Racial Disparities In Environmental Exposures

As discussed more extensively elsewhere in this report, preterm births are more prevalent among African-American women than among women of other racial-ethnic groups, and this pattern has persisted over the years. The terms "environmental justice" and "environmental racism" describe the disproportionate burden of environmental pollution on poor and minority populations (Brown, 1995; Silbergeld and Patrick, 2005). A recent review by Silbergeld and Patrick (2005) discusses in detail the disproportionate exposures of those populations to environmental pollutants and the effects on birth outcomes. Although the latter review emphasizes birth outcomes other than preterm birth, its discussion includes reports of racial-ethnic differences in environmental exposures that are relevant to preterm birth. Silbergeld and Patrick (2005) concluded that, "exposures to these toxicants may explain part of the socioeconomic disparity that is observed in terms of risks of adverse pregnancy outcomes" (Silbergeld and Patrick, 2005, p. ).

Despite the persistent racial-ethnic disparities in the rates of preterm birth and the increased awareness of racial-ethnic disparities in environmental exposures, few studies have considered the interactions among race-ethnicity, environmental chemical exposures, and preterm birth. Woodruff et al. (2003) reported increased levels of air pollution in neighborhoods consisting predominantly of minority populations and, after adjusting for maternal risk factors that included race-ethnicity, found a small increase in the odds of preterm delivery (OR = 1.05; 95 percent CI = 0.99 to 1.12) in association with high levels of air pollution.

Other factors that may influence exposure in racially and ethnically distinct patterns include behavioral, cultural, and sociological characteristics and practices. In a case-control study (188 preterm births and 304 normal births), use of a chemical hair straightener (relaxer) or chemical curl products by African-American women just before or during pregnancy had no effect on the risk for preterm birth (Blackmore-Prince et al., 1999).

More research is needed obtain an improved understanding of environmental pollution with respect to race-ethnicity and preterm birth. Because exposure to environmental chemicals may be codependent with race-ethnicity, examination of racial-ethnic differences in environ mental exposures during pregnancy may provide new insight into the racial-ethnic disparities in the rates of preterm birth.

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