The effects of poverty may linger for generations, according to Chicago researchers who have found that low-birthweight babies are twice as common among middle-class, college-educated blacks as among their white counterparts.
Low birthweight is the most important predictor of whether babies will die, said James W. Collins Jr., a neonatolgist at Children's Memorial Hospital.
Collins and Richard J. David of Cook County Hospital examined 103,072 birth records -- about half of them for whites and half for blacks -- for the years 1982 and 1983.
They found that low-birthweight babies -- those less than 5 1/2 pounds -- were born to blacks at twice the rate they were to whites at almost every income and educational level.
"We suspect that the persistently high rate of low-birthweight infants among blacks reflects generations of poverty," the researchers wrote in their report in the June issue of the American Journal of Public Health. The researchers said they also suspect "it may require more than one generation of non-poverty and adequate services to see an impact upon infant birthweight."
Though they did not look at what might have caused the differences, Collins said nutrition during adolescence may be key.
For blacks in households earning less than $10,000 a year, the rate of low-birthweight babies was 15 percent, compared with 8 percent for whites. For blacks in households earning $30,000 to $40,000 a year, the rate was 10 percent for blacks and 5 percent for whites.
Similarly, for blacks with less than a high school education, the rate was 16 percent, compared to 7 percent for whites. For blacks with a college education, the rate was 10 percent, compared to 5 percent for whites.
"I think psychosocial stress is also a factor, but it's very hard to measure," Collins said. Another factor may be different rates at which blacks and whites seek prenatal care, even when they can afford it, he added.
A study published in November 1988 of 31,000 largely middle-class women enrolled in a California health maintenance organization revealed that blacks sought prenatal care less often than whites.
"I don't know how much racism comes into it," Collins said, adding that blacks may have had so many bad experiences with medical institutions, they tend to avoid them.