# PROXIMATE DETERMINANTS OF LBW AND INFANT MORTALITY

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 1993 · $157,327

## Abstract

Closing the persistent black/white infant mortality differential is a high
priority national objective.  We hypothesize it to be a manifestation of
how social inequality negatively affects the health of black mothers, and
limits their access to pre- and perinatal health services.  Our theoretical
framework connects socioeconomic characteristics to infant outcomes through
biologically-based proximate determinants.  We propose a "weathering"
hypothesis that the effects of social inequality on the health of
populations compound with age.  Our ongoing project confirms that black
women have higher prevalence rates of health and behavioral characteristics
that can complicate pregnancy than white, and that these differences
increase with age.  Black/white differentials in poor birth outcomes also
increase with maternal age.  The differences in women's health may be
important mechanisms driving the black/white infant mortality differential.
The release of state linked birth and infant death certificate tapes for
the 1989 birth cohort, when the birth certificates were improved, makes
testing these hypotheses possible for the first time.  We will analyze
tapes for California, New York, Michigan and North Carolina for the 1989
cohort.  These states offer large numbers of births (including black and
Hispanic), represent each region of the country, and vary in infant
mortality and poverty rates.  We will augment these with census data to
provide measures of SES.  We will supplement and validate the linked
maternal health data with HANES data and do the same for the census data
using data from the PSID.  We will estimate multivariate logit models of
the impact of maternal health, behaviors, prenatal care, and hospital level
on birth outcomes; and of the relationship of maternal age, race, state,
and other characteristics to maternal health.  We will construct in-depth
profiles of the states, as qualitative backdrops to the analyses to aid
interpretation.  Implemented by a multidisciplinary research team, this
research goes beyond the demographic identification of high-risk
populations, and beyond the biomedical focus on disease processes at the
individual level, to connect disease processes to populations.

## Key facts

- **NIH application ID:** 2199059
- **Project number:** 5R01HD024122-06
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **SAM.gov UEI:** GNJ7BBP73WE9
- **Principal Investigator:** Arline T Geronimus
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1993
- **Award amount:** $157,327
- **Award type:** 5
- **Project period:** 1988-06-01 → 1995-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/2199059

## Citation

> US National Institutes of Health, RePORTER application 2199059, PROXIMATE DETERMINANTS OF LBW AND INFANT MORTALITY (5R01HD024122-06). Retrieved via MORVS 2026-10-26 from https://api.morvs.ai/grant/nih/2199059. Licensed CC0.

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