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Schlothauer D, Teschemacher L, Breckenkamp J, Borde T, David M, Abou-Dakn M, Henrich W, Seidel V. Perinatal outcome of immigrant women with and without refugee status compared to non-immigrant women: results of the pregnancy and obstetric care for refugees (PROREF) cross-sectional study. Arch Gynecol Obstet 2024; 310:2413-2424. [PMID: 39150503 PMCID: PMC11485109 DOI: 10.1007/s00404-024-07639-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/05/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE International studies show conflicting evidence regarding the perinatal outcome of immigrant women with and without refugee status compared to non-immigrant women. There are few studies about the situation in Germany. The research question of this article is: Is the perinatal outcome (Apgar, UApH (umbilical artery pH), NICU (neontatal intensive care unit) transfer, c-section rate, preterm birth, macrosomia, maternal anemia, higher degree perinatal tear, episiotomy, epidural anesthesia) associated with socio-demographic/clinical characteristics (migration status, language skills, household income, maternal education, parity, age, body mass index (BMI))? METHODS In the Pregnancy and Obstetric Care for Refugees (PROREF)-study (subproject of the research group PH-LENS), funded by the German Research Foundation (DFG), women giving birth in three centers of tertiary care in Berlin were interviewed with the modified Migrant Friendly Maternity Care Questionnaire between June 2020 and April 2022. The interview data was linked to the hospital charts. Data analysis was descriptive and logistic regression analysis was performed to find associations between perinatal outcomes and migration data. RESULTS During the research period 3420 women (247 with self-defined (sd) refugee status, 1356 immigrant women and 1817 non-immigrant women) were included. Immigrant women had a higher c-section rate (36.6% vs. 33.2% among non-immigrant women and 31.6% among women with sd refugee status, p = 0.0485). The migration status did not have an influence on the umbilical artery pH, the preterm delivery rate and the transfer of the neonate to the intensive care unit. Women with self-defined refugee status had a higher risk for anemia (31.9% vs. 26.3% immigrant women and 23.4% non-immigrant women, p = 0.0049) and were less often offered an epidural anesthesia for pain control during vaginal delivery (42.5% vs. 54% immigrant women and 52% non-immigrant women, p = 0.0091). In the multivariate analysis maternal education was explaining more than migration status. CONCLUSION Generally, the quality of care for immigrant and non-immigrant women in Berlin seems high. The reasons for higher rate of delivery via c-section among immigrant women remain unclear. Regardless of their migration status women with low degree of education seem at increased risk for anemia.
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Affiliation(s)
- Darja Schlothauer
- Klinik Für Geburtsmedizin, Charité Universitätsklinikum, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Louise Teschemacher
- Klinik für angeborene Herzfehler-Kinderkardiologie, Deutsches Herzzentrum Der Charité, Campus Virchow-klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jürgen Breckenkamp
- Fakultät Für Gesundheitswissenschaften, Arbeitsgruppe 3 Epidemiologie and International Public Health, Universität Bielefeld, Bielefeld, Germany
| | - Theda Borde
- Alice Salomon Hochschule Berlin, Alice-Salomon-Platz 5, 12627, Berlin, Germany
| | - Matthias David
- Klinik Für Gynäkologie, Charité Universitätsklinikum, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Michael Abou-Dakn
- Klinik Für Gynäkologie Und Geburtshilfe, St. Joseph Krankenhaus, Wüsthoffstraße 15, 12101, Berlin, Germany
| | - Wolfgang Henrich
- Klinik Für Geburtsmedizin, Charité Universitätsklinikum, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Vera Seidel
- Klinik Für Geburtsmedizin, Charité Universitätsklinikum, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Feister J, Najera C, Rankin K, Collins JW. Lifetime Upward Economic Mobility and US-Born Latina Women's Preterm Birth Rates. Matern Child Health J 2024; 28:1086-1091. [PMID: 38308756 PMCID: PMC11058059 DOI: 10.1007/s10995-023-03890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES To determine whether Latina women's upward economic mobility from early-life residence in impoverished urban neighborhoods is associated with preterm birth (< 37 weeks, PTB) . METHODS Multivariate logistic regression analyses were performed on the Illinois transgenerational birth-file with appended US census income information for Hispanic infants (born 1989-1991) and their mothers (born 1956-1976). RESULTS In Chicago, modestly impoverished-born Latina women (n = 1,674) who experienced upward economic mobility had a PTB rate of 8.5% versus 13.1% for those (n = 3,760) with a lifelong residence in modestly impoverished neighborhoods; the unadjusted and adjusted (controlling for age, marital status, adequacy of prenatal care, and cigarette smoking) RR equaled 0.65 (0.47, 0.90) and 0.66 (0.47, 0.93), respectively. Extremely impoverished-born Latina women (n = 2,507) who experienced upward economic mobility across their life-course had a PTB rate of 12.7% versus 15.9% for those (n = 3,849) who had a lifelong residence in extremely impoverished neighborhoods, the unadjusted and adjusted RR equaled 0.8 (0.63. 1.01) and 0.95 (0.75, 1.22), respectively. CONCLUSIONS FOR PRACTICE Latina women's upward economic mobility from early-life residence in modestly impoverished urban neighborhoods is associated with a decreased risk of PTB. A similar trend is absent among their peers with an early-life residence in extremely impoverished areas.
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Affiliation(s)
- John Feister
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA.
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
| | - Clarissa Najera
- School of Public Health, Department of Epidemiology, University of Illinois, Chicago, USA
| | - Kristin Rankin
- School of Public Health, Department of Epidemiology, University of Illinois, Chicago, USA
| | - James W Collins
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA
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Santaularia NJ, Hunt SL, Bonilla Z. Exploring the Links Between Immigration and Birth Outcomes Among Latine Birthing Persons in the USA. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01999-x. [PMID: 38713369 DOI: 10.1007/s40615-024-01999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Birth outcomes are worse for birthing people and infants in the USA than other high-income economies and worse still for underprivileged communities. Historically, the Latine community has experienced positive birth outcomes, despite low socioeconomic status and other socio-political disadvantages, leading to what has been termed as the Hispanic birth paradox. However, this perinatal advantage and protective effect appears to have been shattered by unfavorable policies, structural conditions, societal attitudes, and traumatic events impacting Latine immigrants, leading to negative effects on the health and well-being of birthing Latines-regardless of citizenship status and increasing rates of preterm birth and low birth weight infants. METHODS AND RESULTS We conducted a comprehensive literature review and identified two pathways through which birth outcomes among Latine birthing persons may be compromised regardless of citizenship status: (1) a biological pathway as toxic levels of fear and anxiety created by racialized stressors accumulate in the bodies of Latines and (2) a social pathway as Latines disconnect from formal and informal sources of support including family, friends, health care, public health programs, and social services during the course of the pregnancy. CONCLUSION Future research needs to examine the impact of immigration climate and policies on health and racial equity in birth outcomes among Latines regardless of citizenship status. Attaining health and racial equity necessitates increased awareness among health providers, public health practitioners, and policy makers of the impact of larger socio-political pressures on the health of Latine birthing persons.
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Affiliation(s)
- N Jeanie Santaularia
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Shanda Lee Hunt
- University Libraries, University of Minnesota, Minneapolis, MN, USA
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Xu J, Luo L, Gamaldo A, Verdery A, Hardy M, Buxton OM, Xiao Q. Trends in sleep duration in the U.S. from 2004 to 2018: A decomposition analysis. SSM Popul Health 2024; 25:101562. [PMID: 38077245 PMCID: PMC10698270 DOI: 10.1016/j.ssmph.2023.101562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 03/02/2024] Open
Abstract
Average sleep duration in the United States declined in recent years, and the decline may be linked with many biopsychosocial factors. We examine how a set of biopsychosocial factors have differentially contributed to the temporal trends in self-reported sleep duration across racial groups between 2004-2005 and 2017-2018. Using repeated nationally representative cross-sections from the National Health Interview Survey, we decompose the influence of biopsychosocial factors on sleep duration trends into two components. One component corresponds to coefficient changes (i.e., changes in the associations between behaviors or exposures and sleep duration) of key biopsychosocial factors, and the other part accounts for the compositional changes (i.e., changes in the distributions of exposures) in these biopsychosocial factors during the study period. We reveal that changes in the coefficients of some biopsychosocial factors are more important than compositional changes in explaining the decline in sleep duration within each racial/ethnic group. Our findings highlight racial differences manifest across multiple biopsychosocial domains that are shifting in terms of association and composition. Methodologically, we note that the standard regression approach for analyzing temporal trends neglects the role of coefficient changes over time and is thus insufficient for fully capturing how biopsychosocial factors may have influenced the temporal patterns in sleep duration and related health outcomes.
