In a recently published study conducted by the CDC, researchers found a higher prevalence of cerebral palsy in black 8-year old children as compared to other racial groups in a five county region of metropolitan Atlanta 1. A subsequent study was conducted by the Autism and Developmental Disabilities Monitoring (ADDM) Network which collected data from three different geographical areas of the country: metropolitan Atlanta, Northern Alabama and Southeastern Wisconsin 2. They found that the prevalence of CP was highest among 8 year old blacks in all three regions and was 30% higher overall than the prevalence found in white non-Hispanic children. In addition, they found that the prevalence of CP was higher among children whose families lived in low- and middle- socioeconomic communities than among those whose families lived in high-income communities. Overall, the prevalence of CP was 70% higher in low- and middle-income communities than in high-income communities.

These findings concur with past studies of hospital records and large health maintenance organizations that have found increased prevalence of CP in black children. A study of California births in 1983–1985 suggested that black ethnicity increased the risk of CP because of an increased rate of premature births 3 which is a well- known risk factor for the development of CP 4. However, Wu and colleagues found that black ethnicity is associated with a 40% increased risk of CP among term and near-term infants 5. In a follow up study that included neuroimaging data to subgroup cases of CP by type of brain injury, Wu et al 6 also found an increased prevalence of CP in term black infants as compared to term white infants. Although the relative risk did not reach statistical significance as in the previous study, it may have been due to a smaller sample size; however the point estimate of relative risk was the same.

Further investigation of increased prevalence of cerebral palsy in black full-term infants is warranted. If it turns out to be the same in all racial groups then the increased prevalence of CP seen in the CDC studies is probably due to higher rate of prematurity seen in blacks as compared to other racial groups since prematurity is to thought account for ½ of all cases of CP 7. (In 2004, preterm births occurred in 11.5% of Caucasian women and 17.9% of non-Hispanic black women.) Thus the real issue in prevention of CP becomes how to prevent/reduce prematurity in black women (this is far from understood, however). On the other hand, if further study shows that there truly is an increased risk of cerebral palsy among black term infants, it is likely due to different, unknown factor (s) that may be a new avenue for prevention research.