17-02-2022 | Original Paper
Race, Multiraciality, Income, and Infant Mortality: Markers of Racial Equity
Gepubliceerd in: Journal of Child and Family Studies | Uitgave 3/2022
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Little is known regarding how family racial structure and income intersect to produce health outcomes. We assessed infant health outcomes (weeks gestation and first year infant mortality rates (IMR)) by family racial structure (specific race group affiliation, and whether multiracial), examining the degree to which income (insurance type as proxy) interacts with family racial composition to predict infant health outcomes. This cross-sectional study utilized secondary data analysis of birth records and linked infant birth/death records spanning a 14 year period (2006–2019) for a single U.S. county. Income was dichotomized into low income and high income based upon insurance type. Race and ancestry data from infant, maternal, and paternal sources were combined into six pan-ethnic categories (Black, Asian, White, Native-American, Latino, and Middle Eastern). We used Generalized Estimating Equation to obtain the associations between a composite race x multiracial x income predictor and outcomes (infant death, weeks gestation), accounting for repeated mother births. Findings reveal that infants with Black heritage have the worst outcomes (12.34 IMR). Multiracial infants (20.5% of the population) tend to be from higher income families than monoracial minority infants. Looking further, we find that this translates to better outcomes depending on racial group and multiraciality. Multiracial higher-income Black families have substantially better outcomes (2.85 IMR) than their single Black race (12.63 IMR) or lower income multiracial peers (16.16 IMR). Single race White families also see health gains with higher income (3.60 IMR versus 6.02 IMR). Other minority race families, whether single or multiracial, see little health gain with higher income; instead, whether this group is multiracial or not is the determining feature (being single-race rather than multiracial is associated with better outcomes (0.97 IMR versus 5.39 IMR)).