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Affiliation(s)
- Jiahui Xu
- The Pennsylvania State University, University Park, PA, USA
| | - Liying Luo
- The Pennsylvania State University, University Park, PA, USA
| | | | - Ashton Verdery
- The Pennsylvania State University, University Park, PA, USA
| | - Melissa Hardy
- The Pennsylvania State University, University Park, PA, USA
| | | | - Qian Xiao
- The University of Texas Health Science Center at Houston, Houston, TX, USA
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5
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Chang J, Lee YJ, Lex H, Kerns C, Lugar K, Wright M. Attention-Deficit Hyperactivity Disorder among children of immigrants: immigrant generation and family poverty. ETHNICITY & HEALTH 2024; 29:254-266. [PMID: 38105627 DOI: 10.1080/13557858.2023.2293657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders diagnosed among children in the US. However, little knowledge is available about ADHD prevalence among children of immigrants, the fastest-growing population in the US. This study seeks to examine ADHD rates among children of immigrants in different generations compared to children of US-born parents and their association with family poverty. DESIGN The sample includes 83,362 children aged 0-17 from the National Health Interview Survey (NHIS) 2010-2018 data. Multivariate logistic regression model is used to estimate prevalence of ADHD among children of immigrants compared to children of US-born parents. We then compare ADHD rates among the children sample in different immigrant generations. For all analyses, we examine ADHD occurrence separately for children in families living below the poverty threshold and those at or above the poverty threshold. RESULTS The odds of having ADHD were significantly lower among children of immigrants compared to children of US-born parents. Both first-generation children and second-generation children of immigrants had significantly lower odds of having ADHD than children of US-born parents. Post hoc tests find that first-generation children had lower odds of having ADHD compared to second-generation children. Likewise, additional analyses showed that children of immigrants, first-generation children in particular, were less likely to have ADHD compared to children of US-born parents, in both lower- and higher-income families. CONCLUSION Using a nationally representative sample of children, we find that the likelihood of having ADHD increases with higher generations, detecting differences in ADHD prevalence by immigration generation. Importantly, first-generation children had a significantly lower risk of having ADHD conditions compared to second-generation children and children of US-born parents, regardless of family socio-economic status. Public health policy and program development would gain from a clear comprehension of the shielding attributes of ADHD among immigrant families.
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Affiliation(s)
- Jina Chang
- Master of Social Work Program, Lesley University, Cambridge, MA, USA
| | - Yeonjung J Lee
- Thompson School of Social Work & Public Health, University of Hawai'i at Manoa, Honolulu, HI, USA
| | - Hannah Lex
- Transition Support Department, Sidney and Lois Eskenazi Hospital, Indianapolis, IN, USA
| | | | - Katie Lugar
- Multicultural Services and Programs, Indiana State University, Terre Haute, IN, USA
| | - Maya Wright
- Master of Social Work Program, Lesley University, Cambridge, MA, USA
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Braveman P, Heck K, Dominguez TP, Marchi K, Burke W, Holm N. African immigrants' favorable preterm birth rates challenge genetic etiology of the Black-White disparity in preterm birth. Front Public Health 2024; 11:1321331. [PMID: 38239790 PMCID: PMC10794556 DOI: 10.3389/fpubh.2023.1321331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
Background We examined over a million California birth records for 2010 through 2021 to investigate whether disparities in preterm birth (PTB) by nativity and race support the widely held but hitherto unsubstantiated belief that genetic differences explain the persistent Black-White disparity in PTB. Methods We examined PTB rates and risk ratios among African-, Caribbean-, and U.S.-born Black women compared to U.S.-born White women. Multivariate analyses adjusted for maternal age, education, number of live births, delivery payer, trimester of prenatal care initiation, pre-pregnancy BMI, smoking, and prevalence of poverty in a woman's residence census tract; and for paternal education. Results In adjusted analyses, African-born Black women's PTB rates were no different from those of U.S.-born White women. Discussion The results add to prior evidence making a genetic etiology for the racial disparity in PTB unlikely. If genetic differences tied to "race" explained the Black-White disparity in PTB among U.S.-born women, the African immigrants in this study would have had higher rates of PTB, not the lower rates observed. Multiple explanations for the observed patterns and their implications are discussed. Failure to distinguish causes of PTB from causes of the racial disparity in PTB have likely contributed to erroneous attribution of the racial disparity to genetic differences. Based on the literature, unmeasured experiences of racism, including racism-related stress and adverse environmental exposures, are plausible explanations for the PTB disparity between Black and White U.S.-born women. The favorable birth outcomes of African-born Black immigrants may reflect less exposure to racism during sensitive life periods, e.g., childhood, when they were in African countries, where Black people are in the racial majority.
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Affiliation(s)
- Paula Braveman
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine Heck
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Tyan Parker Dominguez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Kristen Marchi
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, DC, United States
| | - Nicole Holm
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
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Clay SL, Ibe-Lamberts K, Kelly KD, Nii-Aponsah H, Woodson MJ, Tines F, Mehdi SA. US-Born Black Women and Black Immigrant Women: an Exploration of Disparities in Health Care and Sociodemographic Factors Related to Low Birth Weight. J Racial Ethn Health Disparities 2023; 10:3031-3038. [PMID: 36449128 DOI: 10.1007/s40615-022-01477-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE This study explores whether nativity differences in health care and sociodemographic factors help to account for nativity differences in low birth weight (LBW) when comparing US-born Black women (USBW) to Black Immigrant women (BIW). METHODS Bivariate analyses and multinomial nested logit (MNL) models were performed using the National Survey of Family Growth (NSFG) dataset. RESULTS Statistically significant nativity differences between USBW and BIW were found across variables of LBW (p = .009), marital status (p < .001), education level (p < .001), receiving public assistance (p < .001), health care coverage (p < .001), age (p < .001), and poverty level income (p < .001). Results from the MNL models indicated that BIW were 91% less likely to have a LBW baby (p < .001). When accounting for other sociodemographic and health care related variables differing by nativity, although a statistically significant, narrowing gap between BIW and USBW was observed (OR = .12, p < .001), BIW were still less likely to have a LBW baby. CONCLUSIONS Differences between USBW and BIW across sociodemographic variables and health care related factors related to adverse pregnancy outcomes were observed in this study. Controlling for the factors attenuated nativity differences but did not eliminate the differences on LBW. Future research should continue to explore this relationship.
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Affiliation(s)
- Shondra Loggins Clay
- School of Interdisciplinary Health Professions (SIHP), Northern Illinois University, 370 Wirtz Drive, 323D Wirtz Hall, Dekalb, IL, 60115, USA.
| | - Kelechi Ibe-Lamberts
- Division of Community Health Sciences, School of Public Health, University of Illinois-Chicago, 1603 W. Taylor St, Chicago, IL, 60612, USA
| | - Kelsie D Kelly
- Department of Public Health Sciences, School of Medicine, University of Virginia, P.O. Box 800717, Charlottesville, VA, 22903, USA
| | - Harold Nii-Aponsah
- School of Interdisciplinary Health Professions (SIHP), Northern Illinois University, 370 Wirtz Drive, 323D Wirtz Hall, Dekalb, IL, 60115, USA
| | - Markisha J Woodson
- Department of Public Health, College of Science and Health, Benedictine University, 5700 College Road, Lisle, IL, 60532, USA
| | - Francesca Tines
- School of Interdisciplinary Health Professions (SIHP), Northern Illinois University, 370 Wirtz Drive, 323D Wirtz Hall, Dekalb, IL, 60115, USA
| | - Syed Abbas Mehdi
- Department of Public Health, College of Science and Health, Benedictine University, 5700 College Road, Lisle, IL, 60532, USA
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Treder KM, Amutah-Onukagha N, White KO. Abortion Bans Will Exacerbate Already Severe Racial Inequities in Maternal Mortality. Womens Health Issues 2023:S1049-3867(23)00098-1. [PMID: 37301725 DOI: 10.1016/j.whi.2023.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Kelly M Treder
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Boston Medical Center, One Boston Medical Center Pl, Boston, Massachusetts.
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health and Community Medicine, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, Boston, Massachusetts
| | - Katharine O White
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Boston Medical Center, One Boston Medical Center Pl, Boston, Massachusetts
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Nieves CI, Borrell LN, Evans CR, Jones HE, Huynh M. The application of intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to examine birthweight inequities in New York City. Health Place 2023; 81:103029. [PMID: 37119694 DOI: 10.1016/j.healthplace.2023.103029] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 05/01/2023]
Abstract
Exploring the intersection of dimensions of social identity is critical for understanding drivers of health inequities. We used multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to examine the intersection of age, race/ethnicity, education, and nativity status on infant birthweight among singleton births in New York City from 2012 to 2018 (N = 725,875). We found evidence of intersectional effects of various systems of oppression on birthweight inequities and identified U.S.-born Black women as having infants of lower-than-expected birthweights. The MAIHDA approach should be used to identify intersectional causes of health inequities and individuals affected most to develop policies and interventions redressing inequities.
