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Richard David, MD and James Collins, Jr, MD, MPH

Richard David is with the Division of Neonatology, John H. Stroger Jr Hospital of Cook County, Chicago, Ill, and the Department of Pediatrics, University of Illinois, Chicago. James Collins Jr is with the Division of Neonatology, Children’s Memorial Hospital, Chicago, and the Department of Pediatrics, School of Medicine, Northwestern University, Chicago.

Correspondence: Requests for reprints should be sent to Richard J. David, MD, Division of Neonatology, John H. Stroger Jr Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612 (e-mail: rdavid{at}uic.edu).

ABSTRACT

Since 1950, dramatic advances in human genetics have occurred, racial disparities in infant mortality have widened, and the United States’ international ranking in infant mortality has deteriorated. The quest for a "preterm birth gene" to explain racial differences is now under way.

Scores of papers linking polymorphisms to preterm birth have appeared in the past few years. Is this strategy likely to reduce racial disparities? We reviewed broad epidemiological patterns that call this approach into question.

Overall patterns of racial disparities in mortality and secular changes in rates of prematurity as well as birth-weight patterns in infants of African immigrant populations contradict the genetic theory of race and point toward social mechanisms. We postulate that a causal link to class disparities in health exists.

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				P. L. Hebert, J. E. Sisk, and E. A. Howell When Does A Difference Become A Disparity? Conceptualizing Racial And Ethnic Disparities In Health Health Aff., March 1, 2008; 27(2): 374 - 382. [Abstract] [Full Text] [PDF]