Low birth weight is a leading predictor of neonatal death. Low birth-weight infants are also more likely than normal birth-weight infants to experience long-term developmental and neurological disabilities. The Centers for Disease Control and Prevention report that maternal smoking is the cause of 20% to 30% of all low-weight births in the United States.

Among racial and ethnic groups in Monroe County, low birth weights were highest among African American babies, 15% in 2018. Between 2000 and 2018, the rate among Hispanic babies increased from 7% to 11% and remained steady among white babies at 6% and African American babies at 15%.

Racial disparities in low birth weight of babies emerge from systems that perpetuate structural racism. Higher low birth weight rates among infants of color are directly tied to maternal access to prenatal care throughout pregnancy and quality of care. Research has shown that mothers of color are less likely to receive prenatal care in part because they tend to live in communities with fewer health care providers including neonatal services. While women of color from under-resourced communities gain access to health care via Medicaid, they are often underinsured. Discriminatory treatment by health care providers influences whether the health care needs of women of color are adequately addressed, putting mothers and their infants at higher risk of low birth weight. The overall health of expectant mothers of color and access to comprehensive health care including gynecological services before pregnancy also contributes to low birth weights. Racism experienced by expectant mothers of color in their everyday lives at work and in their neighborhoods (e.g. food insecurity, environmental toxins) places their infants at higher risk of low birth weight. Neighborhood quality including cleaniness, crime rates and community cohesion affect the well-being of expectant mothers and their children at birth. The physiological response to structural racism by mothers of color influences racial disparities in low birth weight rates.

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