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Affiliation(s)
- Christina I Nieves
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States.
| | - Luisa N Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States
| | - Clare R Evans
- Department of Sociology, University of Oregon, Eugene, OR, United States
| | - Heidi E Jones
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, United States; Institute for Implementation Science, City University of New York, New York, NY, United States
| | - Mary Huynh
- New York City Department of Health and Mental Hygiene, New York, NY, United States
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Lee M, Pöhlmann A, Abou-Dakn M, David M. Acculturation Experiences and Preterm Birth in Berlin: Does Acculturative Stress Contribute to Preterm Birth? J Immigr Minor Health 2023:10.1007/s10903-023-01480-7. [PMID: 37081192 DOI: 10.1007/s10903-023-01480-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/22/2023]
Abstract
Acculturation and acculturative stress are potential risk factors for adverse perinatal outcomes. This study investigates whether and how acculturative stress affects preterm birth (PTB) in a sample of migrant women in Berlin. We interviewed 955 women who recently gave birth using standardized questionnaires (Frankfurt Acculturation Scale and Acculturative Stress Index). Multivariable logistic regression analyses assessed the effects of acculturation and acculturative stress on PTB. Women with migrant backgrounds did not have significantly higher PTB rates than German natives. First-generation migrants experienced higher acculturative stress levels than second-generation migrants, 38.8% vs. 13.2%. Acculturative stress could not be identified as a risk factor for PTB in our sample. These results need to be considered in the context of an international city and the wide use of antenatal care services in our population, which could be responsible for similarly good perinatal outcomes and highlights the potential of good access to perinatal care for vulnerable groups.
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Affiliation(s)
- Marlene Lee
- Department of Gynecology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Anna Pöhlmann
- Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Michael Abou-Dakn
- Department of Gynecology and Obstetrics, St. Joseph Krankenhaus Berlin Tempelhof, Wüsthoffstraße 15, 112102, Berlin, Germany
| | - Matthias David
- Department of Gynecology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
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Lucchini M, Rayport Y, Valeri L, Jelic S, St-Onge MP, O'Brien LM, Alcantara C. Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study. Obesity (Silver Spring) 2023; 31:923-933. [PMID: 36863765 DOI: 10.1002/oby.23697] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 03/04/2023]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence and severity of sleep-disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6 to 15 and 22 to 31 weeks gestational age, examine whether BMI modifies the association between race/ethnicity and SDB, and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB. METHODS Differences by race/ethnicity in SDB prevalence and severity were quantified via linear, logistic, or quasi-Poisson regression. Controlled direct effect was used to estimate whether intervening on BMI would remove/diminish differences by race/ethnicity in SDB severity. RESULTS This study comprised 61.2% non-Hispanic White (nHW), 11.9% non-Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian people. SDB prevalence was higher for nHB compared with nHW pregnant people at 6 to 15 weeks (odds ratio [OR] 1.81, 95% CI [1.07, 2.97]), whereas at 21 to 32 weeks, Asian pregnant people had a higher SDB prevalence than nHW (OR 2.2, 95% CI [1.1, 4.0]). The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea-hypopnea index (AHI) (OR 1.35, 95% CI [1.07, 1.69]) compared with nHW. Having overweight/obesity was associated with a higher AHI (β = 2.36, 95% CI [1.97, 2.84]). Controlled direct effect analyses indicated that in early pregnancy, nHB and Hispanic pregnant people would have a lower AHI compared with nHW people had they had normal weight. CONCLUSIONS This study extends knowledge on racial/ethnic disparities in SDB to a pregnant population.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Yael Rayport
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Sanja Jelic
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Marie-Pierre St-Onge
- Division of General Medicine and Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Louise M O'Brien
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Michigan Medicine, Ann Arbor, Michigan, USA
- Division of Sleep Medicine, Department of Neurology, Michigan Medicine, Ann Arbor, Michigan, USA
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Almeida J, Belanoff C, Erbetta KF, Black A. Ethnic, Nativity and Country of Origin Inequities in Preterm Birth Among Hispanic and Non-Hispanic Whites in New York City: What's Stress Got to Do With It? J Immigr Minor Health 2023; 25:406-414. [PMID: 35960400 DOI: 10.1007/s10903-022-01392-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Abstract
Hispanic populations experience good birth outcomes despite their socioeconomic disadvantage, a phenomenon referred to as the Hispanic paradox. This health advantage, however, deteriorates over time and understanding of this pattern is limited. Using data from the 2009-2013 New York City (NYC) PRAMS survey linked with birth certificate data, we tested whether stressful life events (SLEs) partially accounted for differences in preterm birth (PTB) between birthing parents across ethnicity, nativity and country of foreign birth (CFB). Experiencing 3+ SLEs in the prenatal period was associated with increased odds of PTB (OR = 1.49, 95% CI 1.13, 1.97). However, stressors were not associated with greater risk of PTB among US-born Hispanic participants, or differences across CFB. SLEs are associated with increased odds of PTB after a threshold of 3+, but do not explain greater PTB among US-born, or some Hispanic subgroups, despite differences in SLEs across ethnicity and CFB among Hispanic birthing parents.
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Affiliation(s)
- Joanna Almeida
- School of Social Work, Simmons University, 300 The Fenway, Office M430-D, Boston, MA, 02115, USA.
| | - Candice Belanoff
- School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA
| | - Kristin F Erbetta
- School of Social Work, Simmons University, 300 The Fenway, Office M430-D, Boston, MA, 02115, USA
| | - Adriana Black
- Pritzker School of Medicine, University of Chicago, 924 E. 57th Street, Suite 104, Chicago, IL, 60637, USA
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13
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Association of maternal nationality with preterm birth and low birth weight rates: analysis of nationwide data in Japan from 2016 to 2020. Matern Health Neonatol Perinatol 2023; 9:3. [PMID: 36882805 PMCID: PMC9993667 DOI: 10.1186/s40748-023-00149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/14/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND The rate of low birth weight or preterm birth is known to vary according to the birth place of mothers. However, in Japan, studies that investigated the association between maternal nationalities and adverse birth outcomes are few. In this study, we investigated the association between maternal nationalities and adverse birth outcomes. METHODS We obtained live birth data from the Vital Statistics 2016-2020 of the Ministry of Health, Labour, and Welfare. We used data on maternal age, sex, parity, gestational age, birth weight, number of fetuses, household occupation, paternal nationality, and maternal nationality for each infant. We compared the rates of preterm birth and low birth weight at term among mothers whose nationalities were Japan, Korea, China, Philippines, Brazil, and other countries. Log binomial regression model was used to investigate the association between maternal nationality and the two birth outcomes using the other infants' characteristics as covariates. RESULTS In the analysis, data on 4,290,917 singleton births were used. Mothers from Japan, Korea, China, the Philippines, Brazil, and other nations had preterm birth rates of 4.61%, 4.16%, 3.97%, 7.43%, 7.69%, and 5.61%, respectively. The low birth weight rate among Japanese mothers was 5.36% and was the highest among the maternal nationalities. Regression analysis showed that the relative risk for preterm birth among Filipino, Brazilian, and mothers from other countries (1.520, 1.329, and 1.222, respectively) was statistically significantly higher compared with Japanese mothers. In contrast, the relative risk for Korean and Chinese mothers (0.870 and 0.899, respectively) was statistically significantly lower compared with Japanese mothers. Mothers from Korea, China, the Philippines, Brazil, and other nations had a relative risk for low birth weight that was statistically significantly lower than that of Japanese mothers (0.664, 0.447, 0.867, 0.692, and 0.887, respectively). CONCLUSIONS Support for mothers from the Philippines, Brazil, and other countries are necessary to prevent preterm birth. A future study is necessary to investigate the differences in characteristics among mothers of different nationalities in order to uncover the reason for the high risk for low birth weight among Japanese mothers.
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14
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Davis BA, Arcaya MC, Williams DR, Krieger N. The impact of county-level fees & fines as exploitative revenue generation on US birth outcomes 2011-2015. Health Place 2023; 80:102990. [PMID: 36842240 DOI: 10.1016/j.healthplace.2023.102990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/30/2022] [Accepted: 02/08/2023] [Indexed: 02/28/2023]
Abstract
Fees and fines collected through courts and law enforcement can comprise a considerable proportion of revenue for local governments. Law enforcement, as agents of revenue generation, change policing behavior to increase revenue, at times targeting Black and brown neighborhoods to bolster municipal budgets. This structural racism in revenue generation has not yet been assessed as an exposure for adverse health. Using the 2012 Census of Governments, and 2011-2015 vital statistics from the National Center of Health Statistics, we examine the relationship between countyaverage fees and fines as a percent of total own-source revenue and county-level characteristics, and risk of preterm birth and low birthweight across the United States. Mothers residing in counties with the greatest reliance on fees and fines had 1.08 (95% CI: 1.03-1.12) times the odds of preterm birth and 1.07 (95% CI: 1.02-1.11) times the odds of low birthweight than mothers residing in counties with the least reliance on fees and fines, controlling for individual- and county-level covariates. The addition of countylevel racial composition, and the Index of Concentration at the Extremes (ICE), reduced these associations yet remained statistically significant. Future studies should continue to examine how racist, exploitative revenue generation through police and court activities influences the health of residents.
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Affiliation(s)
- Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Mariana C Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA.
