scholarly journals Maternal Age Patterns of Preterm Birth: Exploring the Moderating Roles of Chronic Stress and Race/Ethnicity

2020 ◽  
Vol 54 (9) ◽  
pp. 653-664 ◽  
Author(s):  
Sangmi Kim ◽  
Eun-Ok Im ◽  
Jianghong Liu ◽  
Connie Ulrich
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Chronic Stress ◽  
Maternal Age ◽  
Ethnic Disparities ◽  
Birth Certificates ◽  
Future Research ◽  
Age Related ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Despite the suggested contribution of cumulative chronic stress to the racial/ethnic disparities in preterm birth (PTB), it is unclear how chronic stress, maternal age, and race/ethnicity are linked underlying PTB. Purpose We investigated the moderating effect of chronic stress on the maternal age–PTB association among non-Hispanic (N-H) White, N-H Black, Hispanic, and Asian women. Methods We analyzed the Washington State’s Pregnancy Risk Assessment Monitoring System data linked with birth certificates. The sample included women aged 18 years or older who birthed the first, singleton baby without birth defects. Chronic stress was measured by race/ethnicity-specific chronic stress indices. A maternal age–chronic stress interaction was modeled to predict PTB by logistic regression stratified by race/ethnicity. In subanalysis, the moderating role of racism was investigated in the maternal age–chronic stress interaction among three minority groups combined. Results Women’s maternal age trajectory of PTB varied by their race/ethnicity and chronic stress level. N-H White and N-H Black women showed a steeper maternal age-related increase in PTB (weathering) under higher chronic stress, indicating a chronic stress’ cumulative effect with maternal age. Besides, the extent of weathering was amplified by racism on top of chronic stress, particularly among N-H Black women. Conclusions These results show that both chronic stress and racism may develop accelerated PTB risk among minority women. Future research should use more objective and accurate chronic stress measures to ascertain the complex relationships among chronic stress, racial discrimination, and maternal age underlying the racial/ethnic differentials in PTB.

Factor Structure for Chronic Stress Before and During Pregnancy by Racial/Ethnic Group

2018 ◽  
Vol 41 (5) ◽  
pp. 704-727 ◽  
Author(s):  
Sangmi Kim ◽  
Eun-Ok Im ◽  
Jianghong Liu ◽  
Connie Ulrich
Keyword(s):  
New York ◽  
Chronic Stress ◽  
Physical Violence ◽  
The United States ◽  
Birth Certificates ◽  
Specific Factor ◽  
Pregnancy Risk ◽  
Chronic Stressors ◽  
Race Ethnicity ◽  
Racial Ethnic

This study aimed to explore race/ethnicity-specific dimensionalities of chronic stress before and during pregnancy for non-Hispanic (N-H) White, N-H Black, Hispanic, and Asian women in the United States. This study analyzed the data among 6,850 women from the New York City and Washington State Pregnancy Risk Assessment Monitoring System (2004-2007) linked with birth certificates. Separate exploratory factor analysis was conducted by race/ethnicity using a maximum-likelihood extraction method with 26 chronic stress items before and during pregnancy. Correlations and internal consistency reliabilities among items and latent factors determined race/ethnicity-specific factor structures of chronic stress. Chronic stress was race/ethnicity-distinctive and multidimensional with low correlations among the factors ( r = .07-.28, p < .05). Despite financial hardship, perceived isolation, and physical violence underlying chronic stress among the racial/ethnic groups, intergroup variations existed under each group’s cultural or sociopolitical contexts. This study could help develop targeted strategies to intervene with women’s chronic stressors before childbirth.

scholarly journals Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability

2019 ◽  
Vol 57 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Evelyn Arana ◽  
Amy Carroll-Scott ◽  
Philip M. Massey ◽  
Nora L. Lee ◽  
Ann C. Klassen ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Black Women ◽  
Medical Record ◽  
Ethnic Groups ◽  
White Women ◽  
Ethnic Disparities ◽  
Medical Record Data ◽  
Record Data ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were &lt;50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.

Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

2020 ◽  
Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Postneonatal Mortality ◽  
Maternal Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

scholarly journals How Administrative Data Collection and Analysis Can Better Reflect Racial and Ethnic Identities

2020 ◽  
Vol 44 (1) ◽  
pp. 301-331
Author(s):  
Samantha Viano ◽  
Dominique J. Baker
Keyword(s):  
Data Collection ◽  
Administrative Data ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
Ethnic Identities ◽  
Birth Certificates ◽  
Data Sets ◽  
Race Ethnicity ◽  
Equivalent Sources ◽  
Racial Ethnic

Measuring race and ethnicity for administrative data sets and then analyzing these data to understand racial/ethnic disparities present many logistical and theoretical challenges. In this chapter, we conduct a synthetic review of studies on how to effectively measure race/ethnicity for administrative data purposes and then utilize these measures in analyses. Recommendations based on this synthesis include combining the measure of Hispanic ethnicity with the broader racial/ethnic measure and allowing individuals to select more than one race/ethnicity. Data collection should rely on self-reports but could be supplemented using birth certificates or equivalent sources. Collecting data over time, especially for young people, will help identify multiracial and American Indian populations. For those with more complex racial/ethnic identities, including measures of country of origin, language, and recency of immigration can be helpful in addition to asking individuals which racial/ethnic identity they most identify with. Administrative data collection could also begin to incorporate phenotype measures to facilitate the calculation of disparities within race/ethnicity by skin tone. Those analyzing racial/ethnic disparities should understand how these measures are created and attempt to develop fieldwide terminology to describe racial/ethnic identities.

Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions

2021 ◽  
pp. 003335492097466
Author(s):  
Matthew Z. Dudley ◽  
Rupali J. Limaye ◽  
Daniel A. Salmon ◽  
Saad B. Omer ◽  
Sean T. O’Leary ◽  
...  
Keyword(s):  
Black Women ◽  
Health Care Providers ◽  
White Women ◽  
Ethnic Disparities ◽  
Vaccine Safety ◽  
Care Providers ◽  
Vaccine Acceptance ◽  
Race Ethnicity ◽  
Perceive Risk ◽  
Racial Ethnic

Objectives Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women’s knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity. Methods We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs. Results Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women. Conclusions Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.

scholarly journals Risk Factors Contributing to Racial/Ethnic Disparities in Iron Deficiency in US Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 725-725
Author(s):  
Rebecca Campbell ◽  
Heng Wang ◽  
Rashid Ahmed
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Iron Deficiency ◽  
Healthy Eating ◽  
Ethnic Disparities ◽  
Healthy Eating Index ◽  
Depression Symptoms ◽  
Iron Intake ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Objectives Iron deficiency (ID) in women of reproductive age can negatively impact women's health, pregnancy outcomes and the health and development of their infants. Disparities in rates of iron deficiency by race and ethnicity in the US are persistent, but their causes are not well understood. This study was conducted to describe risk factors for ID and sources of racial/ethnic disparities in ID burden. Methods Adult women ages 20–49 years (N = 1,069) from the National Health and Nutrition Examination Survey 2015–16 who completed the questionnaire and laboratory examinations were included in the analysis. Risk factors for ID (serum ferritin (SF) &lt; 12 µg/L) were examined in three domains: diet (total iron intake, total vitamin C intake, Healthy Eating Index (HEI) score), sociodemographic and acculturation (race/ethnicity, age, place of birth, interview language), and health (BMI, depression symptoms). Prevalence of ID overall and in subgroups were assessed in mean models accounting for the survey design. Associations of risk factors with ID were examined in logistic regression models using survey commands in SAS. Results In total, 153 women (11.3%) had ID. Prevalence of ID was highest in Mexican American (20.5%, n = 213) and non-Hispanic Black women (19.9%, n = 234) and lower in other Hispanic (13.5%, n = 136) and non-Hispanic, non-Black women (7.7%, n = 486) (p &lt; 0.001). Non-US birth and Spanish language interview were associated with 67% (p = 0.01) and 77% (p = 0.001), respectively, greater risk of ID. Low iron intake and Healthy Eating Index (HEI) were not associated with risk of ID in this sample, while vitamin C intake was inversely associated with risk of ID (β (95% CI): 1.81 (1.0–3.29), p = 0.0. Finally, neither BMI nor depression symptoms was associated with ID in this sample. Stratified and multivariable analyses will be conducted in the 2015–16 and 2017–18 NHANES surveys combined to explore risk factors by race/ethnicity. Conclusions Sociodemographic and lifestyle characteristics are predictive of ID risk in US women. Planned analyses will generate race/ethnicity-specific risk profiles and identify actionable targets for intervention to reduce racial/ethnic disparities in ID prevalence. Funding Sources None.

