Population studies increasingly find women’s mortality risk to be associated with childlessness status, low parity (one child), and high parity (6+ children) in a U-shaped pattern, although U.S. studies are inconsistent overall and by race/ethnicity. No studies, however, have examined infecundity differentials among women and their potential contributions to the parity–post-reproductive mortality relationship or the race/ethnicity-related mortality gap. This study, co-authored by Cheryl Elman and Angela O’Rand, investigates parity–post-reproductive mortality associations in the context of women’s biophysiological likelihood of (in)fecundity as well as voluntary control practices limiting fertility. The study utilizes zero-inflation methods to estimate infecundity risk and parity in a sample of non-Hispanic Black and White women, born 1920–1941, drawn from the Health and Retirement Study. It then uses proportional hazards modeling to examine the associations between infecundity risk and parity and all-cause mortality by race/ethnicity, adjusting for early-life-course health and social statuses, and post-reproductive health and social statuses. The study finds Black women’s infecundity probability to be twice that of White women and their expected parity 40% higher. While infecundity risk increases mortality risk for all women, parity–post reproductive mortality associations differ by race/ethnicity. White women with 1 and 5+ children (in a U-shaped curve) have elevated mortality risk, net of infecundity risk and early-life factors; adjusting for post-reproductive health and social status completely attenuates parity-related mortality risk. Black women’s post-reproductive mortality risk, in contrast, is anchored in early-life conditions that elevated infecundity risk; parity–post-reproductive mortality associations do not reach statistical significance. These findings suggest that a focus on upstream and early life course exposures may better elucidate race/ethnic-related social determinants of women’s reproductive health, infecundity, parity, and mortality.
A second study, co-authored by Cheryl Elman, focuses on two early twentieth-century public health campaigns in the American South, the unhealthiest U.S. region at that time. Black southerners—denied basic health, political, economic, and social rights under a rising Jim Crow regime—self-organized health services networks, including through the Tuskegee Woman’s Club, the Negro Organization Society of Virginia, and the Moveable School (1890s–1915). Around the same time, a philanthropic project, the Rockefeller Sanitary Commission (RSC, 1909–1914), seeded state-level public health agencies in eleven southern states, thereby installing public health in a top-down manner. Using archival data sources, the study outlines key similarities and differences in the public health concerns and coalition-building approaches of each campaign and southern resistance to their efforts. The study finds that Black-led campaigns often blurred the color line to form coalitions to provide services to the underserved, also tackling environmental public health risks at the community level. In contrast, RSC affiliates in southern states were directed by RSC administrators to provide health services using short-term “pop-up” public dispensaries. RSC services reached Black and White communities willing to participate but in a manner that did not overtly challenge Jim Crow-era practices. Ultimately, southern Jim Crow-era resistance to public health expansion persisted under each approach. Legacies of these struggles remain: political-economic and ideological forces that limited public health expansion in the past, also marginalizing Black community health efforts, reverberate in public health inequities today.