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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15
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Abstract
The COVID-19 pandemic has taken a large toll on population health and well-being. We examine the consequences of prenatal exposure for infant health, through which the pandemic may have lasting intergenerational effects. We examine multiple pathways by which the pandemic shaped birth outcomes and socioeconomic disparities in these consequences. Analysis of more than 3.5 million birth records in California with universal information on COVID infection among persons giving birth at the time of delivery reveals deep inequalities in infection by education, race/ethnicity, and place-based socioeconomic disadvantage. COVID infection during pregnancy, in turn, predicts a large increase in the probability of preterm birth, by approximately one third. At the population level, a surprising reduction in preterm births during the first months of the pandemic was followed by an increase in preterm births during the surge in COVID infections in the winter of 2021. Whereas the early-pandemic reduction in preterm births benefited primarily highly educated mothers, the increase in preterm births during the winter infection surge was entirely concentrated among mothers with low levels of schooling. The COVID-19 pandemic is expected to exacerbate U.S. inequality in multiple ways. Our findings highlight a particularly enduring pathway: the long-term legacy of prenatal exposure to an unequal pandemic environment.
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Affiliation(s)
| | - Jenna Nobles
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
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16
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Lucchini M, O’Brien LM, Kahn LG, Brennan PA, Glazer Baron K, Knapp EA, Lugo-Candelas C, Shuffrey L, Dunietz GL, Zhu Y, Wright RJ, Wright RO, Duarte C, Karagas MR, Ngai P, O’Connor TG, Herbstman JB, Dioni S, Singh AM, Alcantara C, Fifer WP, Elliott AJ. Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study. Sleep 2022; 45:zsac075. [PMID: 35724979 PMCID: PMC9453625 DOI: 10.1093/sleep/zsac075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Indexed: 01/10/2023] Open
Abstract
In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants' self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = -0.55 [-0.80,-0.31]; T3: β = -0.65 [-0.99,-0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = -0.5 [-1.0,-0.12]; T3: β = -1.21 [-2.07,-0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Louise M O’Brien
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Kelly Glazer Baron
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claudia Lugo-Candelas
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cristiane Duarte
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Pakkay Ngai
- Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Thomas G O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, New York NY, USA
| | - Sean Dioni
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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17
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Abstract
BACKGROUND Low job control may predict shorter breastfeeding (BF) among working mothers and may contribute to racial disparities in BF. METHODS We used demographic, employment, and health data for n = 631 observations from the Panel Study of Income Dynamics. Job control scores came from a job-exposure matrix.Using path analysis, we assessed whether job control predicted BF and mediated Black-White BF differences. We controlled for education, working hours, marital status, and low birthweight. RESULTS Lower job control predicted decreased odds of BF for at least 6 months (odds ratio, 0.61; 95% confidence interval, 0.31-0.90; reference, no BF). Low job control explained 31% of the Black-White difference for both shorter-term and longer-term BF. CONCLUSIONS Low job contributes to shorter BF and to BF disparities by race. Intervening to enhance job control could improve BF.
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Affiliation(s)
- Margaret D Whitley
- From the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan (Dr Whitley); Program in Public Health, University of California, Irvine, Irvine, California (Dr Ro); and Center for Work and Health Research, Irvine, California (Mr Choi)
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18
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Ifatunji MA, Faustin Y, Lee W, Wallace D. Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9166. [PMID: 35954520 PMCID: PMC9367942 DOI: 10.3390/ijerph19159166] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
After more than a century of research and debate, the scientific community has yet to reach agreement on the principal causes of racialized disparities in population health. This debate currently centers on the degree to which "race residuals" are a result of unobserved differences in the social context or unobserved differences in population characteristics. The comparative study of native and foreign-born Black populations represents a quasi-experimental design where race is "held constant". Such studies present a unique opportunity to improve our understanding of the social determinants of population health disparities. Since native and foreign-born Black populations occupy different sociocultural locations, and since populations with greater African ancestry have greater genetic diversity, comparative studies of these populations will advance our understanding of the complex relationship between sociocultural context, population characteristics and health outcomes. Therefore, we offer a conceptual framing for the comparative study of native and foreign-born Blacks along with a review of 208 studies that compare the mental and physical health of these populations. Although there is some complexity, especially with respect to mental health, the overall pattern is that foreign-born Blacks have better health outcomes than native-born Blacks. After reviewing these studies, we conclude with suggestions for future studies in this promising area of social and medical research.
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Affiliation(s)
- Mosi Adesina Ifatunji
- Departments of African American Studies and Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 53706, USA
| | - Yanica Faustin
- Department of Public Health Studies, College of Arts and Sciences, Elon University, Elon, NC 27244, USA;
| | - Wendy Lee
- Department of Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 54706, USA;
| | - Deshira Wallace
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
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19
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Chu MT, Ettinger de Cuba S, Fabian MP, Lane KJ, James-Todd T, Williams DR, Coull BA, Carnes F, Massaro M, Levy JI, Laden F, Sandel M, Adamkiewicz G, Zanobetti A. The immigrant birthweight paradox in an urban cohort: Role of immigrant enclaves and ambient air pollution. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:571-582. [PMID: 34980894 PMCID: PMC9250941 DOI: 10.1038/s41370-021-00403-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Foreign-born Black and Latina women on average have higher birthweight infants than their US-born counterparts, despite generally worse socioeconomic indicators and prenatal care access, i.e., "immigrant birthweight paradox" (IBP). Residence in immigrant enclaves and associated social-cultural and economic benefits may be drivers of IBP. Yet, enclaves have been found to have higher air pollution, a risk factor for lower birthweight. OBJECTIVE We investigated the association of immigrant enclaves and children's birthweight accounting for prenatal ambient air pollution exposure. METHODS In the Boston-based Children's HealthWatch cohort of mother-child dyads, we obtained birthweight-for-gestational-age z-scores (BWGAZ) for US-born births, 2006-2015. We developed an immigrant enclave score based on census-tract percentages of foreign-born, non-citizen, and linguistically-isolated households statewide. We estimated trimester-specific PM2.5 concentrations and proximity to major roads based residential address at birth. We fit multivariable linear regressions of BWGAZ and examined effect modification by maternal nativity. Analyses were restricted to nonsmoking women and term births. RESULTS Foreign-born women had children with 0.176 (95% CI: 0.092, 0.261) higher BWGAZ than US-born women, demonstrating the IBP in our cohort. Immigrant enclave score was not associated with BWGAZ, even after adjusting for air pollution exposures. However, this association was significantly modified by maternal nativity (pinteraction = 0.014), in which immigrant enclave score was positively associated with BWGAZ for only foreign-born women (0.090, 95% CI: 0.007, 0.172). Proximity to major roads was negatively associated with BWGAZ (-0.018 per 10 m, 95% CI: -0.032, -0.003) and positively correlated with immigrant enclave scores. Trimester-specific PM2.5 concentrations were not associated with BWGAZ. SIGNIFICANCE Residence in immigrant enclaves was associated with higher birthweight children for foreign-born women, supporting the role of immigrant enclaves in the IBP. Future research of the IBP should account for immigrant enclaves and assess their spatial correlation with potential environmental risk factors and protective resources.
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Affiliation(s)
- MyDzung T Chu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
| | | | - M Patricia Fabian
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Kevin James Lane
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fei Carnes
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Marisa Massaro
- Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, MA, USA
| | - Jonathan I Levy
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Megan Sandel
- Department of Pediatrics, School of Medicine, Boston University, Boston, MA, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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20
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Andrasfay T. Birth Outcomes among Descendants of Foreign-Born and US-Born Women in California: Variation by Race and Ethnicity. J Immigr Minor Health 2022; 24:605-613. [PMID: 34075511 PMCID: PMC8633185 DOI: 10.1007/s10903-021-01221-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
This study quantifies the magnitude and persistence of differences in adverse birth outcomes between descendants of foreign-born and US-born women by race/ethnicity. Using 1978-2015 California birth records, I linked records of infants to those of their mothers to create an intergenerational sample (N = 501,323 second generation mothers and 633,102 third generation daughters). Prevalence of low birthweight and preterm birth were calculated in both generations by race/ethnicity, and foreign-born status. An initial foreign-born advantage in birth outcomes is present among most racial/ethnic groups with the exception of foreign-born Asian women. In the subsequent generation, the foreign-origin advantage diminishes for most groups and a foreign-origin disadvantage in low birthweight emerges for descendants of Asian women. Findings largely persist after adjustment for sociodemographic and healthcare-related characteristics. These results underscore the importance of disaggregating by race, ethnicity, and foreign origin when possible to better understand perinatal health disparities in the population.
