New Research on Socially Assigned Race and Health Inequity, and on Mass Incarceration and Preterm Birth

The 2019-20 Doctoral Student Cohort of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University continues to produce research on important social issues.

Is Socially Assigned Race a Useful Category for Monitoring Racial Inequity in Health?

Jourdyn Lawrence, photo by Keletso Makofane

A new International Journal for Equity in Health review examines the usefulness of socially assigned race, or the perception of one’s race by others, in monitoring and evaluating racial/ethnic inequities. Authored by Kellee White, FXB Center 2019-2020 Doctoral Cohort member Jourdyn A. Lawrence, Nedelina Tchangalova, Shuo J. Huang, and Jason L. Cummings, the review examines 18 articles that evaluate associations between socially assigned race and health or health-related outcomes.

Self-reported race has been the most frequently used approach to collect data on race/ethnicity; however, it may not fully depict the relational and contextual aspects of race, particularly where racism is the underlying mechanism. Assessments of socially assigned race are additionally important given that how one’s race is perceived may serve as the basis for unfair or differential treatment before there is knowledge on how one self-identifies.

Researchers have proposed using multidimensional measures of race (such as socially assigned race, phenotype, racial ancestry) to create more detailed representations of the social construction of race, especially when examining patterns of racial advantage and disadvantage.

The results of studies identified by the authors found there to be greater concordance in socially assigned and self-identified race among individuals that self-identify as Black or white, although there was much discordance among Latinx, American Indian or Alaskan Native, Native Hawaiian or other Pacific Islander, and multiracial populations. There was also evidence of a generally lower quality of health for those socially assigned as marginalized racial/ethnic groups compared to those socially assigned as white or European.

This review was funded by a Provost Grant from the University of South Carolina. The authors hope that these findings will result in increased collection and assessment of socially assigned race to better characterize the lived experiences of individuals in racialized societies and to evaluate its impact on racial/ethnic inequities.

Read the article here.

New Study Calls Attention to Mass Incarceration as a

Determinant of Preterm Birth

Jacquelyn Jahn, photo by Keletso Makofane

FXB Center Doctoral Student Cohort Member Jaquelyn L. Jahn is the lead author of a new article for Social Science & Medicine examining levels of mass incarceration as a determinant of preterm birth. “County-level jail incarceration and preterm birth among non-Hispanic Black and white U.S. women, 1999–2015” suggests that there are intergenerational health consequences of living in a heavily incarcerated area in the United States, even after accounting for confounding maternal-level factors, like educational attainment, and county-level factors, like racial and economic residential segregation and crime rates.

Jail incarceration rates largely reflect pretrial detention (that is, confinement after arrest before being convicted of a crime). Jail incarceration can impose serious psychological and economic strain on social networks. These strains include financial costs associated with bail, stress related to changes in parenting responsibilities, and instability in income, employment, and/or housing. These kinds of social network stressors may increase maternal risk of preterm birth and, further, affect access to prenatal care and perinatal health behaviors. Moreover, high jail incarceration rates also likely reflect budgetary tradeoffs made by local governments between funding incarceration and policing versus funding social and economic services that prevent preterm birth and promote population health.

The analysis, with coauthors Jarvis T. Chen, Madina Agénor, and Nancy Krieger, uses data from over 40 million birth certificates for all registered births to Black and white women from 1999-2015, an era when jail incarceration rates largely rose, and links these birth data to county-level data on jail incarceration rates recently compiled by researchers at the Vera Institute of Justice. This is the first national analysis to evaluate incarceration rates as a determinant of preterm birth using geographic data below the state level, which is important given that some counties have very high levels of jail incarceration compared with other counties in the same state.

The paper also demonstrated that in addition to preterm birth risk associated with overall rates of jail incarceration, Black-white racial inequities in incarceration rates were also detrimental for preterm birth among both Black and white women, although associations were stronger among Black women. Sociologists have, for decades, called attention to the racial inequities in mass incarceration as an example of structural racism. This paper suggests that structural racism in the criminal legal system may also be harmful for birth outcomes in heavily incarcerated communities.

The U.S. is currently in a political moment where changes to the criminal legal system are more feasible than ever before. This paper, when taken with other research such as Human Impact Partners’ recent study on pretrial incarceration and money bail, suggests that lowering or abolishing pretrial detention may prevent negative health consequences, including preterm birth.

Read the article (full article available through March 31, 2020; after that link is to abstract).

Top: Jacquelyn Jahn and Jourdyn Lawrence at a recent FXB Center presentation, photo by Ashley Gripper