# Understanding racial and ethnic disparities in preterm birth: a systems science approach

> **NIH NIH K01** · NORTHEASTERN UNIVERSITY · 2020 · $127,415

## Abstract

SUMMARY/ABSTRACT
Preterm birth (PTB; childbirth <37 weeks) is responsible for approximately 35% of infant deaths in the U.S.,
and is an important cause of short- and long-term morbidity. The estimated annual societal economic cost of
PTB nationally is more than $26 billion. PTB disparities are well documented, with racial/ethnic minority
populations persistently experiencing higher PTB rates. Intermediary determinants, including individual and
interpersonal level factors, and structural determinants such as healthcare, community and societal level
factors, are posited contributors to racial/ethnic disparities. However, researchers have not examined how
these interdependent and interacting determinants influence PTB disparities within a racialized social system.
Such an understanding is needed to develop effective interventions. The candidate hypothesizes that
inequitable customs, practices and laws in various sectors of society operate in self-reinforcing/correcting ways
to maintain inequality. The functioning of these determinants is dynamically complex and cannot be studied via
conventional statistical methods due to the interdependence of multi-level factors, inherent feedback processes
and interactions between them, and time delays between ‘exposures’ and outcome. System Dynamics
Modeling (SDM) is designed to study dynamically complex problems, and has been successfully used to
inform policies regarding social determinants of health. The candidate is applying for this award in order to
develop expertise in SDM. The training component of the award also includes formal/informal training in health
equity measurement, health policy, and benefit-cost analysis. The research component of the award aims to
address significant gaps in our understanding of how structural and intermediary determinants generate and
perpetuate racial/ethnic PTB disparities, as well as inform strategies to address these disparities. Aim 1 is to
identify pathways through which structural and intermediary determinants generate or maintain racial/ethnic
PTB disparities. Aim 2 will build upon the foundational work of the first aim and develop a quantitative SD
model of mathematical relationships representing the causal mechanisms. Additionally, this aim will test
dynamic effects of healthcare sector interventions (progestogens and low-dose aspirin administration for
women at risk for preterm delivery and pre-eclampsia). Aim 3 is to conduct benefit-cost analyses and simulate
efficacy of the healthcare sector interventions. The candidate is a social and perinatal epidemiologist, well
trained in diverse and complementary analytical tools of quantitative and qualitative methodology. The
proposed training program supports the candidate’s long-term career goal to become a renowned investigator
in health disparities research, with particular emphasis on understanding determinants of disparities in
maternal and child health and the development and evaluation of effective interventions...

## Key facts

- **NIH application ID:** 10023942
- **Project number:** 5K01MD013911-02
- **Recipient organization:** NORTHEASTERN UNIVERSITY
- **Principal Investigator:** Collette N Ncube
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $127,415
- **Award type:** 5
- **Project period:** 2019-09-24 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10023942

## Citation

> US National Institutes of Health, RePORTER application 10023942, Understanding racial and ethnic disparities in preterm birth: a systems science approach (5K01MD013911-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10023942. Licensed CC0.

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