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Affiliation(s)
- Theresa Andrasfay
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
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21
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Sow M, Raynault MF, De Spiegelaere M. Associations between socioeconomic status and pregnancy outcomes: a greater magnitude of inequalities in perinatal health in Montreal than in Brussels. BMC Public Health 2022; 22:829. [PMID: 35468779 PMCID: PMC9040289 DOI: 10.1186/s12889-022-13165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Comparing health inequalities between countries helps us to highlight some factors specific to each context that contribute to these inequalities, thus contributing to the identification of courses of action likely to reduce them. This paper compares the associations between socioeconomic status (SES) and 1) low birth weight (LBW) and 2) preterm birth, in Brussels and Montreal (in general population, natives-born mothers, and immigrant mothers). Methods A population-based study examining associations between SES and pregnancy outcomes was conducted in each city, using administrative databases from Belgian and Quebec birth records (N = 97,844 and 214,620 births in Brussels and Montreal, respectively). Logistic regression models were developed in order to estimate the relationship between SES (maternal education and income quintile) and pregnancy outcomes, in each region. The analyses were first carried out for all births, then stratified according to the mother’s origin. Results For the general population, SES is associated with LBW and preterm birth in both regions, except for income and preterm birth in Brussels. The association is stronger for mothers born in Belgium and Canada than for those born abroad. The main difference between the two regions concerns the magnitude of inequalities in perintal health, which is greater in Montreal than in Brussels among the general population. For native-born mothers, the magnitude of inequalities in perinatal health is also greater for mothers born in Canada than for those born in Belgium, except for the association between income and preterm birth. The socioeconomic gradient in perinatal health is less marked among immigrant mothers than native mothers. Conclusion Significant differences in inequalities in perinatal health are observed between Brussels and Montreal. These differences can be explained by : on the one hand, the existence of greater social inequalities in Montreal than in Brussels and, on the other hand, the lower vulnerability of immigrants with low SES in Brussels. Future studies seeking to understand the mechanisms that lead to inequalities in health in different contexts should take into account a comparison of immigration and poverty contexts, as well as the public policies related to these factors.
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Affiliation(s)
- Mouctar Sow
- School of Public Health, University of Montreal, Quebec, Canada. .,Université Libre de Bruxelles, École de santé publique, Brussels, Belgium. .,Lea-Roback Research Centre on Social Inequalities in Health, CRCHUM, Quebec, Canada.
| | - Marie-France Raynault
- School of Public Health, University of Montreal, Quebec, Canada.,Lea-Roback Research Centre on Social Inequalities in Health, CRCHUM, Quebec, Canada
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22
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Jacobson MH, Wang Y, Long SE, Liu M, Ghassabian A, Kahn LG, Afanasyeva Y, Brubaker SG, Mehta-Lee SS, Trasande L. The Effect of Maternal US Nativity on Racial/Ethnic Differences in Fetal Growth. Am J Epidemiol 2022; 191:1568-1583. [PMID: 35434731 PMCID: PMC9618163 DOI: 10.1093/aje/kwac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/01/2022] [Accepted: 04/06/2022] [Indexed: 01/29/2023] Open
Abstract
While racial/ethnic differences in fetal growth have been documented, few studies have examined whether they vary by exogenous factors, which could elucidate underlying causes. The purpose of this study was to characterize longitudinal fetal growth patterns by maternal sociodemographic, behavioral, and clinical factors and examine whether associations with maternal race/ethnicity varied by these other predictors. Between 2016 and 2019, pregnant women receiving prenatal care at NYU Langone Health (New York, New York) were invited to participate in a birth cohort study. Women completed questionnaires, and clinical data were abstracted from ultrasound examinations. Maternal characteristics were assessed in relation to fetal biometric measures throughout pregnancy using linear mixed models. Maternal race/ethnicity was consistently associated with fetal biometry: Black, Hispanic, and Asian women had fetuses with smaller head circumference, abdominal circumference, and biparietal diameter than White women. The associations between race/ethnicity and fetal growth varied by nativity for Asian women, such that the disparity between Asian and White women was much greater for US-born women than for foreign-born women. However, associations for Black and Hispanic women did not vary by nativity. While race/ethnicity-specific fetal growth standards have been proposed, additional work is needed to elucidate what could be driving these differences, including factors that occur in parallel and differentially affect fetal growth.
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Affiliation(s)
- Melanie H Jacobson
- Correspondence to Dr. Melanie H. Jacobson, Department of Pediatrics, Grossman School of Medicine, New York University, 227 East 30th Street, 8th Floor, New York, NY 10016 (e-mail: )
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23
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Racism and the Reproductive Health Experiences of U.S.-Born Black Women. Obstet Gynecol 2022; 139:407-416. [PMID: 35115434 DOI: 10.1097/aog.0000000000004675] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/18/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore Black women's lived experiences of racism and the associated effects on reproductive health decisions and the reproductive health care experience. METHODS We recruited participants through social media and community outreach. We conducted semi-structured individual interviews focusing on Black women's lived experiences of racism and their effects on reproductive health. We coded and analyzed interview transcripts using process coding methodology. RESULTS Participants (N=21) were 21-45 years old and from Boston, Chicago, and Atlanta. Our primary themes were: 1) reproductive health racism across the life course, 2) anti-Black racism in the reproductive health care system, and 3) self-protective actions when interacting with the reproductive health care system. Reproductive racism across the life course included subthemes of early sexualization of Black women, heightened awareness of reproductive health inequities, and knowledge of reproductive oppression. Anti-Black racism in the reproductive health care system included subthemes of absence of shared decision making; vicarious reproductive health experiences; stereotyping, invalidation, and dismissal by reproductive health professionals; and medical mistrust. Participants guarded themselves against racism within reproductive health care by engaging in a variety of self-protective actions including seeking a health care professional of color, overpreparing for their appointments, enlisting advocates, seeking care only when desperate, and heightening symptoms to be heard. CONCLUSION Personal, vicarious, and historical experiences of racism within reproductive health care triggered participants to perform self-protective actions when interacting with the reproductive health care system. These actions served to promote safety, autonomy and rehumanization within a system that has historically and contemporarily devalued Black reproductive health.
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Disparities in Prenatal Sexually Transmitted Infections among a Diverse Population of Foreign-Born and US-Born Women. Reprod Sci 2022; 29:1651-1660. [PMID: 35212932 PMCID: PMC9005420 DOI: 10.1007/s43032-022-00891-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/13/2022] [Indexed: 01/09/2023]
Abstract
This study examined association between foreign-born (FB) status and a sexually transmitted infection (STI) diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, or syphilis among a cohort of expecting mothers, and stratified by race/ethnicity. As a secondary analysis, subsequent adverse birth outcomes following STIs were examined. We used data from a large perinatal database to conduct a retrospective cohort study of 37,211 singleton births. Logistic regression was used to determine the association between FB status and STIs. We adjusted for maternal demographics, prior complications, and chronic disease. As a secondary analysis, we examined the association between STIs, and adverse birth outcomes stratified by FB status. FB women had lower odds of STI diagnosis (ORadj 0.81, 95% CI 0.71-0.93); this was observed for each STI. Among Hispanic women, FB status did not reduce odds of STIs (ORadj 0.89, 95% CI 0.76-1.04). However, FB Black women had reduced odds of STIs (ORadj 0.53, 95% CI 0.36-0.79). Secondary analyses revealed that STIs increased odds of adverse birth outcomes among US-born Black women but not US-born Hispanic women. Among FB Black women, STIs increased odds of medically indicated preterm birth (ORadj 3.77, 95% CI 1.19-12.00) and preeclampsia (ORadj 2.35, 95% CI 1.02-5.42). This was not observed among FB Hispanic women. Previous studies suggest that FB women are less likely to have adverse birth outcomes; our study extends this observation to risk of prenatal STIs. However, FB status does not protect Black women against adverse birth outcomes following an STI.
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Hackman DA, Suthar H, Palmer Molina A, Dawson WC, Putnam-Hornstein E. Neighborhood poverty, intergenerational mobility, and early developmental health in a population birth cohort. Health Place 2022; 74:102754. [PMID: 35151183 DOI: 10.1016/j.healthplace.2022.102754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/25/2022]
Abstract
Living in a neighborhood with high levels of intergenerational mobility is associated with better childhood cognition and behavior as well as adult health. Nevertheless, it is unclear if such differences originate earlier, and thus if neighborhood intergenerational mobility is associated with health differences at birth. To address this question, we examined whether neighborhood intergenerational mobility, independent of neighborhood poverty, was associated with low birth weight (LBW) in a population-based cohort of singleton children born in California in 2017 (n = 426,873). Although increased neighborhood mobility was associated with a decreased likelihood of LBW, it was no longer associated with LBW (OR = 0.98, CI = 0.96, 1.00) after adjusting for neighborhood poverty. Meanwhile, neighborhood poverty was associated with LBW (OR = 1.04, CI = 1.02, 1.05) after accounting for mobility, with the odds of LBW 9.4% higher among children born where neighborhood poverty was in the 90th percentile compared with children born where neighborhood poverty was in the 10th percentile. Findings indicate that neighborhood poverty, but not intergenerational mobility, is a robust and independent correlate of increased LBW births, and thus early developmental health. These findings also suggest that the role of neighborhood intergenerational mobility in child and adult health outcomes may emerge later in development, independent of LBW, or that the role of neighborhood intergenerational mobility in LBW may be indirectly mediated through exposure to neighborhood poverty.
