The effects of racial density and income incongruity on pregnancy outcomes

Kate E. Pickett*, James W. Collins, Christopher M. Masi, Richard G. Wilkinson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

107 Scopus citations


This study shows that living in a better area reduces the risk of adverse pregnancy outcomes but, among African-American women, living in an area in which they are in a racial minority may increase the risk. Using the 1991 cohort of single infants born to African-American women in Chicago, we measured census tract socioeconomic status and defined women as having "positive income incongruity" if they lived in wealthier tracts than the average African-American woman of comparable education and marital status. We examined whether or not the effect of positive income incongruity differed according to whether or not African-American women lived in predominantly black, or mixed tracts. Among the women living in predominantly black census tracts, positive income incongruity was associated with a lower risk of low birth weight (odds ratio (OR)=0.91) and preterm delivery (OR=0.83). These effects were modest, but statistically significant for gestation (p-value=0.01). In contrast, among the women living in mixed tracts positive income incongruity was not associated with low birth weight (OR=1.04) or preterm delivery (OR=1.11). In mixed areas the expected benefits of positive income incongruity are completely offset by the racial density effect, suggesting that the positive effects of a better socioeconomic context may be countered for minority women by the adverse effects of racism or racial stigma.

Original languageEnglish (US)
Pages (from-to)2229-2238
Number of pages10
JournalSocial Science and Medicine
Issue number10
StatePublished - May 2005


  • Low birth weight
  • Pregnancy
  • Preterm delivery
  • Racism
  • Segregation
  • Social class
  • USA

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science


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