Document text
Principal Investigator: Rachel R Hardeman
Organization: UNIVERSITY OF MINNESOTA
Fiscal Year: 2024
Award: $487,145
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY/ABSTRACT
Black women in the US are twice as likely to experience a preterm birth (PTB), a low birth weight (LBW) infant, or the
death of a child before age one compared to white women. This profoundly disturbing racialized pattern of adverse
reproductive outcomes has endured for as long as data have been available. Decades of medical and public health research
have documented the magnitude of racial inequity in maternal and child health, and it persists although the total infant
mortality rate has declined and despite efforts aimed at improving access to prenatal care and early childhood initiatives.
The intractability of this problem suggests structural racism—the ways in which societies foster discrimination by
reinforcing inequitable systems that in turn reinforce discriminatory beliefs, values, and distribution of resources—as a
root cause of these racial health inequities. The overall objective of the proposed project is to understand the degree to
which acts of police violence—a pervasive form of structural racism—negatively impact reproductive health outcomes
among black women and exacerbate inequities in adverse birth outcomes at the population level. This project will test the
hypothesis that incidences of racialized police violence have both a direct and an indirect link to negative birth outcomes
among black women compared to white women. Understanding the mechanisms through which racialized police violence
is a source of psychosocial stress for black women will lead to novel intervention targets that may reduce racial inequities
in birth outcomes. The project has three specific aims. Aim 1: Quantify the risk of PTB and LBW related to spatial and
social proximity to the killing of a black man by police and the ensuing civil unrest. This population-based cohort study
leverages vital records from the Minnesota Department of Health to assess if black women experienced worse birth
outcomes following the killing of Philando Castile by police and the subsequent civil unrest. It will also assess if spatial
proximity to the site of the incident and civil unrest increased risk for worse birth outcomes among all women. Aim 2:
Quantify the impact of police violence on PTB and LBW risk among black women. Using a quasi-experimental causal
framework and leveraging 13 years of birth records available from every county in the US, this aim assesses if incidents
of police violence across the US are associated with greater risk for PTB and LBW among black women. Aim 3:
Illuminate the lived experience of how racialized police violence impacts black women during pregnancy. An online
survey administered to black women (n=200) who were pregnant and living in two communities with incidents of high-
profile police violence (Twin Cities, MN, and Baton Rouge, LA) will assess psychosocial stress related to police violence,
followed by 50 in-depth interviews in each city with women to characterize the impact of police violence on birth
outcomes and to identify patterns and mechanisms. The long-term goal of this project is to eliminate inequities in birth
outcomes for black women. This timely and urgent project not only aligns with NICHD’s goal of preventing pregnancy-
related complications and reducing maternal and infant death, but it will further underscore the negative impact of
racialized police violence on society, bolstering arguments for large-scale change in police-community interactions.
Terms: <0-11 years old><Acute><Age><Belief><Birth><Birth Records><Black American><Caucasian><Caucasian Females><Caucasian Race><Caucasian Women><Caucasians><Caucasoid><Caucasoid Race><Cessation of life><Characteristics><Charge><Child><Child Youth><Children (0-21)><Cities><Cognitive Discrimination><Cohort Studies><Communities><Concurrent Studies><County><Crime><Data><Death><Death Rate><Discrimination><Distal><Event><Family><Fostering><Gestation><Goals><Health><Health Inequity><Improve Access><Incidence><Inequalities in Health><Inequities in Health><Inequity><Infant><Infant Mortality><Infant Mortality Total><Intervention><Intervention Strategies><Interview><Link><Lived experience><Lived experiences><Low Birth Weight Infant><Maternal Mortality><Maternal and Child Health><Medical><Minnesota><NICHD><Names><National Institute of Child Health and Human Development><National Institute of Children's Health and Human Development><Neighborhoods><Occidental><Outcome><Parturition><Pathway interactions><Pattern><Persons><Police><Population><Pregnancy><Pregnancy Complications><Pregnant Women><Premature Birth><Prematurely delivering><Prenatal care><Preterm Birth><Psychosocial Assessment and Care><Psychosocial Stress><Public Health><Quasi-experiment><Quasi-experimental analysis><Quasi-experimental approach><Quasi-experimental design><Quasi-experimental methods><Quasi-experimental research><Quasi-experimental study><Quasi-experimental technique><Race><Races><Records><Reporting><Reproductive Health><Research><Research Resources><Resources><Risk><Risk Factors><Site><Societies><Source><Stress><Structural Racism><Survey Instrument><Surveys><System><Testing><Twin Cities><Violence><White Females><White Women><Woman><adverse birth outcomes><ages><black female><black male><black men><black women><complications during pregnancy><death among infants><death in first year of life><death in infancy><death in infants><disparities in race><disparity due to race><early childhood><expectant mother><expecting mother><experience><health inequalities><inequality due to race><inequity due to race><infant death><infant demise><infantile death><interventional strategy><kids><killings><low birth weight><low birthweight><maternal death><maternal stress><mortality in infants><mortality rate><mortality ratio><name><named><naming><novel><pathway><population based><pregnancy care><pregnancy-related complications><pregnant><pregnant mothers><premature childbirth><premature delivery><prenatal appointment><prenatal checkup><prenatal visit><preterm delivery><prevent><preventing><psychosocial assessment><psychosocial care><psychosocial studies><psychosocial support><public health research><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial><racial background><racial disparity><racial inequality><racial inequity><racial origin><racially unequal><racism><reproductive><reproductive outcome><social><stressed mothers><stressor><violent><violent behavior><white race><youngster>