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Affiliation(s)
- Daniel A Hackman
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
| | - Himal Suthar
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Abigail Palmer Molina
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - William C Dawson
- School of Social Welfare, California Child Welfare Indicators Project, University of California, Berkeley, CA, USA
| | - Emily Putnam-Hornstein
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Belanoff C, Alade MO, Almeida J. Preterm Birth Among US and Foreign-Born Non-Hispanic Black Birthing Parents in Massachusetts: Variation by Nativity, Region, and Country of Origin. Matern Child Health J 2022; 26:834-844. [PMID: 34982341 DOI: 10.1007/s10995-021-03368-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Foreign-born non-Hispanic Black (NHB) birthing parents are less likely to have a preterm birth (PTB) than US-born NHBs. There is further variation by region and country of origin. We update previous studies by examining PTB rates by nativity, region and country of origin among NHBs in Massachusetts, a state with a heterogeneous population of foreign-born NHBs, including communities excluded from previous studies. METHODS Using 2011-2015 natality data from the three largest metropolitan areas in Massachusetts, we documented associations between nativity, region, and 18 individual countries of origin and PTB, using multivariable logistic regression to adjust for individual-level risk factors. RESULTS PTB was highest among US-born NHBs (9.4%) and lowest among those from Sub-Saharan Africa (SSA) (6.6%). Country-specific rates ranged from 4.0% among Angolans to 12.6% among those from Barbados and Trinidad and Tobago. While NHBs from SSA had significantly lower odds of PTB, risk among those from the Caribbean and Brazil was not different from US-born NHBs. The significantly lower risk among foreign-born NHBs and SSAs, in particular, remained robust in adjusted models. DISCUSSION Individual-level factors do not explain observed variation among NHB birthing parents. Future research should investigate explanations for lower PTB risk among SSAs, and congruent risk among foreign-born Caribbeans, Brazilians and US-born NHBs. Exposure to racism, a known risk factor for PTB, likely contributes to these inequities in PTB and merits further exploration. Prenatal care providers should assess place of birth among foreign-born NHBs, as well as exposure to racial discrimination among all NLB birthing parents.
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Affiliation(s)
- Candice Belanoff
- Boston University School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA
| | - Mayowa Oluwatosin Alade
- Boston University School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Joanna Almeida
- Simmons School of Social Work, Simmons University, 300 The Fenway, Office P412-B, Boston, MA, 02115, USA.
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Behlim T, Basso O, Bushnik T, Kramer MS, Kaufman JS, Yang S. Differences in birthweight by maternal and paternal nativity status in Canada. Paediatr Perinat Epidemiol 2022; 36:113-122. [PMID: 34811763 DOI: 10.1111/ppe.12817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parental nativity, as well as duration of residence of foreign-born parents in the host country, has been shown to be associated with size at birth. However, most studies have focused on maternal nativity status only and have not accounted for important characteristics of both parents. OBJECTIVE To explore whether maternal and paternal nativity and length of residence (LOR) are independently associated with birthweight for gestational age in a representative sample of infants in Canada. METHODS We compared mean differences in sex- and gestational age-standardised birthweight z-score by nativity status of both parents in a nationally representative sample of 130,532 singleton infants born between May 2004 and May 2006 to mothers residing in Canada. We categorised parental nativity status into four groups (both parents Canada-born, mother only foreign-born, father only foreign-born and both parents foreign-born) and parents' LOR into three (both ≤10 years, only one parent ≤10 years and both >10 years). We estimated mean differences in birthweight z-score and their 95% confidence intervals in linear regression models adjusted for parity, parents' ages, education, ethnicity and marital status of the mother. RESULTS Compared with babies of Canada-born couples, those of two foreign-born parents had on average smaller birthweight z-score, -0.23 (95% CI -0.28, -0.25). However, after adjustment, the mean difference in z-score was -0.02 (95% CI -0.05, 0.00). Infants born to parents who had both resided in Canada for ≤10 years had a unadjusted mean difference in z-score of -0.27 (95% CI -0.29, -0.26), compared infants whose parents were both Canada-born, but the difference became negligible (-0.02, 95% CI -0.04, 0.01) after adjustment. CONCLUSION The birthweight differences by parental nativity or length of residence observed in our study population could be attributed to differences in the distribution of other parental characteristics that affect birthweight.
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Affiliation(s)
- Tarannum Behlim
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Olga Basso
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Obstetrics and Gynecology, Faculty of Medicine, Montreal, QC, Canada
| | | | - Michael S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Paediatrics, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Brown LJ, Sear R. How do reproduction, parenting, and health cluster together? Exploring diverging destinies, life histories and weathering in two UK cohort studies. ADVANCES IN LIFE COURSE RESEARCH 2021; 50:100431. [PMID: 36661290 DOI: 10.1016/j.alcr.2021.100431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 06/17/2023]
Abstract
Life history theory researchers often assume reproductive, parenting and health behaviours pattern across a fast-slow continuum, with 'fast' life histories (typified by short lifespans, early maturation and investing in quantity over quality of children) favoured in poor quality environments and/or when resources are scarce. Some researchers further reduce this down to a simplistic 'fast' versus 'slow' dichotomy. Some of these ideas, with different theoretical motivations, are echoed in the 'diverging destinies' and 'weathering' frameworks developed in the social sciences. Whether clustering of reproductive, parenting and health traits exists has rarely been empirically tested, however. Using latent class analysis on data on mothers from the UK's Millennium Cohort (MCS) and Born in Bradford (BiB) studies, we explored whether reproduction and parenting traits clustered into 'diverging destinies', whether 'weathering' effects tied together health and reproduction, and whether all three domains were combined into either 'fast' vs 'slow' life histories, or into three groups more indicative of a fast-slow continuum. We leveraged ethnic diversity in these samples to examine four groups of mothers separately: 1. MCS White British/Irish (n = 15,423); 2. MCS Pakistani-origin (n = 923); 3. BiB White British (n = 3937); 4. BiB Pakistani-origin (n = 4351), and explored whether faster 'weathering' was evident amongst Pakistani-origin mothers. Both two and three class models emerged as potential descriptions of latent subgroups, potentially providing support for fast and slow life histories or a continuum of traits. However, response profiles provided only limited support for theoretical predictions of which traits should cluster together, with inconsistent and restricted clustering of traits both within and between the domains of reproduction, parenting, and health. In addition, trait clustering was more pronounced amongst White mothers and we found no clear evidence supporting faster 'weathering' amongst Pakistani-origin mothers; the observed clustering instead suggested that cultural constraints may influence linkages between traits. Our results therefore provide some limited support for models which suggest certain traits cluster together in predictable ways, but it is also clear that theoretical frameworks should not emphasise very rigid clustering of large numbers of traits and should allow for contextual influences on clustering.
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Affiliation(s)
- Laura J Brown
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, UK; Department of International Development, London School of Economics & Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Rebecca Sear
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, UK
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Adegoke TM, Pinder LF, Ndiwane N, Parker SE, Vragovic O, Yarrington CD. Inequities in Adverse Maternal and Perinatal Outcomes: The Effect of Maternal Race and Nativity. Matern Child Health J 2021; 26:823-833. [PMID: 34424456 DOI: 10.1007/s10995-021-03225-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the effect of race and ethnicity on differences in maternal and perinatal outcomes among U.S.-born and foreign-born women, as well as racial and ethnic disparities in outcomes within these groups. METHODS This retrospective study analyzed singleton pregnancies (n = 11,518) among women delivering at Boston Medical Center from January 2010-March 2015. Outcomes of interest included preterm birth, early preterm birth, cesarean delivery, hypertensive disorders, diabetes, low birth weight at term (LBW, < 2500 g), NICU admission and intrauterine fetal demise (IUFD). Prevalence ratios and 95% confidence intervals comparing outcomes between U.S.- and foreign-born women were calculated and stratified by race. Obstetric outcomes among Black and Hispanic women were compared to those of white women within both U.S.- and foreign-born groups. RESULTS Preterm birth, hypertensive disorders, LBW and NICU admission were more likely to occur among U.S.-born women and their neonates compared to foreign-born women. Controlling for sociodemographic characteristics did not significantly impact these disparities. Among foreign-born women, Black women had a higher prevalence of many maternal and neonatal complications, while Hispanic women had a lower prevalence of some complications compared to white women. Black woman and infants consistently exhibit worse outcomes regardless of their nativity, while Hispanic women foreign-born women experience less disparate outcomes. CONCLUSIONS FOR PRACTICE Overall, women born in the United States are at higher risk of several adverse perinatal outcomes compared to foreign-born women. Racial and ethnic disparities in birth outcomes exist in both groups. However, the complex interplay between biopsychosocial influences that mediate these inequities appear to have different effects among U.S- and foreign- born women. A better understanding of these factors can be used to combat disparities and improve outcomes for all women.
