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Race and Pregnancy Outcomes in the Twentieth Century: A Long-Term Comparison

  • Dora L. Costa

Differentials between blacks and whites in birth weights and prematurity and stillbirth rates have been persistent over the entire twentieth century. Differences in prematurity rates explain a large proportion of the black-white gap in birth weights both among babies attended by Johns Hopkins physicians in the early twentieth century and babies in the 1988 National Maternal and Infant Health Survey. In the early twentieth century untreated syphilis was the primary observable explaining differences in black-white prematurity and stillbirth rates. Today the primary observable explaining differences in prematurity rates is the low marriage rate of black women. Maternal birth weight accounts for 5-8 percent of the gap in black-white birth weights in the recent data, suggesting a role for intergenerational factors. The Johns Hopkins data also illustrate the value of breast-feeding in the early twentieth century -- black babies fared better than white babies in terms of mortality and weight gain during the first ten days of life spent in the hospital largely because they were more likely to be breast-fed.

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File URL: http://www.nber.org/papers/w9593.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9593.

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Date of creation: Mar 2003
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Publication status: published as Costa, Dora L. "Race And Pregnancy Outcomes In The Twentieth Century: A Long-Term Comparison," Journal of Economic History, 2004, v64(4,Dec), 1056-1086.
Handle: RePEc:nbr:nberwo:9593
Note: DAE CH
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  1. Goldin, Claudia & Margo, Robert A., 1989. "The poor at birth: Birth weights and infant mortality at Philadelphia's almshouse hospital, 1848-1873," Explorations in Economic History, Elsevier, vol. 26(3), pages 360-379, July.
  2. Costa, Dora L., 1998. "Unequal at Birth: A Long-Term Comparison of Income and Birth Weight," The Journal of Economic History, Cambridge University Press, vol. 58(04), pages 987-1009, December.
  3. Smith, James P, 1998. "Socioeconomic Status and Health," American Economic Review, American Economic Association, vol. 88(2), pages 192-96, May.
  4. Steckel, Richard H., 1986. "Birth weights and infant mortality among American slaves," Explorations in Economic History, Elsevier, vol. 23(2), pages 173-198, April.
  5. Preston, Samuel H. & Hill, Mark E. & Drevenstedt, Greg L., 1998. "Childhood conditions that predict survival to advanced ages among African-Americans," Social Science & Medicine, Elsevier, vol. 47(9), pages 1231-1246, November.
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