RESEARCH ISSUES IN THE STUDY OF VERY-LOW-BIRTH-WEIGHT AND PRETERM DELIVERY AMONG AFRICAN-AMERICAN WOMEN

Very low birthweight and preterm delivery explain two thirds of the ex cess deaths experienced by African-American infants. Although comprehe nsive, good quality services for all African-American women will help to reduce the twofold higher rate of infant mortality experienced by A frican-American infants compared with white infants, the infant mortal ity gap will not be closed until prevention research is conducted that incorporates the social, cultural, and political context of life for African-American women; the environmental stressors and the physiologi c responses associated with stress; and the protective mechanisms avai lable in the community for responding to stress. Discrimination may be an important stressor that influences a woman's susceptibility to a p oor pregnancy outcome. Strategies already exist in the community to co pe with discrimination and other environmental stressors. To capture t he effects of discrimination and other environmental factors and the p rotective factors important for prevention, the research approach must involve African-American women and their communities as collaborators in the research. Such collaboration will help to avoid problems with scientific racism.