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Affiliation(s)
- Tejumola M Adegoke
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA.
| | - Leeya F Pinder
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Olivera Vragovic
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Christina D Yarrington
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
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Impact of Socio-economic Status on Low Birthweight: Decomposing the Differences Between Natives and Immigrants in Spain. J Immigr Minor Health 2021; 23:71-78. [PMID: 32410013 PMCID: PMC7847452 DOI: 10.1007/s10903-020-01027-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this population-based study, we explored the relationships between immigration, socio-economic status (SES), and perinatal outcomes. We quantified the effects of SES on birthweight disparities between native and immigrant mothers in Spain. We obtained birth and SES data from the 2011 census and administrative registers for years 2011–2015. The associations between origin, statuses, and the likelihood of low birthweight were estimated using logistic regressions. Fairlie’s nonlinear extension of the Oaxaca–Blinder decomposition method was applied to identify the extent to which the differences in birthweight between groups corresponded to socio-economic composition or to rates. Our results showed that African and Latin American mothers exhibited advantage in the perinatal outcomes over native mothers [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.63–0.90 and OR 0.73; 95% CI 0.65–0.82, respectively]. Decomposition analyses revealed that such advantage was not affected by the lower positions within the socio-economic structure that African and Latin American populations occupied.
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Whitley MD, Ro A, Palma A. Work, race and breastfeeding outcomes for mothers in the United States. PLoS One 2021; 16:e0251125. [PMID: 33951094 PMCID: PMC8099119 DOI: 10.1371/journal.pone.0251125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background In the United States, mothers’ employment status and occupation are related to breastfeeding. However, it is unclear whether not working leads to longer breastfeeding duration even when compared to professional/managerial jobs, which tend to accommodate breastfeeding better than service/manual labor jobs. Furthermore, occupation and breastfeeding are racially patterned, and it is possible that race could moderate the relationships between mother’s work and breastfeeding. Methods Using data from the Panel Study of Income Dynamics, we modeled breastfeeding duration based on mother’s employment/occupation (not working, professional/managerial work, or service/labor work) during the first 6 months postpartum, as well as mother’s race (White, Black or other) and other potential confounders. We used zero-inflated negative binomial regression models and tested an interaction between employment/occupation type and race. Predictive margins were used to compare breastfeeding duration among subgroups. Results Mothers working in service/labor occupations had the shortest breastfeeding duration of the three employment/occupation groups, and there was no significant difference in duration between not working and professional/managerial occupation. White mothers had longer breastfeeding duration than Black mothers on average. When we included an interaction between employment/occupation and race, we found that among White mothers, non-working mothers breastfed the longest, while mothers in service/labor work breastfed for the shortest duration, but among Black mothers, mothers in professional/managerial work breastfed for longer than mothers in the other two work categories. Discussion Race moderated the relationship between employment status/occupation type and breastfeeding such that, for White mothers, not working was the most advantageous circumstance for breastfeeding, in line with traditional work-family conflict theory. In contrast, for Black mothers, professional/managerial work was the most advantageous circumstance. These findings support the idea of the Market-Family Matrix, which allows that different work scenarios may be more or less advantageous for parenting behaviors like breastfeeding, depending on mothers’ circumstances.
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Affiliation(s)
- Margaret D. Whitley
- Program in Public Health, University of California, Irvine, Irvine, CA, United States of America
- * E-mail:
| | - Annie Ro
- Program in Public Health, University of California, Irvine, Irvine, CA, United States of America
| | - Anton Palma
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States of America
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Sudhinaraset M, Woofter R, Young MEDT, Landrian A, Vilda D, Wallace SP. Analysis of State-Level Immigrant Policies and Preterm Births by Race/Ethnicity Among Women Born in the US and Women Born Outside the US. JAMA Netw Open 2021; 4:e214482. [PMID: 33825841 PMCID: PMC8027912 DOI: 10.1001/jamanetworkopen.2021.4482] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/13/2021] [Indexed: 01/23/2023] Open
Abstract
Importance Criminalizing immigrant policies, a form of structural racism, are associated with preterm birth; however, to date, few population studies have examined this association by race and nativity status or examined the association of inclusive immigrant policies with preterm birth. Objective To assess the extent to which variation in preterm birth by race/ethnicity and nativity status is associated with state-level criminalizing vs inclusive immigrant policies. Design, Setting, and Participants This retrospective, cross-sectional study analyzed birth record data from all 50 states and the District of Columbia in 2018, as well as state-level indicators of inclusive and criminalizing immigrant policies. White, Black, Asian, and Latina women who had singleton births were included in the study. Statistical analysis was performed from June 1, 2020, to February 5, 2021. Two continuous variables were created to capture the number of criminalizing vs inclusive immigrant policies in effect as of 2017 in each state. Main Outcomes and Measures The main outcome measure was preterm birth (<37 weeks' gestation). Results Among the 3 455 514 live births that occurred in 2018, 10.0% were preterm, and 23.2% were to mothers born outside the US. Overall, for women born outside the US, each additional state-level inclusive policy was associated with a 2% decrease in preterm birth (adjusted odds ratio [aOR], 0.98 [95% CI, 0.96-1.00]); there were no significant associations between inclusive policies and preterm birth among women born in the US. In models examining the combined associations of criminalizing and inclusive immigrant policies with preterm birth, each additional criminalizing policy was associated with a 5% increase in preterm birth among Black women born outside the US (aOR, 1.05 [95% CI, 1.00-1.10]). Each additional inclusive immigrant policy was associated with a lower likelihood of preterm birth for Asian women born in the US (aOR, 0.95 [95% CI, 0.93-0.98]) and White women born outside the US (aOR, 0.97 [95% CI, 0.95-0.99]). No significant associations were found among other groups. Conclusions and Relevance This study suggests that criminalizing immigrant policies are associated with an increase in preterm birth specifically for Black women born outside the US. Inclusive immigrant policies are associated with a decrease in preterm birth for immigrants overall, Asian women born in the US, and White women born outside the US. No associations were found between criminalizing or inclusive immigrant policies and preterm birth among Latina women.
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Affiliation(s)
- May Sudhinaraset
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles
| | - Rebecca Woofter
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles
| | - Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced
| | - Amanda Landrian
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles
| | - Dovile Vilda
- Mary Amelia Center for Women’s Health Equity Research, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Steven P. Wallace
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles
- Center for Health Policy Research, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles
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Wakeel F, Njoku A. Application of the Weathering Framework: Intersection of Racism, Stigma, and COVID-19 as a Stressful Life Event among African Americans. Healthcare (Basel) 2021; 9:145. [PMID: 33540498 PMCID: PMC7912903 DOI: 10.3390/healthcare9020145] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/16/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
The disproportionate impact of coronavirus disease 2019 (COVID-19) on African American communities necessitates an increased focus on the intersectional roles of racism, stigma, and other social determinants of health in influencing disease and mortality risk. The Weathering Framework is applied to demonstrate the dynamic interrelationships between these factors and to conceptualize COVID-19 as a stressful life event that will have profound health implications over the life course for African Americans. Recommendations for population health research, interventions and policies aimed at reducing COVID-19 incidence and mortality, and mitigation of the long-term impacts of the pandemic on communities of color are discussed.
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Affiliation(s)
- Fathima Wakeel
- College of Health, Lehigh University, 1 W. Packer Ave., STEPS Building, Room 366, Bethlehem, PA 18015, USA
| | - Anuli Njoku
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, 144 Farnham Avenue, New Haven, CT 06515, USA;
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Riggan KA, Gilbert A, Allyse MA. Acknowledging and Addressing Allostatic Load in Pregnancy Care. J Racial Ethn Health Disparities 2021; 8:69-79. [PMID: 32383045 PMCID: PMC7647942 DOI: 10.1007/s40615-020-00757-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/18/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022]
Abstract
The USA is one of the few countries in the world in which maternal and infant morbidity and mortality continue to increase, with the greatest disparities observed among non-Hispanic Black women and their infants. Traditional explanations for disparate outcomes, such as personal health behaviors, socioeconomic status, health literacy, and access to healthcare, do not sufficiently explain why non-Hispanic Black women continue to die at three to four times the rate of White women during pregnancy, childbirth, or postpartum. One theory gaining prominence to explain the magnitude of this disparity is allostatic load or the cumulative physiological effects of stress over the life course. People of color disproportionally experience social, structural, and environmental stressors that are frequently the product of historic and present-day racism. In this essay, we present the growing body of evidence implicating the role of elevated allostatic load in adverse pregnancy outcomes among women of color. We argue that there is a moral imperative to assign additional resources to reduce the effects of elevated allostatic load before, during, and after pregnancy to improve the health of women and their children.
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Affiliation(s)
- Kirsten A Riggan
- Biomedical Ethics Research Program, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Anna Gilbert
- Biomedical Ethics Research Program, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Megan A Allyse
- Biomedical Ethics Research Program, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
- Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, MN, USA.
