Preconception Health Risks Among U.S. Women: Disparities at the Intersection of Disability and Race or Ethnicity

Willi Horner-Johnson, Ilhom Akobirshoev, Ndidiamaka N. Amutah-Onukagha, Jaime Slaughter-Acey, Monika Mitra

Research output: Contribution to journalArticlepeer-review


Introduction: Prior research has found that some preconception health risks are more prevalent among women in historically minoritized racial and ethnic groups. Preconception health risks are also increased among women with disabilities. Risks could be even greater among women who both have a disability and belong to a minoritized racial or ethnic group. The purpose of this study was to assess preconception health at the intersection of disability and race or ethnicity. Methods: We analyzed data from the 2016 Behavioral Risk Factor Surveillance System to estimate the prevalence of health behaviors, health status indicators, and preventive healthcare receipt among nonpregnant women 18–44 years of age. We used modified Poisson regression to compare non-Hispanic White women with disabilities and women with and without disabilities in three other race/ethnicity groups (non-Hispanic Black, Hispanic, other race) to a reference group of non-Hispanic White women without disabilities. Disability status was defined based on affirmative response to at least one of six questions about difficulty with seeing, hearing, mobility, cognition, personal care, or independent living tasks. Multivariate analyses adjusted for other sociodemographic characteristics such as age and marital status. Results: In every racial and ethnic group, women with disabilities had a significantly higher prevalence of most preconception health risks than their counterparts without disabilities. The disparity in obesity for Black women with disabilities was additive, with the adjusted prevalence ratio (PR, 1.77; 95% confidence interval [CI], 1.57–2.00) equal to the sum of the prevalence ratios for disability alone (PR, 1.29; 95% CI, 1.19–1.41) and Black race alone (PR, 1.47; 95% CI, 1.36–1.58). Conclusions: Women at the intersection of disability and minoritized race or ethnicity may be at especially high risk of adverse outcomes. Targeted efforts are needed to improve the health of women of reproductive age in these doubly marginalized populations.

Original languageEnglish (US)
Pages (from-to)65-74
Number of pages10
JournalWomen's Health Issues
Issue number1
StatePublished - Jan 1 2021

Bibliographical note

Funding Information:
Funding: Research reported in this publication was supported in part by Award Number 90DDUC0039 from the Administration on Community Living, Cooperative Agreement Number NU27DD000014 from the National Center on Birth Defects and Developmental Disabilities of the Centers for Disease Control and Prevention , Award Numbers R01HD074581 , R01HD090103 , and R01HD082105 from the National Institute of Child Health and Human Development of the National Institutes of Health , and Award Number 90DPGE000 from the National Institute on Disability, Independent Living, and Rehabilitation Research . The contents are solely the responsibility of the authors and do not necessarily represent the official views of the funding sources.

Publisher Copyright:
© 2020 Jacobs Institute of Women's Health

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

Cite this