Social Determinants of Health Associated with Perinatal Health Outcomes in Different Racial/Ethnic Groups: A Narrative Review of Reviews

Abstract

Objective:

Perinatal health disparities are an important public health concern. Women from racial/ethnic minority groups have elevated rates of maternal and infant morbidities and mortality. In the general population, the social determinants of health (SDoH) are known to worsen overall health outcomes. We did not find a review of studies on SDoH during the perinatal period in different racial/ethnic groups. This narrative review focused on studies comparing Black and/or Hispanic women with non-Hispanic (NH) White women.

Methods:

Articles were identified using PubMed, PsycINFO, and EMBASE databases based on specified criteria. Six systematic reviews, one scoping review, and one integrative review met the inclusion criteria.

Results:

The rates of maternal comorbidities, including hypertension, diabetes, and obesity, as well as preterm birth, low birth weight, still births, and maternal and infant mortality, were higher in Black and Hispanic women than in NH White women. Adverse SDoHs that were more common in minority populations included socioeconomically disadvantaged neighborhoods, food insecurity, low education, poverty, segregation, and air pollution. While adverse SDoHs were associated with worse maternal and infant health, some studies unexpectedly reported more severe effects of these SDoHs in White women than in minority women. Several studies have had methodological limitations.

Conclusions:

This underexplored area of research highlights the urgent need for well-designed research on SDoHs related to maternal–infant health in different racial/ethnic groups, such as the development and testing of pragmatic interventions. Public health professionals, researchers, and policymakers should address health care disparities to improve perinatal outcomes.