Twitter-derived measures of sentiment towards minorities (2015–2016) and associations with low birth weight and preterm birth in the United States

Abstract Introduction The objective of this study was to investigate the association between state-level publicly expressed sentiment towards racial and ethnic minorities and birth outcomes for mothers who gave birth in that state. Methods We utilized Twitter's Streaming Application Programming Interface (API) to collect 1,249,653 tweets containing at least one relevant keyword pertaining to a racial or ethnic minority group. State-level derived sentiment towards racial and ethnic minorities were merged with data on all 2015 U.S. births (N = 3.99 million births). Results Mothers living in states in the lowest tertile of positive sentiment towards racial/ethnic minorities had greater prevalences of low birth weight (+6%), very low birth weight (+9%), and preterm birth (+10%) compared to mothers living in states in the highest tertile of positive sentiment, controlling for individual-level maternal characteristics and state demographic characteristics. Sentiment towards specific racial/ethnic groups showed a similar pattern. Mothers living in states in the lowest tertile of positive sentiment towards blacks had an 8% greater prevalence of low birth weight and very low birth weight, and a 16% greater prevalence of preterm birth, compared to mothers living in states in the highest tertile. Lower state-level positive sentiment towards Middle Eastern groups was also associated with a 4–13% greater prevalence of adverse birth outcomes. Results from subgroup analyses restricted to racial/ethnic minority mothers did not differ substantially from those seen for the full population of mothers. Conclusions More negative area-level sentiment towards blacks and Middle Eastern groups was related to worse individual birth outcomes, and this is true for the full population and minorities.