PROJECT SUMMARY/ABSTRACT
Despite the well-known Latina birth paradox, recent data (2020) show that Latina mothers are 1.2-1.5 times
more likely to have low birth weight infants compared to White mothers. Additionally, compared to White
women, annual national vital statistics data from 1989 through 2020 show consistently higher rates of worse
birth outcomes among Latinas. The longstanding focus on the Latina birth paradox has left a gap in the
literature, resulting in a critical need for research on birth outcome disparities faced by Latinas, and the
mechanisms driving those disparities. We propose two novel mechanisms as contributors to poor birth
outcomes for Latinas: anticipatory racism threat and area-level racial bias. A strong body of evidence has
demonstrated links between chronic social stress and poor birth outcomes. Racial discrimination, a chronic
psychosocial stressor, is a prominent explanation for racial/ethnic disparities in birth outcomes. However,
evidence is limited by the predominant focus on racism events and racism experiences at the individual-level.
We previously developed and validated a measure of anticipatory racism threat (aRT) for African American
women and found associations with hypertension, allostatic load and telomere length. These preliminary
studies suggest that anticipating racism, above and beyond actual racism events, is related to biological
dysregulation, including dysregulation of systems that have previously been linked with low birthweight and
preterm birth. Another neglected component of racism-related stress is area-level racial bias. Emerging
evidence demonstrates significant links between negative area-level racial sentiment and birth outcomes for
racial/ethnic minorities groups. The specific objectives of the K99 phase are to 1) create and psychometrically
validate an aRT-Latina scale and 2) examine associations with low birth weight and preterm birth in recent
Latina mothers. R00 phase objectives include developing and testing associations between a novel
county-level indicator of area-level racial bias towards Latines and county-level birth outcomes among Latinas.
The expected impact of the proposed research is re-focusing attention on poor birth outcomes among Latinas,
a long-standing disparity but largely neglected area of investigation; helping to elucidate some of the predictors
and underlying mechanisms driving those disparities; and ultimately informing the types of interventions likely
to ameliorate those disparities. These data will also provide preliminary data for a subsequent R01 application.
Our central hypothesis is that higher anticipatory racism threat and more negative area-level racial bias toward
Latines will predict worse birth outcomes (i.e., low birth weight and pre-term birth) for Latina mothers.
