More than one-third of infant deaths in California are related to being born too soon, and babies born prematurely who do survive can face a lifetime of health complications. The stark reality of premature birth in California is one of health inequity. While 1 in 12 babies are born too soon, the rate of preterm birth among Black women is 47 percent higher than the rate among all other women. We assert that structural and interpersonal racism along with other key social determinants are important drivers of an epidemic that disproportionately affects women of color in our state, and nationally. We’re starting at the root of the issue by redefining the crisis of premature birth through justice and equity. By calling out racism and mending broken systems we’re addressing deep racial disparities in preterm birth and creating a healthier future for everyone. The California Preterm Birth Initiative conducts and funds transdisciplinary research across the reproductive life course to probe risk and resilience factors and to identify promising interventions that can turn the curve on the preterm birth epidemic.