Racial Disparities in Preterm Birth in USA: A Biosensor of Physical and Social Environmental Exposures
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The infant mortality rate in USA exceeds that of most other developed nations, ranking 26th among Organisation for Economic Co-operation and Development countries.Non-Hispanic black infants in USA die more than twice as often as non-Hispanic white infants (11.4 vs 4.9 per 1000 live births).This disparity reflects disparities in preterm birth (PTB) rates, since two-thirds of infant mortality occurs in preterm infants. The PTB rate is 52% higher for black (13.8%) than white (9.0%) women. Efforts to reduce PTB and its disparities have failed. We propose that racial disparities in PTB are a cumulative biosensor of exposures that vary by race, arising from long-standing inequities.