Preterm birth rates climbed sharply among America’s poorest families over the past decade, with racial disparities persisting even among wealthy Black mothers, according to research analyzing more than 400,000 births nationwide.
From 2011 to 2021, preterm births increased from 9.7% to 11.1% among households earning below the federal poverty level. Similar increases occurred among families earning just above poverty wages, rising from 7.8% to 10.0%. Higher-income families saw no such increase.
Black mothers faced significantly elevated risks across every income bracket examined. In the poorest households, Black mothers experienced 19% greater risk of preterm birth compared with white mothers. Even among the wealthiest families studied, Black mothers still faced 13% higher risk than their white counterparts.
Dr. Erika Cordova-Ramos of Boston Medical Center and colleagues emphasized these patterns reveal that “interventions focused solely on addressing income disparities may be insufficient to eliminate the racial and ethnic disparities in preterm birth.”
The findings suggest racism operates independently of economic factors in shaping birth outcomes. Dr. Sunah Hwang of the University of Colorado noted the data “strikingly illustrates that the wealthiest Black person is far more likely to experience preterm birth than the poorest white person.”
Hwang stressed that racism at individual, institutional, and structural levels drives inequitable access to respectful healthcare and social determinants of health. Preterm birth remains a leading cause of infant death and disability, with stark racial disparities persisting for decades despite medical advances.
See: “Preterm Birth Rates Rise in Low-Income Households” (January 2, 2026)
