The author believes that to search for a genetic cause of the disparity in birth weight between the races is premature before the contribution of socioeconomic factors to birth weight and other pregnancy outcomes are explored. A prospective study is needed to explore the intergenerational socioeconomic status effect on perinatal outcomes. Sustained intergenerational well-being may alleviate not only the organizational barriers to health care, such as poor access and paucity of medical facilities, but also the more challenging attitudinal barriers, such cultural isolation, fatalism, and fear. Thus, “sustained intergenerational well-being may lead to better efforts at health promotion and disease prevention.”

Furthermore, the Centers for Disease Control and Prevention estimated that premature morbidity from the 10 leading causes of death in the U.S. is 10% due to inadequate access to health care service, 20% due to environmental exposure, 20% to genetics, and the remaining 50% is estimated to be the result of adverse behavioral factors. The unhealthy behaviors include tobacco use, unsafe sex practices, poor diet, sedentary lifestyle, alcohol and drug abuse, violent and abusive behavior and other risk taking behaviors. Socioeconomic and behavioral factors appear to have a greater affect on morbidity and mortality than genetic variables among the 10 leading causes of death. Thus, it is feasible that these factors if accurately measured could be shown to have a significant effect on pregnancy outcomes.