Narrator: SEVERAL YEARS AGO, TWO PHYSICIANS IN CHICAGO SET OUT TO SOLVE A MYSTERY -- WHY DO AFRICAN-AMERICAN WOMEN HAVE BABIES THAT ARE BORN TOO SMALL AT TWICE THE RATE OF WHITE AMERICAN WOMEN? RICHARD DAVID AND JAMES COLLINS ARE NEONATOLOGISTS -- PEDIATRICIANS WHO SPECIALIZE IN THE CARE OF INFANTS WHO COME INTO THE WORLD TOO EARLY OR DANGEROUSLY UNDERWEIGHT, AND OFTEN BOTH. LIKE VIRTUALLY EVERYONE IN THEIR FIELD, THEY WERE TROUBLED BY THE STRIKING RACIAL DIFFERENCES IN RATES OF PREMATURE AND LOW-BIRTH-WEIGHT BABIES. WHAT COULD ACCOUNT FOR THE DIFFERENCES? Dr. Collins: ORIGINALLY, I THOUGHT THAT THE DISPARITY IN PREMATURE DELIVERY WAS REALLY DRIVEN BY SOCIOECONOMIC DIFFERENCES BETWEEN AFRICAN-AMERICANS AND WHITES. IT'S WELL-KNOWN THAT AFRICAN-AMERICANS HAVE A LOWER, COLLECTIVELY, SOCIOECONOMIC STATUS THAN WHITES. THEY'RE LESS LIKELY TO RECEIVE COLLEGE EDUCATION THAN WHITES. SO I THOUGHT, ONCE YOU CORRECTED FOR THAT, THAT THE GAP WOULD GO AWAY. Narrator: BUT COLLINS AND DAVID DISCOVERED THE GAP DIDN'T GO AWAY. Dr. Collins: WE WERE VERY SURPRISED TO FIND THAT THE GAP ACTUALLY WIDENED AS EDUCATION AND SOCIOECONOMIC STATUS IMPROVED. AND THEN BEGAN TO LOOK AT IT FROM A BIGGER PERSPECTIVE AND BROADER PERSPECTIVE, AND REALLY STARTED TO REALIZE, WELL, MAYBE IT'S SOMETHING ABOUT LIFELONG MINORITY STATUS WHICH IS THE DRIVING FACTOR HERE. THERE'S SOMETHING ABOUT GROWING UP AS A BLACK FEMALE IN THE UNITED STATES THAT'S NOT GOOD FOR YOUR CHILDBEARING HEALTH. I DON'T KNOW HOW ELSE TO SUMMARIZE IT. Narrator: SO THE TWO NEONATOLOGISTS BEGAN TO EXPLORE WHETHER BEING A MEMBER OF A PARTICULAR MINORITY GROUP MIGHT AFFECT PREGNANCY OUTCOMES, AND THEY CAME UP WITH A CONTROVERSIAL HYPOTHESIS. WHAT'S BEHIND THE LOW BIRTH WEIGHT AND PREMATURE BIRTH FOR AFRICAN-AMERICAN BABIES IS THE UNEQUAL TREATMENT OF AFRICAN-AMERICANS IN AMERICAN SOCIETY. IN OTHER WORDS, RACISM IS TAKING A HEAVY TOLL ON AFRICAN-AMERICAN CHILDREN EVEN BEFORE THEY LEAVE THEIR MOTHERS' WOMBS. IT'S AN IDEA THAT'S SLOWLY GAINING ACCEPTANCE. Dr. David: WE'RE IN THE MIDST OF A PARADIGM SHIFT. 