Tiny babies and inequality: Study examines health disparities

Kristin Claes Mathews
February 02, 2017

Draw a map of Chicago, overlay data about nearly any health problem, and a stark pattern emerges. Poor health outcomes disproportionately affect the most segregated and underserved areas of the city, mostly on the south and west sides. But it doesn't have to be that way, says sociologist Fernando De Maio.

As co-director of the Center for Community Health Equity, De Maio led a study that compares rates of low birth weight in Toronto and Chicago. The center is a collaboration between DePaul University and Rush University Medical Center, and scholars from both schools are examining the root causes of health inequities-differences that are avoidable, unnecessary and unjust. 

"Toronto has broken the link between segregation and low birth weight," De Maio says. "It sets up an example of what can be accomplished when health equity is a priority."

Researchers compared publicly available community health data from Chicago and Toronto to examine low birth weight within specific neighborhoods and communities. This innovative approach allowed researchers to keep the differences within a place present, while comparing across cities, De Maio explains.

The study, "Racial/ethnic minority segregation and low birth weight: a comparative study of Chicago and Toronto community-level indicators," will be published in a forthcoming issue of "Critical Public Health."

While the study does not reveal the causes of low birth weight in either city, De Maio believes it can be a starting point in examining structural determinants of health, such as access to health care and systemic segregation and racism.

"There's a shift now in literature, and researchers recognize it's not the color of a person's skin, but the process by which we give meaning in society, that can determine health outcomes," De Maio says.

Coauthors from the Center for Community Health Equity include center co-director Raj C. Shah and David Ansell of Rush University Medical Center; and Kellie Schipper and Realino Gurdiel at DePaul. Researchers found that low birth weight was worse overall in Chicago, affecting 10.1 percent of all live births versus 7.3 percent in Toronto.

However, in Toronto, the rates of low birth weight did not vary significantly across communities. Places where most residents are minorities had rates of low birth weight that were similar to areas with low minority populations, De Maio explains.

Segregation is more severe in Chicago, with areas that have a high percentage of one racial or ethnic population.

"The more segregated a community is in Chicago, the worse the outcome for low birth weight," De Maio says. Communities in Chicago with highly segregated African-American populations fared the worst, while many segregated Latino communities had rates that were in-line with the rest of the city, he says.

As next steps, researchers plan to compare data from other cities to learn whether Chicago is an extreme example or if similar trends exist within other U.S. cities.

"This research shows it doesn't have to be the way that it is, and we can break the link between factors like segregation and poor health outcomes," De Maio says. "It doesn't show us how to do it just yet, but it shows us it's possible."

To learn more, visit http://www.healthequitychicago.org/