Description: Ratio of African American LBW prevalence compared to White LBW prevalence using 5 year aggregate rates. Low Birth Weight (LBW). These percentages are based on 5-year aggregates, with the year shown indicating the last year of the 5-year period. The value shown indicates the % of live births with infants weighing less than 2500 grams. 2500 grams = 5.5 pounds.

Calculation: (2015) 5 yr rate (per 1,000 live births) of African American LBW = 15.9 and White LBW = 7.4

Calculate ratio by dividing African American LBW by White LBW (15.9/7.4 = 2.15). Meaning African American low birth weight is 1.95 times that of White low birth weight.

Source: Available from North Carolina State Center for Health Statistics (NC SCHS), County Health Data Book (by year). Look in "Pregnancy and Live Births" section and find report called, "Low and Very Low Weight Births by Race" at http://www.schs.state.nc.us/schs/data/databook/

The disparity ratio between 5 year low birth weight prevalence for African American and White infant mortality has gradually increased over since 2010 and in 2014 was 2.0. From 2010-2014 Buncombe county had 1195 white infants with low birth weight and 182 African American infants with low birth weight. This translates in an LBW prevalence of 9.2% of births for white infants and 17.0% of births for African American infants.

In the United States, significant disparities in birth outcomes exist based on race and/or ethnicity. African American women experience higher rates of preterm birth, low birthweight and infant mortality. Racial disparities have diverse causes. According to the CDC, reported causes include differences in socioeconomic status, prenatal care, maternal risk behaviors, infection, nutrition, stress, and genetics. Multidisciplinary research into the factors influencing preterm birth is needed for developing effective intervention strategies. Some research has found a link between racism-related maternal stress, stress hormones, and infant and child health outcomes which may explain why preterm birth rate disparities between white and black infants persist even after accounting for known risk factors such as obesity, smoking, and hypertension. Disparities in poor birth outcomes have lifelong implications for the health and well-being of families and the US population.

Increase access to quality healthcare for African American women across the lifespan including interconception care, preconception care, quality prenatal care, and healthcare throughout the life course. Enhance family and community systems with strategies such as strengthening father involvement, systems integration, increasing reproductive social capital, and community building. Address social and economic inequities through closing the education gap, reducing poverty, and supporting working mothers. A life course approach which addresses both early life disadvantages and cumulative and chronic stress should be employed. It is necessary to look beyond behavior and the biomedical model to address inequities that underlie health disparities.

Programs that are working in other communities:

African-American maternal and child health program that encourages better birth outcomes by providing support to women during pregnancy and for one year after birth. Aims to assist local communities in improving health status by addressing the systemic causes, including lack of education, lack of social justice, and economic disparities compounded by institutional political and personal barriers. Birthing Projects actively engage community residents in identifying their needs; implementing and evaluating services; and working collaboratively with other agencies, organizations and individuals. Also provides guidance and support to fathers. The Birthing Project concept has grown into a nationally recognized model which has been replicated in more than 90 communities.

This is an additional indicator that the group has identified to monitor. Please see the infant mortality rate indicator for a detailed action plan.