15 YEARS AGO, RACISM AS A RISK FACTOR WAS ALMOST NEVER HEARD OF IN A SCIENTIFIC PAPER, WHEREAS NOW IT'S MUCH MORE A POSSIBILITY. Narrator: THE STORY OF KIM ANDERSON, A SUCCESSFUL ATLANTA EXECUTIVE AND LAWYER, ILLUSTRATES EXACTLY WHAT DAVID AND COLLINS ARE TALKING ABOUT. WE KNOW THAT A HEALTHY LIFESTYLE SHOULD LEAD TO A HEALTHY BABY. WOMEN WHO EAT WELL, EXERCISE, GET PRENATAL CARE, AVOID ALCOHOL AND DRUGS AND CIGARETTES ARE MORE LIKELY TO HAVE A GOOD PREGNANCY. BUT ONE OF THE BEST PREDICTORS FOR A HEALTHY PREGNANCY OUTCOME IS HIGHER EDUCATION. Anderson: THIS IS A PICTURE OF ME, MAY 1984, WHEN I GRADUATED FROM COLUMBIA LAW SCHOOL. PEOPLE WOULD THINK I'M LIVING THE AMERICAN DREAM -- A LAWYER WITH 2 CARS, 2 1/2 KIDS, THE DOG, THE PORCH, A GOOD HUSBAND, GREAT FAMILY. I'VE ALWAYS BEEN LUCKY TO HAVE GOOD HEALTH -- ALWAYS ATE WELL, EXERCISED, NEVER SMOKED. Narrator: SO, WHEN WE LOOK AT KIM ANDERSON -- A WELL-PAID LAWYER IN GOOD HEALTH -- WE WOULD EXPECT HER NEWBORN TO BE A HEALTHY, FULL-TERM BABY. IT DIDN'T TURN OUT THAT WAY. BACK IN 1990, WHEN SHE WAS PREGNANT WITH HER FIRST CHILD, KIM WENT INTO LABOR 2 1/2 MONTHS EARLY. I JUST WANTED TO KNOW AT LEAST THAT IF SHE WAS BORN ALIVE, THAT AT LEAST WE HAD A FIGHTING CHANCE. I HEARD HER CRY. I SAID, "THANK, GOD." BUT SHE WAS SO SMALL. YOU COULD, LIKE, HOLD HER IN THE PALM OF YOUR HAND. Narrator: KIM'S BABY, DANIELLE, WEIGHED ONLY 2 POUNDS, 13 OUNCES WHEN SHE WAS BORN. SHE JOINED THE RANKS OF ALMOST 300,000 LOW-BIRTH-WEIGHT INFANTS BORN IN THE U.S. THAT YEAR, ABOUT 1 OUT OF EVERY 14 BABIES, ALL OF THEM AT A HIGH RISK OF DYING BEFORE THEIR FIRST BIRTHDAY. Anderson: I REMEMBER GETTING HOME AND BEING IN THE BATHROOM, JUST -- I FELL APART. YOU KNOW, 'CAUSE IT'S LIKE I DIDN'T GET TO TAKE MY BABY HOME. I REMEMBER JUST SORT OF FALLING APART. Narrator: PRETERM AND LOW BIRTH WEIGHT ARE THE LEADING REASONS THAT THE U.S. CLAIMS THE DUBIOUS DISTINCTION OF HAVING ONE OF THE WORST INFANT-SURVIVAL RATES IN THE INDUSTRIALIZED WORLD. WE FALL BEHIND DOZENS OF COUNTRIES. BABIES BORN IN SLOVENIA, CYPRUS, MALTA, AND CROATIA STAND A BETTER CHANCE OF LIVING TO THE AGE OF 1 THAN A BABY BORN HERE. Dr. David: IT IS KIND OF LIKE THE CANARY IN THE MINE. IT'S THE MOST SENSITIVE OF OUR HEALTH OUTCOME INDICATORS PER POPULATION. Narrator: AND INFANT MORTALITY IS NOT JUST A PROBLEM FOR AFRICAN-AMERICANS. Dr. David: WHITE AMERICANS, IF THEY WERE A SEPARATE COUNTRY, WOULD STILL RANK 23rd IN THE WORLD. SO, OUTCOMES ARE VERY BAD.