African American Unemployment and the Disparity in Periviable Births

Abstract

Periviable infants (i.e., born before 26 complete weeks of gestation) represent fewer than .5% of births in the US but account for 40% of infant mortality and 20% of billed hospital obstetric costs. African American women contribute about 14% of live births in the US, but these include nearly a third of the country’s periviable births. Consistent with theory and with periviable births among other race/ethnicity groups, males predominate among African American periviable births in stressed populations. We test the hypothesis that the disparity in periviable male births among African American and non-Hispanic white populations responds to the African American unemployment rate because that indicator not only traces, but also contributes to, the prevalence of stress in the population. We use time-series methods that control for autocorrelation including secular trends, seasonality, and the tendency to remain elevated or depressed after high or low values. The racial disparity in male periviable birth increases by 4.45% for each percentage point increase in the unemployment rate of African Americans above its expected value. We infer that unemployment—a population stressor over which our institutions exercise considerable control—affects the disparity between African American and non-Hispanic white periviable births in the US.

Fertility in a Pandemic: Evidence from California

“…Disruptions in people's ability to meet new partners during quarantines or other social-distancing policies mechanically result in temporal fertility delay (Wagner, Choi, and Cohen 2020). Reductions in health-either from acquiring viral infection or associated with the physiological stress of unemployment and uncertainty-can reduce fecundity (Catalano et al 2005(Catalano et al , 2022Chen et al 2022).…”