title: Contextualizing racial disparities in preterm delivery: a rhetorical analysis of U.S. epidemiological research at the turn of the 21st century.
abstract: Preterm delivery (PTD), defined as delivery prior to 37 weeks gestation, is a key contributor to persistent racial disparities in infant mortality in the United States. Five major funding initiatives were devoted to advancing PTD epidemiology during the 1990s and 2000s. By examining content and rhetorical features of 94 studies conducted under these initiatives, and published between 1993 and 2011, this paper considers how calls for more "contextual" approaches (focusing on social and environmental contexts) interacted with more "conventional" approaches (focusing on individual-level risk factors) to PTD epidemiology during this period. Contextual advocates initially emphasized complex biosocial reasoning to better connect social adversity with embodied outcomes. Yet responses by researchers invested in conventional approaches, as well as in studies published under new initiatives that explicitly claimed to incorporate contextual insights, often reframed this complex reasoning in biologically reductionist terms. Subsequent contextual advocates then focused on developing statistical methods to support research about social and environmental causes of PTD, and this strategy appears to have gained some traction with conventional researchers. These findings call for closer attention to language and power in both social scientific studies of epidemiological knowledge production, as well as among epidemiologists themselves.
authors: Department of Anthropology, University of Iowa, 114 Macbride Hall, Iowa City, IA 52242, USA; Department of Community & Behavioral Health, University of Iowa, 100 CPHB, Iowa City, IA 52242, USA. Electronic address: erica-prussing@uiowa.edu.
authors: Erica
authors: E
authors: Prussing
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Medical anthropology; Preterm delivery; Race; Rhetoric; Science & technology studies