Previous research illustrates the persistence of racial disparities in adverse birth outcomes across all age groups, including teen mothers. However, limited literature exists that examined contributors of these disparities specifically between racial groups of teen mothers. This study extended previous research with the examination and comparison of individual and structural factors between non-Hispanic African-American and white teen mothers as potential contributors to racial disparities in adverse birth outcomes. Birth record data for a cross-sectional sample of North Carolina teen mothers (n=16,472) were examined through multilevel models, and an intersectional conceptual framework served as a theoretical foundation for this examination to determine how race, socioeconomic status as defined by neighborhood factors, and age intersect in impacting birth outcomes and explaining racial disparities. This study focused on infant birth weight in grams, gestational age in weeks, low birth weight and preterm birth as birth outcome variables, whereas secondary focus was placed on pregnancy health status and health behaviors (prenatal care use and smoking). Neighborhood socioeconomic status was operationalized by neighborhood risk and census-tract median household income. The two papers included in this dissertation address the following questions: 1) Are there racial differences in birth weight outcomes between African-American and White teen mothers after controlling for neighborhood risk? 2) Does neighborhood income moderate racial differences in gestational age and preterm birth outcomes of infants born to teen mothers? 3) Does neighborhood income moderate racial differences in gestational age & preterm birth outcomes differently between younger and older teen mothers? In this sample, African-American teens gave birth to infants of significantly lower birth weights and gestational ages and had higher odds of low birth weight and preterm birth outcomes in comparison to White teens across all census-tracts. Neighborhood risk had a significant negative association with infant birth weight; however racial differences remained significant after controlling for neighborhood risk. Racial differences in gestational age and preterm birth outcomes varied significantly by neighborhood income. With birth weight and gestational age, the greatest disparities were identified between African-American and White teens living in neighborhoods of lower neighborhood risk and higher income levels. Significant differences were not found in birth weight and gestational age outcomes based on maternal age. Overall, findings from this study suggest that racial factors intersect with socioeconomic circumstances to subsequently impact birth weight outcomes and racial disparities for teen populations. Future examinations need to explore these intersectional influences in context of other individual and interpersonal factors, community and social context to enhance understanding on birth outcome disparities among teen mothers
