her baby will weigh under 5.5 pounds.
But race trumps education: A college-educated black woman is a fraction more likely to have a low-birth-weight baby than a white woman who didn’t finish high school. Incredibly, 7.6 percent of babies – about 1 in 13 – born to college-educated black women are underweight.
These sad tidings are brought to you by the Metropolitan Area Planning Council, the regional planning nonprofit, which is set to release a wide-ranging report Tuesday on inequality in Greater Boston. Their stunning finding, culled from five years of state statistics, mirrors a trend seen across the nation.
What gives? In piecing together an explanation, researchers provide a measure of how far we have to go, two generations after the civil rights movement began. Among their findings:
College-educated black women are bound by their histories, says Dr. David Williams, a professor of public health at Harvard. They’re more likely to have experienced poverty as children, and the deficits in health care and nutrition that come with it, and to have been born underweight themselves – all of which increase the chance that they will give birth to smaller babies.
While these women are better off financially than their less well-educated counterparts, they are still black, and they still report experiences of discrimination. Several researchers have found that those experiences send stress hormones coursing through women’s bodies, which can also contribute to low birth weight.
A third finding is the most fascinating, and distressing: Despite gains in civil rights, black and white people still generally live in stubbornly segregated communities, in this region and in most others. Affluent whites tend to move out of the city and into wealthy enclaves. But there’s no black Weston. College-educated black women tend to remain in largely black neighborhoods. And those neighborhoods tend to experience more of the social ills – from higher poverty levels to more pollution, crime, and daily stress – that contribute to lower birth weight.
“Across every dimension you can think of, segregated [minority] neighborhoods are less healthy ,’’ says Williams.
This is a state of affairs that affects all of us. Coming into the world at under 5.5 pounds makes a person more likely to develop ADHD, educational or developmental delays, diabetes, and asthma, among other maladies. We all bear the costs of these problems, in ways human and monetary – from personal suffering to higher insurance premiums.
And according to the planning council’s report, the problem of low birth weight could worsen: The region’s minority population is growing, and the racial divisions between communities show no signs of abating.
All of this has officials at the state Department of Public Health worried enough to embark on a statewide study of infants and the factors that affect their welfare.
“I don’t think any of us can continue to ignore the importance of what is happening,’’ says DPH medical director Lauren Smith. “We need to create more global, community-level intervention.’’ That might mean more decent housing options, grocery stores, and better public safety in unhealthy neighborhoods, for example. Hard, but not impossible. Changing the attitudes that separate our neighborhoods will prove more challenging.
“Segregation is not an act of God,’’ says Williams. But it may take one to undo its effects.
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Yvonne Abraham is a Globe columnist. She can be reached at abraham@globe.com
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