Evidence map›Paper›PMID 40634813›Full record

ArticleJournal of racial and ethnic health disparities2026

Racialized Economic Segregation and Disparities in the Risk of Stillbirth.

Amal Rammah, Jasmine Drake, Iman Moussa, Kristina W Whitworth, Howard Henderson, Juan Alvarez, Elaine Symanski

Abstract read
In one paragraph

Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Amal RammahCenter for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Jasmine DrakeDepartment of Administration of Justice, Texas Southern University, Houston, TX, USA.
Iman MoussaCenter for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Kristina W WhitworthCenter for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Howard HendersonDepartment of Administration of Justice, Texas Southern University, Houston, TX, USA.
Juan AlvarezCenter for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Elaine SymanskiCenter for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA. elaine.symanski@bcm.edu.ORCID 0000-0002-9073-8898

Funding

Project 2: Disparities-Aware Classifiers for Maternal and Infant HealthP50MD015496 · NIMHD · BAYLOR COLLEGE OF MEDICINE · PI SYMANSKI, ELAINE · 2020 to 2024
$7.2M
NIMHD NIH HHS P50 MD015496NIMHD NIH HHS P50MD015496
6 · The paper itself

Abstract

backgroundWhile there is growing evidence of the negative impact of neighborhood segregation on maternal and infant health, the evidence for stillbirth is limited.

methodsA retrospective cohort study of live births and stillbirths for 2007-2020 was conducted in greater Houston, TX, to examine the associations of racialized economic segregation, assessed using the Index of Concentrations at the Extremes (ICE), with stillbirth. Here, ICE contrasted census tract-level racial and economic privilege with disadvantage (i.e., high-income non-Hispanic White persons vs. low-income Persons of Color). Additionally, Oaxaca-Blinder decomposition methods were applied to examine the degree to which segregation and maternal risk factors explained observed racial disparities in stillbirth.

resultsThe prevalence of stillbirth was highest among non-Hispanic Black mothers (9.1/1000) compared with Hispanic mothers (4.7/1000), non-Hispanic White mothers (3.8/1000), and mothers whose race or ethnicity was unknown or classified as other (3.7/1000). In models adjusted for age, pre-pregnancy body mass index (BMI), smoking during pregnancy, and education, odds of stillbirth were reduced for non-Hispanic White mothers living in the most privileged neighborhoods (OR = 0.82, 95% CI 0.60, 1.12 for ICE tertile 3 vs. ICE tertile 1). In contrast, residing in more privileged neighborhoods did not confer the same benefit for mothers of other racial and ethnic groups. Based on the decomposition analysis, maternal age, education, pre-pregnancy BMI, smoking, and ICE explained 21.2% of the disparity in stillbirth between non-Hispanic Black and non-Hispanic White mothers; of which, having a high school education or less (12.3%), living in the most privileged neighborhoods (9.7%), and being obese (7.2%) contributed the most.

conclusionsNeighborhood privilege appears to confer benefits for White mothers but not for non-White mothers, potentially due to experiences of racial discrimination that offset economic advantages. While racialized economic segregation contributed modestly to Black-White disparities in stillbirth, much of the disparity remains unexplained by the factors examined. Future research should explore additional individual- and neighborhood-level contributors to these disparities while addressing inequities to reduce stillbirth risks across all populations.

Indexed as

StillbirthAdultBlack or African AmericanFemaleHispanic or LatinoHumansPregnancyResidential SegregationRetrospective StudiesRisk FactorsSocioeconomic Disparities in HealthTexasWhiteDisparitiesSegregationSpatial social polarizationStillbirth

Identifiers

PMID40634813
PMCPMC12927666

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.