The Association between Maternal Race and Ethnicity and Risk Factors for Primary Cesarean Delivery in Nulliparous Women

2019 ◽  
Author(s):  
Elisabeth L. Stark ◽  
William A. Grobman ◽  
Emily S. Miller
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Black Women ◽  
Cesarean Delivery ◽  
White Women ◽  
Ethnic Disparities ◽  
Nulliparous Women ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Abstract Objective To understand whether maternal, perinatal, and systems-level factors can be identified to explain racial/ethnic disparities in cesarean delivery rates. Study Design This retrospective cohort study included nulliparous women with singleton gestations who delivered at a tertiary care center from 2015 to 2017. Maternal, perinatal, and systems-level factors were compared by race/ethnicity. Multilevel multivariable logistic regression was used to identify whether race/ethnicity was independently associated with cesarean. Effect modification was evaluated using interaction terms. Bivariable analyses and multinomial logistic regression were used to determine differences in indication for cesarean. Results Of 9,865 eligible women, 2,126 (21.5%) delivered via cesarean. The frequency of cesarean was lowest in non-Hispanic white women (19.2%) and highest in non-Hispanic black women (28.2%; p < 0.001). Accounting for factors associated with cesarean delivery did not lessen the odds of cesarean associated with non-Hispanic black race (aOR: 1.58, 95% CI: 1.31–1.91). Compared with non-Hispanic white women, non-Hispanic black women were more likely to undergo cesarean for nonreassuring fetal status (aOR: 2.73, 95% CI: 2.06–3.61). Conclusion Examined maternal, perinatal, and systems-level risk factors for cesarean delivery did not explain the racial/ethnic disparities observed in cesarean delivery rates. Increased cesarean delivery for nonreassuring fetal status contributed substantially to this disparity.

Neighborhood Privilege, Preterm Delivery, and Related Racial/Ethnic Disparities: An Intergenerational Application of the Index of Concentration at the Extremes

2020 ◽  
Vol 189 (5) ◽  
pp. 412-421 ◽  
Author(s):  
Bina Patel Shrimali ◽  
Michelle Pearl ◽  
Deborah Karasek ◽  
Carolina Reid ◽  
Barbara Abrams ◽  
...  
Keyword(s):  
Early Childhood ◽  
Black Women ◽  
Preterm Delivery ◽  
White Women ◽  
Hispanic Women ◽  
Ethnic Disparities ◽  
Estimating Equation ◽  
Individual Level ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract We assessed whether early childhood and adulthood experiences of neighborhood privilege, measured by the Index of Concentration at the Extremes (ICE), were associated with preterm delivery and related racial/ethnic disparities using intergenerationally linked birth records of 379,794 California-born primiparous mothers (born 1982–1997) and their infants (born 1997–2011). ICE measures during early childhood and adulthood approximated racial/ethnic and economic dimensions of neighborhood privilege and disadvantage separately (ICE-income, ICE-race/ethnicity) and in combination (ICE–income + race/ethnicity). Results of our generalized estimating equation models with robust standard errors showed associations for ICE-income and ICE–income + race/ethnicity. For example, ICE–income + race/ethnicity was associated with preterm delivery in both early childhood (relative risk (RR) = 1.12, 95% confidence interval (CI): 1.08, 1.17) and adulthood (RR = 1.07, 95% CI: 1.03, 1.11). Non-Hispanic black and Hispanic women had higher risk of preterm delivery than white women (RR = 1.32, 95% CI: 1.28, 1.37; and RR = 1.11, 95% CI: 1.08, 1.14, respectively, adjusting for individual-level confounders). Adjustment for ICE–income + race/ethnicity at both time periods yielded the greatest declines in disparities (for non-Hispanic black women, RR = 1.23, 95% CI: 1.18, 1.28; for Hispanic women, RR = 1.05, 95% CI: 1.02, 1.09). Findings support independent effects of early childhood and adulthood neighborhood privilege on preterm delivery and related disparities.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Sign in / Sign up

Export Citation Format

Share Document