{
  "abstract": "BackgroundRacialized disparities in hypertensive disorders of pregnancy persist, yet the role of interconnected structural determinants has not been fully explored. We evaluated the association between county-level indicators of structural racial discrimination (SRD) and Black-White disparities in HDP in Georgia.\n\nMethodsWe conducted exploratory factor analysis to identify latent factors of county-level SRD from 12 indicators representing historic racial violence, criminal justice, residential segregation, and political representation. We linked factor scores to 2020-2024 Georgia natality data and estimated associations between factor scores (tertiles) and Black-White differences in HDP rates.\n\nResultsWe identified two latent factors: Historic Racism and Racialized Polarization. HDP occurred in 15.5% of 206,438 Black births and 13.1% of 265,693 White births. Compared with the first tertile of Historic Racism factor scores, scores in the second (T2) and third (T3) tertiles were associated with increased Black-White HDP disparities (T2: 6.3, 95% confidence interval [CI]: -3.0-15.5; T3: 5.0, 95% CI: 5.4-15.4). Higher Racialized Polarization scores were associated with increased Black-White HDP disparities (T2: 9.1, 95% CI: -0.3-18.5; T3: 9.8, 95% CI: -1.5-21.2).\n\nConclusionsStructural racism contributes to racial disparities in HDP in Georgia, where historic oppression remains embedded in contemporary legal, political, and social systems.",
  "abstract_shown": true,
  "affiliations": [
    "Boston University Chobanian & Avedisian School of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "S. L. Boulet"
    },
    {
      "name": "R. S. Zhang"
    },
    {
      "name": "R. Abdelghany"
    },
    {
      "name": "R. Kienle"
    },
    {
      "name": "K. K. Stanhope"
    },
    {
      "name": "J. Darville"
    },
    {
      "name": "M. Kramer"
    },
    {
      "name": "S. Carter"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/axrreyehx9q4b.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.05.26362353",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.05.26362353v1.full",
  "id": "axrreyehx9q4b",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.05.26362353v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "obstetrics and gynecology"
    ],
    [
      "openalex",
      "2729|Pregnancy and preeclampsia studies"
    ]
  ],
  "openalex": "W7212030795",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.05.26362353v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-05",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/axrreyehx9q4b.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:03Z",
      "native_id": "10.64898/2026.09.05.26362353",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.05.26362353v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:obstetrics and gynecology",
      "subfield": "reproductive-child"
    }
  ],
  "title": "County-Level Structural Racism and Racial Disparities in Hypertensive Disorders of Pregnancy in Georgia",
  "title_text": "County-Level Structural Racism and Racial Disparities in Hypertensive Disorders of Pregnancy in Georgia",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:03Z",
  "url": "https://research.draconitic.com/paper/axrreyehx9q4b",
  "venue": "medRxiv",
  "versions": []
}