Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis

Introduction

Racial discrimination has been consistently linked to various health outcomes and health disparities, including studies associating racial discrimination with patterns of racial disparities in adverse pregnancy outcomes. To expand our knowledge, this systematic review and meta-analysis assesses all available evidence on the association between self-reported racial discrimination and adverse pregnancy outcomes.

Methods

Eight electronic databases were searched without language or time restrictions, through January 2022. Data were extracted using a pre-piloted extraction tool. Quality assessment was conducted using the Newcastle–Ottawa Scale (NOS), and across all included studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects meta-analyses were performed on preterm birth and small for gestational age. Heterogenicity was assessed using Cochran’s χ² test and I² statistic.

Results

Of 13 597 retrieved records, 24 articles were included. Studies included cohort, case–control and cross-sectional designs and were predominantly conducted in the USA (n=20). Across all outcomes, significant positive associations (between experiencing racial discrimination and an adverse pregnancy event) and non-significant associations (trending towards positive) were reported, with no studies reporting significant negative associations. The overall pooled odds ratio (OR) for preterm birth was 1.40 (95% CI 1.17 to 1.68; 13 studies) and for small for gestational age it was 1.23 (95% CI 0.76 to 1.99; 3 studies). When excluding low-quality studies, the preterm birth OR attenuated to 1.31 (95% CI 1.08 to 1.59; 10 studies). Similar results were obtained across sensitivity and subgroup analyses, indicating a significant positive association.

Conclusion

These results suggest that racial discrimination has adverse impacts on pregnancy outcomes. This is supported by the broader literature on racial discrimination as a risk factor for adverse health outcomes. To further explore this association and underlying mechanisms, including mediating and moderating factors, higher quality evidence from large ethnographically diverse cohorts is needed.

Detecting Prejudice From Egalitarianism: Why Black Americans Don't Trust White Egalitarians' Claims

Although White Americans increasingly express egalitarian views, how they express egalitarianism may reveal inegalitarian tendencies and sow mistrust with Black Americans. In the present experiments, Black perceivers inferred likability and trustworthiness and accurately inferred underlying racial attitudes and motivations from White writers' declarations that they are nonprejudiced and egalitarian (Experiments 1 and 2). White writers believed that their egalitarianism seemed more inoffensive and indicative of allyship than was perceived by Black Americans (Experiment 1a). Linguistic analysis revealed that, when inferring racial attitudes and motivations, Black perceivers accurately attended to language emphasizing humanization, support for equal opportunity, personal responsibility, and the idea that equality already exists (Experiment 1b). We found causal evidence that these linguistic cues informed Black Americans' perceptions of White egalitarians (Experiment 2). Suggesting societal costs of these perceptions, White egalitarians' underlying racial beliefs negatively predicted Black participants' actual trust and cooperation in an economic game (Experiment 3). Our experiments (N = 1,335 adults) showed that White Americans' insistence that they are egalitarian itself perpetuates mistrust with Black Americans.

Associations Between Openness Facets, Prejudice, and Tolerance: A Scoping Review With Meta-Analysis

The personality factor of openness to experience, which encompasses curiosity, imagination, and a desire for new experiences, has been associated negatively with prejudice and positively with the closely related value of tolerance. While these relationships have been reviewed at the factor level, there has been no review of research at the lower facet level. This review aims to uncover the relationships between the facets of openness and the constructs of prejudice and tolerance. We conducted a preregistered scoping review with meta-analysis following the recommended guidelines from Joanna Briggs Institute. A total of 2,349 articles were reviewed, with 16 primary research articles (or 17 studies) meeting the criteria for inclusion. Aggregated effect sizes via random-effect meta-analysis revealed that all revised neuroticism-extraversion-openness personality inventory (NEO-PI-R) and international personality item pool (IPIP)-based facets of openness significantly predicted prejudice and tolerance. Out of the three measures [i.e., NEO-PI-R, IPIP-NEO, and honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness to experience personality inventory (HEXACO-PI), and the facets of openness examined], the NEO-PI-R facet of value was most strongly associated with prejudice. In contrast, the NEO-PI-R facet of aesthetics was the facet most strongly associated with tolerance. However, these results should be treated as preliminary in light of the small number of meta-analyzed studies and more primary research studies are needed to confirm the trends found in this review. This review represents the first step in the systematic investigation of the link between the facets of openness and components of prejudice and tolerance and contributes toward explaining prejudice and tolerance.

Understanding Gender Differences in Rape Victim Blaming: The Power of Social Influence and Just World Beliefs

Victims of sexual violence are frequently blamed by friends, family, or legal personnel in the aftermath of an attack, with men attributing greater blame on average than women. Victims' experiences of being blamed may generate a vicious cycle in which they are more likely to be blamed in the future. Moreover, just world beliefs (JWB) have been studied extensively as an underlying cognitive mechanism that predicts greater blame. Studies examining the influence of social support on blame have yet to examine the unique role of JWB on these attributions. The current study examined blame attribution of a fictional rape victim who received either positive, negative, or neutral support from friends and family in a sample of 383 undergraduate men and women. Individually, social support and JWB were both significant predictors of blame, and women were more influenced by social support than men; specifically, gender was a more salient predictor of blame toward the positively supported victim, suggesting that positive support received by friends and family may evoke a domino effect of support from other women. Conditional effects revealed that JWB were most influential on blame when responding to the positively supported victim. Implications and suggestions for future research are discussed.