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New research adds to the evidence that police violence-related stress may cause preterm delivery and heart disease in Black women. ER Productions Limited/Getty Images
  • Reports of racial disparity in women’s health in the United States are not a new event.
  • Scientists say that two of the most pronounced and least understood disparities involve preterm delivery (PTD) and cardiovascular disease (CVD).
  • Studies show that Black women have significantly higher risks of CVD and PTD compared with white women.
  • In a new study, researchers at Northwestern University in Evanston, IL, have investigated one possible cause of this phenomenon.

Due to systemic racism and historical marginalization, people belonging to certain racial or ethnic groups in the U.S. have neither the same access to healthcare nor the same health outcomes as their white counterparts.

For instance, several studies show that Black women in the U.S. have shorter life expectancies relative to other U.S.–based women.

In addition, Black women in the U.S. are unevenly burdened with chronic health conditions, such as CVD, diabetes, and obesity.

Although many studies have attributed this disparity to differences in socioeconomic standing between Black women and their counterparts, an overview of existing research shows that socioeconomic status is only a partial explanation for these inequities.

Now, a new study zooms in on one of the additional explanations for this health disparity.

The initial conclusion of the new study is that police misconduct may also play a role in the disparity of health outcomes observed in Black women in the U.S.

The results from the study appear in the journal Science Advances.

Co-lead author Dr. Alexa Freedman, Ph.D., a researcher at Northwestern, explained the study findings to Medical News Today.

She said, “we were motivated by recent events, particularly the high profile killings of Black individuals by police, which has brought more attention to long-standing racial bias in policing practices.”

“We found that Black women living in neighborhoods where complaints about excessive use of force by police are more common are more likely to deliver preterm and to develop cardiovascular disease, even after accounting for neighborhood disadvantage and crime.”

– Dr. Freedman

The new study investigated whether formal complaints about excessive force by police (EFP) were associated with health disparities observed in Black women.

At the start of the experiment, the researchers examined data that they had obtained from electronic health records (EHR) in a single hospital in Chicago.

Based on these data, the experimenters derived two distinct sample groups: a pregnancy group and a CVD group.

In the pregnancy group, the scientists obtained records for all live births between March 2008 and March 2018.

In total, the research team included a sample size containing 67,976 births attributed to 53,478 women. These women were of white, Hispanic, Black, and Asian origins.

Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.

For the CVD group, the experimenters obtained records for individuals aged 30–80 years.

They selected the participants based on a visit to an internal medicine physician between January 2001 and December 2018.

The researchers limited their selection to women who were CVD-free on their first visit to the doctor.

For both groups, the researchers excluded women living outside Chicago and those with incomplete addresses. In addition, they removed from the study women who had missing race and ethnicity details or who identified as “other.”

Altogether, the CVD group contained a final sample size of 6,773 women, all of whom were Black or white.

The scientists compared the EHR data against a database of complaints that people had filed against the Chicago police for the use of excessive force.

For both groups, they observed that Black women had a higher likelihood of exposure to EFP complaints compared with white women: 27.6% versus 13.9%.

In the pregnancy group, the scientists noted that Black women were twice as likely to deliver preterm than white women: 14.3% compared with 6.8%.

Furthermore, they also noted that Black women had a higher likelihood of delivering infants who were of small gestational age (SGA). In medicine, SGA refers to babies who are smaller in size than usual for the number of weeks of pregnancy.

For the CVD group, Dr. Freedman and her team observed that in comparison with white women, Black women were more likely to experience an incident of CVD.

Dr. Luz Maria Garcini, an assistant professor at the Center for Research to Advance Community Health (ReACH) at UT Health, San Antonio, explained the study results to MNT.

She said:

“Violence is associated with increased health risk, and this can be particularly taxing on the health of historically marginalized women who likely experience compounded stressors from many other additional sources of stress.”

Dr. Garcini further explained that “adverse life events, such as violent encounters with police, or any other source of exposure to violence is likely to be associated with stress that may, in turn, affect maternal health, including delivery outcomes.”

However, she concluded by saying that “no causality can be established [from the study results].”

This statement echoes the similar conclusion that the study authors make.

They write that “these findings must be interpreted with caution until [they are] replicated and substantiated [by larger studies].”

Dr. Freedman and her team note that the study findings “add to growing evidence suggesting that police violence adversely affects the health of Black communities.”

The study authors explain that their definition of police violence was limited to complaints, as opposed to “patients’ reports of interactions with police or police behavior in their environment.”

They also revealed that the data available in EHRs limited their study.

Finally, the scientists explain that their sample size was limited to a single institution in Chicago. As such, their data may not be representative of the city or be generalizable to other locations.

The study authors revealed to MNT that they plan to conduct future studies to expand on their work.

It is safe to expect further research from Dr. Freedman and her team in the next couple of years.