ALBANY, N.Y. (Dec. 15, 2022) — In the United States, Black mothers and their infants disproportionately experience negative health outcomes in the first postpartum year, compared to non-Black families. University at Albany researchers recently received $3 million from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to investigate social and environmental causes of these disparities. Findings from the five-year study will inform strategies aimed at improving Black maternal-infant health.
“Discrepancies in postpartum death rates among Black mothers and their children are staggering, yet the underlying causes have yet to be clarified,” said Betty Lin, assistant professor of psychology at UAlbany’s College of Arts and Sciences who will lead the interdisciplinary, multi-institution research team. “We are undertaking a comprehensive assessment of a range of social and environmental factors that can influence the health of Black families, with special attention to how various life course and pregnancy stress exposures, including racism and discrimination, can ‘get under the skin’ in ways that may affect not only Black women themselves, but also their infants and future generations of Black families.”
Planning a Holistic Assessment
Lin’s prior research has shown that unlike many health disparities that fall along racial lines, disparities in health outcomes for Black mothers and their babies cannot be explained by socioeconomic factors.
“Black mothers of higher socioeconomic status are actually more likely to face negative health outcomes than less affluent Black mothers,” said Lin. “This suggests that factors beyond access to healthcare and other essential resources are influencing the wellbeing of Black mothers and their infants. Instead, social and environmental factors are likely driving poor health outcomes.”
The team also recognizes that social and environmental factors can help build resilience and have a positive effect on health. Identifying these influences will play a critical role in developing strategies to improve health outcomes for Black families.
“We are interested in the individual, familial, cultural and community factors that support healthy mothers and children,” said Lin. “Even though poor birth outcomes affect Black families at high rates, most Black families experience positive birth outcomes. Looking at what is working for Black families with healthy pregnancies can give us information about the elements in their lives that help make this happen. For example, how do romantic partners/fathers, who are largely underrepresented in existing maternal-infant research, help support maternal-infant health?”
Measuring Family Health, History
Over the five-year study, the research team will follow 350 Black families from pregnancy through the first postpartum year. Mothers will be recruited over a three-year period from the prenatal clinic at Albany Medical Center — a major referral center in the region, which serves 25 counties in northeastern NY and western New England. Fathers/romantic partners of any sex/gender involved in their infant’s life will also be invited to participate in the study.
For each family, the study period will begin during pregnancy. Parents will be interviewed about various life experiences — positive and negative — including familial and neighborhood experiences during childhood, experiences of racism and discrimination, as well as stresses related specifically to pregnancy, among other factors.
“We know that stress has physical consequences, with legacy effects that can span generations,” said co-investigator Allison Appleton, associate professor of epidemiology and biostatistics at UAlbany’s School of Public Health. “Understanding which forms of stress are most closely connected to negative health outcomes for parents and their offspring can help hone strategies for interventions, including which actions are most helpful and when they are most effective.”
Psychophysiological responses such as heart rate, breathing rate and palm sweat will be measured in both parents and infants over the course of the study. These indices provide information about body systems linked to stress, which are thought to influence maternal-infant health.
The team will also assess factors that promote health and resilience. These will include things like resources available in the neighborhood environment (like access to parks and healthy food), social factors (support from family and friends) and individual factors like religious involvement and positive coping strategies.
“We know that where someone lives can affect many facets of health, and the strength of this effect changes at different stages of life” said co-investigator Beth Feingold, associate professor in the Department of Environmental Health Sciences at the School of Public Health. “We’ll use historical mapping — looking at where participants have lived at different points in their lives — to better understand how surroundings influence stress exposures and health.”
Finally, the team will assess indices of maternal-infant health, including pregnancy conditions, birth outcomes and health status during the first postpartum year.
Mitigating Disparities
“Knowledge gained from this research will help identify risk and resiliency factors that can inform specific targets for prevention and intervention to reduce racial disparities in Black maternal-infant health, and ultimately increase health equity for generations of Black families,” said Lin. “We are optimistic that our research will not only inform and potentially shape current approaches to thinking about these health disparities, but also for stimulating more research and interest in efforts to address these disparities through actions like family interventions, community programs and regional policies.”
The team will seek additional funding to continue following the infants’ health and other life course outcomes beyond the first year.
