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The weathering hypothesis and the health of African-American women and infants: evidence and speculations.
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1992
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African-american WomenSocial Determinants Of HealthSocial SciencesRaceFertility-timing DistributionsAfrican American StudiesBlack WomenPrematurityRacial VariationPublic HealthDevelopmental EpidemiologyEarly Life ExposureDemographic ForecastingDemographic ChangeMaternal HealthDemographic ProcessEpidemiologyPregnancyPreterm BirthWeathering HypothesisDemographyWomen's Health
Variation in fertility timing and the belief that the 20s–early 30s are low‑risk childbearing ages contribute to infant mortality differentials, with African‑American and non‑Hispanic white populations differing in which maternal ages carry the lowest neonatal risk. The study proposes the weathering hypothesis to explain racial differences in maternal age patterns and birth outcomes, suggesting early adulthood deterioration of African‑American women's health due to cumulative socioeconomic disadvantage. The mechanism posits that cumulative socioeconomic disadvantage leads to early adulthood health deterioration in African‑American women, affecting maternal age patterns and neonatal outcomes. Findings show that neonatal mortality patterns differ by race, with African‑American infants of teen mothers having a survival advantage and the black‑white infant mortality gap widening at older maternal ages.
Observed variation between populations in fertility-timing distributions has been thought to contribute to infant mortality differentials. This hypothesis is based, in part, on the belief that the 20s through early 30s constitute "prime" childbearing ages that are low-risk relative to younger or older ages. However, when stratified by racial identification over the predominant first child-bearing ages, maternal age patterns of neonatal mortality vary between groups. Unlike non-Hispanic white infants, African-American infants with teen mothers experience a survival advantage relative to infants whose mothers are older. The black-white infant mortality differential is larger at older maternal ages than at younger ages. While African Americans and non-Hispanic whites differ on which maternal ages are associated with the lowest risk of neonatal mortality, within each population, first births are most frequent at its lowest-risk maternal ages. As a possible explanation for racial variation in maternal age patterns of births and birth outcomes, the "weathering hypothesis" is proposed: namely, that the health of African-American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage.