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

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  • Dora L. Costa

Abstract

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.

Suggested Citation

  • Dora L. Costa, 2003. "Race and Pregnancy Outcomes in the Twentieth Century: A Long-Term Comparison," NBER Working Papers 9593, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9593
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    References listed on IDEAS

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    1. Smith, James P, 1998. "Socioeconomic Status and Health," American Economic Review, American Economic Association, vol. 88(2), pages 192-196, May.
    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(4), pages 987-1009, December.
    3. 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.
    4. 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.
    5. Steckel, Richard H., 1986. "Birth weights and infant mortality among American slaves," Explorations in Economic History, Elsevier, vol. 23(2), pages 173-198, April.
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    Cited by:

    1. Galofré-Vilà, Gregori, 2018. "Growth and maturity: A quantitative systematic review and network analysis in anthropometric history," Economics & Human Biology, Elsevier, vol. 28(C), pages 107-118.
    2. Eric B. Schneider, 2017. "Children's growth in an adaptive framework: explaining the growth patterns of American slaves and other historical populations," Economic History Review, Economic History Society, vol. 70(1), pages 3-29, February.
    3. Leah Boustan & Robert A. Margo, 2014. "Racial Differences in Health in Long-Run Perspective," Working Papers 2014-1, Princeton University. Economics Department..
    4. Logan, Trevon D., 2009. "Health, human capital, and African-American migration before 1910," Explorations in Economic History, Elsevier, vol. 46(2), pages 169-185, April.
    5. Leah Boustan & Robert A. Margo, 2014. "Racial Differences in Health in Long-Run Perspective: A Brief Introduction," NBER Working Papers 20765, National Bureau of Economic Research, Inc.
    6. Charles Baum, 2012. "The effects of food stamp receipt on weight gained by expectant mothers," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(4), pages 1307-1340, October.
    7. Elder Todd E & Goddeeris John H & Haider Steven J, 2011. "A Deadly Disparity: A Unified Assessment of the Black-White Infant Mortality Gap," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(1), pages 1-44, June.
    8. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    9. Aparna Lhila & Sharon Long, 2012. "What is driving the black–white difference in low birthweight in the US?," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 301-315, March.
    10. Charles L. Baum II, 2010. "The Effects of Food Stamps on Weight Gained by Expectant Mothers," Working Papers 201002, Middle Tennessee State University, Department of Economics and Finance.
    11. Gregori Galofré‐Vilà & Bernard Harris, 2021. "Growth before birth: the relationship between placental weights and infant and maternal health in early twentieth‐century Barcelona," Economic History Review, Economic History Society, vol. 74(2), pages 400-423, May.
    12. Atheendar S. Venkataramani, 2011. "The intergenerational transmission of height: evidence from rural Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1448-1467, December.
    13. Dora L. Costa & Joanna Lahey, 2003. "Becoming Oldest-Old: Evidence from Historical U.S. Data," NBER Working Papers 9933, National Bureau of Economic Research, Inc.
    14. Eric B. Schneider, 2017. "Children's growth in an adaptive framework: explaining the growth patterns of American slaves and other historical populations," Economic History Review, Economic History Society, vol. 70(1), pages 3-29, February.
    15. Cook, Lisa D. & Logan, Trevon D. & Parman, John M., 2016. "The mortality consequences of distinctively black names," Explorations in Economic History, Elsevier, vol. 59(C), pages 114-125.
    16. Voigt, Manfred & Heineck, Guido & Hesse, Volker, 2004. "The relationship between maternal characteristics, birth weight and pre-term delivery: evidence from Germany at the end of the 20th century," Economics & Human Biology, Elsevier, vol. 2(2), pages 265-280, June.
    17. Andrew S. London & Cheryl Elman, 2017. "Race, Remarital Status, and Infertility in 1910: More Evidence of Multiple Causes," Demography, Springer;Population Association of America (PAA), vol. 54(5), pages 1949-1972, October.

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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • N3 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy

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