Researcher Laura Gunn

Biostatistics researcher Laura Gunn is seeking to answer why African-American women have a significantly higher incidence of adverse birth outcomes than those of other ethnicities.

She recently collaborated with Alison Macfarlane and Nirupa Dattani of City University London, to compare birth outcome data among English and Welsh women of African and Caribbean origin with that of the same ethnic minority groups in the U.S.

“One idea we have is that of a generational effect, which is why we’re interested in looking at the mother’s country of origin or birth,” said Gunn. “We have data on births in the U.S., England, and Wales and we have information on the mother’s country of birth. We can determine, through a biostatistical analysis, whether there are trends from one generation to the next.”

Gunn said she hopes to determine if there are disparities between African- American or Caribbean-American women born in the U.S. and African- British and Welsh or Caribbean- British and Welsh women born in the U.K. compared to these same ethnic minority women born in Africa or the Caribbean. “Does there appear to be a potential generational effect as a result of immigration from more traditionally underserved and disparate regions?” Gunn wondered. “Do disparities persist or widen among black African or Caribbean women whose country of origin is outside the U.S. or U.K. compared to the same groups born within the U.S. or U.K.? Or, is there hope of discovering a narrowing of the disparities among such women?

“One component when comparing the U.S. to England and Wales is that of prenatal care,” she said. “In particular, one hypothesis is that there will be larger disparities in the U.S. with regard to prenatal care’s association with adverse birth outcomes compared to that of the U.K. and Wales based on the vastly different health systems.”

One factor that led to her invitation to collaborate in the U.K. was a paper co-authored by Gunn, health and kinesiology professors Diana Sturges and Padmini Shankar, and M.P.H. graduate student Shrikrisha Shroff. “We found clear disparities in infant mortality between African-American and white infants, with black infants’ rate of death more than doubling that of white infants,” said Gunn. This led to a second paper which considered maternal behavioral and medical factors and infant characteristics among the same women in the 2007 study associated with these disparities.