An underweight person is a person whose body weight is considered too low to be healthy. A person who is underweight is malnourished. Assessment
The body mass index, a ratio of a persons weight to their height, has traditionally been used to assess the health of a person as it pertains to weight: under the cut-off point at a BMI of 18.5, a person is considered underweight. The calculation is either weight in kilograms divided by height in meters, squared, or weight in pounds times 703, divided by height in inches, squared. Another measure of underweight is through comparison to the average weight of a cohort of people of a similar age and height: people who are at least 15% to 20% below the average weight for the group are considered underweight.Body fat percentage has been suggested as another way to assess whether a person is underweight. Unlike the body mass index, which is a proxy measurement, the body fat percentage takes into account the difference in composition between adipose tissue (fat cells) and muscle tissue and their different roles in the body. The American Council on Exercise defines the amount of essential fat, below which a person is underweight, as 10–13% for women and 2–5% for men. The greater amount of essential body fat in women supports reproductive function. Prevalence
Using the body mass index as a measure of weight-related health, with data from 2014, age-standardised global prevalence of underweight in women and men were 9.7% and 8.8%, respectively.
One way to decrease rates of low birth weight and premature delivery is to focus on the health of women prior to conception through reproductive education, screening and counseling regarding mental health issues and stress, and access to primary care. Racial stress
Non-Hispanic Blacks have the highest infant mortality rate in the United States (11.4 deaths per 1,000 live births compared to the national average of 5.9 deaths per 1,000 live births). Subsequently,  there has been growing research supporting the idea of racial discrimination as a risk factor for low birth weight. In one study by Collins et al., evidence suggested that African American mothers who experienced high levels of racial discrimination were at significantly higher risk of delivering a very low-birth weight baby compared to African American mothers who had not experienced racial discrimination. Black infants (13.2%) are more likely to have low birth weight compared to Asian and Pacific Islander (8.1%), American Indian and Alaska Native (7.6%), Non-Hispanic White (7.0%), and Hispanic Infants (7.1%). Environmental factors
Environmental factors, including exposure of the mother to secondhand smoke can be a factor in determining the birth weight of child. In 2014, 13% of children exposed to smoke were born with low birth weight compared with 7.5% of those children born to nonsmokers. Children born to mothers who smoked or were exposed to secondhand smoke are more likely to develop health problems earlier in life such as neurodevelopmental delays.