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Luo L, Buxton OM, Gamaldo AA, Almeida DM, Xiao Q. Opposite educational gradients in sleep duration between Black and White adults, 2004-2018. Sleep Health 2021; 7:3-9. [PMID: 33358437 PMCID: PMC8783663 DOI: 10.1016/j.sleh.2020.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the heterogeneous effects of education on sleep duration for Black and White adults and how the education effects changed between 2004 and 2018. METHODS A total of 251,994 adult participants in the 2004 to 2018 National Health Interview Survey were included in pooled cross-sectional data analyses. Separately for Black and White men and women, we calculated prevalence ratio and average marginal probability of short sleep (<7 hours) for each education level over the study period based on weighted logistic regression models. RESULTS Opposite educational gradients in short sleep were observed between Black and White adults. Greater educational attainment was associated with lower likelihood of short sleep among White adults but higher likelihood of short sleep among Black adults. Such heterogeneous educational gradients were robust after accounting for a set of socioeconomic, family, and health factors and persisted between 2004 and 2018. CONCLUSIONS The health implications of education are not uniform in the US population, and heterogeneous education effects on sleep duration persisted over the past decade. More scholarly attention is needed to identify challenges and barriers that may be unique for race, sex, and education subpopulations to maintain healthy sleep.
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Affiliation(s)
- Liying Luo
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA.
| | - Orfeu M Buxton
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - Alyssa A Gamaldo
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - David M Almeida
- Pennsylvania State Unviersity, University Park, Pennsylvania, USA
| | - Qian Xiao
- The University of Texas Health Science Center at Houston, Houston Texas, USA
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Strully KW, Bozick R, Huang Y, Burgette LF. Employer Verification Mandates and Infant Health. POPULATION RESEARCH AND POLICY REVIEW 2020; 39:1143-1184. [PMID: 33281251 DOI: 10.1007/s11113-019-09545-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In recent decades, several states have enacted their own immigration enforcement policies. This reflects substantial variation in the social environments faced by immigrants and native-born citizens, and has raised concerns about unintended consequences. E-Verify mandates, which require employers to use an electronic system to ascertain legal status as a pre-requisite for employment, are a common example of this trend. Drawing on birth certificate data from 2007-2014, during which 21 states enacted E-Verify mandates, we find that these mandates are associated with a decline in birthweight and gestational age for infants born to immigrant mothers with demographic profiles matching the undocumented population in their state as well as for infants of native-born mothers. In observing negative trends for both immigrants and natives, our findings do not support the hypothesis that E-Verify has a distinct impact on immigrant health; however, the broader economic, political, and demographic contexts that coincide with these policies, which likely impact the broader community of both immigrants and natives, may pose risks to infant health.
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Affiliation(s)
- Kate W Strully
- University at Albany, SUNY, 1400 Washington Ave, AS 308, Albany, NY 12222
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Sudhinaraset M, Vilda D, Gipson JD, Bornstein M, Wallace ME. Women's Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status. Am J Prev Med 2020; 59:787-795. [PMID: 33067070 PMCID: PMC7683369 DOI: 10.1016/j.amepre.2020.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Reproductive rights policies can potentially support or inhibit individuals' abilities to attain the highest standard of reproductive and sexual health; however, research is limited on how broader social policies may differentially impact women of color and immigrants in the U.S. This study examines the associations among state-level reproductive rights policies, race, and nativity status with preterm birth and low birth weight in the U.S. METHODS This was a retrospective, cross-sectional analysis of all births occurring within all the 50 states and the District of Columbia using vital statistics birth record data in 2016 (N=3,945,875). Modified log-Poisson regression models with generalized estimating equations were fitted to estimate the RR of preterm birth and low birth weight associated with tertiles of the reproductive rights policies index. Analyses were conducted between 2019 and 2020. RESULTS Compared with women in states with the most restrictive reproductive rights policies, women living in the least restrictive states had a 7% lower low birth weight risk (adjusted RR=0.93, 95% CI=0.88, 0.99). In particular, low birth weight risk was 8% lower among Black women living in the least restrictive states than among their counterparts living in the most restrictive states (adjusted RR=0.92, 95% CI=0.86, 0.99). In addition, low birth weight risk was 6% lower among U.S.-born Black women living in the least restrictive states than among those living in the most restrictive states, but this was marginally significant (adjusted RR=0.94, 95% CI=0.89, 1.00). No other significant associations were found for race-nativity-stratified models. CONCLUSIONS Women living in states with fewer restrictions related to reproductive rights have lower rates of low birth weight, especially for Black women.
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Affiliation(s)
- May Sudhinaraset
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
| | - Dovile Vilda
- Mary Amelia Douglas-Whited Community Women's Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Jessica D Gipson
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Marta Bornstein
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - Maeve E Wallace
- Mary Amelia Douglas-Whited Community Women's Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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Zhang N, Tan J, Yang H, Khalil RA. Comparative risks and predictors of preeclamptic pregnancy in the Eastern, Western and developing world. Biochem Pharmacol 2020; 182:114247. [PMID: 32986983 PMCID: PMC7686229 DOI: 10.1016/j.bcp.2020.114247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/15/2022]
Abstract
Preeclampsia (PE) is a complication of pregnancy characterized by hypertension (HTN-Preg), and often proteinuria. If not managed promptly, PE could lead to eclampsia and seizures. PE could also lead to intrauterine growth restriction (IUGR) and prematurity at birth. Although PE is a major cause of maternal and fetal morbidity and mortality, the underlying mechanisms are unclear. Also, there is a wide variability in the incidence of PE, ranging between 2 and 8% of pregnancies in the Eastern, Western and Developing world, suggesting regional differences in the risk factors and predictors of the pregnancy-related disorder. Several demographic, genetic, dietary and environmental factors, as well as maternal circulating biomarkers have been associated with PE. Demographic factors such as maternal race and ethnicity could play a role in PE. Specific genetic polymorphisms have been identified in PE. Maternal age, parity, education and socioeconomic status could be involved in PE. Dietary fat, protein, calcium and vitamins, body weight, and environmental factors including climate changes and air pollutants could also play a role in PE. Several circulating cytoactive factors including anti-angiogenic factors and cytokines have also been associated with PE. Traditional midwifery care is a common practice in local maternity care units, while advanced perinatal care and new diagnostic tools such as uterine artery Doppler velocimetry have been useful in predicting early PE in major medical centers. These PE risk factors, early predictors and diagnostic tools vary vastly in different regions of the Eastern, Western and Developing world. Further understanding of the differences in the demographic, genetic, dietary and environmental factors among pregnant women in different world regions should help in designing a region-specific cluster of risk factors and predictors of PE, and in turn provide better guidance for region-specific tools for early detection and management of PE.
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Affiliation(s)
- Ning Zhang
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jing Tan
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - HaiFeng Yang
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Schönborn C, Castetbon K, Sow M, Racape J, De Spiegelaere M. Mothers' experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey. BMJ Open 2020; 10:e038400. [PMID: 33257481 PMCID: PMC7705495 DOI: 10.1136/bmjopen-2020-038400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION In Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women's perinatal care trajectories and experiences of care. METHODS Using a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records. ANALYSIS We will estimate the associations of women's socioeconomic and migration characteristics with:Women's antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.Patient experience such as feelings of discrimination, respect, and understanding of information.We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions. ETHICS AND DISSEMINATION Ethical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars.
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Affiliation(s)
- Claudia Schönborn
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Katia Castetbon
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Mouctar Sow
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Judith Racape
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Myriam De Spiegelaere
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
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Variations in Relationships Between Perceived Stress and Birth Outcomes by Immigration Status. Matern Child Health J 2020; 24:1521-1531. [PMID: 33048312 DOI: 10.1007/s10995-020-03014-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Past research shows that stress during pregnancy predicts adverse birth outcomes. These patterns might differ based on immigration status. Our objective was to analyze differences in relationships between perceived stress during pregnancy and birth outcomes by immigration status. METHODS We recruited 81 pregnant women in Canada for a prospective longitudinal study of stress during pregnancy and infant development. Participants completed the Perceived Stress Questionnaire at 16-18, 24-26 and 32-34 weeks of pregnancy. Birth records were available for 73 women, including 24 non-immigrants, 18 long-term immigrants (≥ 5 years), and 31 recent immigrants (< 5 years). We used General Linear Models to test relationships between perceived stress and birthweight, birthweight for gestational age Z-scores, and gestational age, and differences based on immigration status. RESULTS Controlling for sociodemographic covariates, we observed interactive relationships between immigration status and perceived stress with birthweight at 16-18 (p = 0.032, partial η2 = 0.11) and 24-26 weeks pregnancy (p = 0.012, partial η2 = 0.15). Results were similar for birthweight for gestational age Z-scores at 16-18 weeks (p = 0.016, partial η2 = 0.13) and 24-26 weeks pregnancy (p = 0.013, partial η2 = 0.14). Perceived stress predicted smaller birthweight measurements among long-term immigrants. No relation was found between perceived stress, immigration status and gestational age. DISCUSSION Risk of adverse health outcomes, including birth outcomes, tends to increase with duration of residence among immigrants. Stress during pregnancy might represent one risk factor for adverse birth outcomes among long-term immigrant women. Promoting psychosocial health screening and care among immigrant women, and assuring continued care with acculturation, might improve both maternal and infant health outcomes.
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Andrasfay T, Goldman N. Intergenerational Change in Birthweight: Effects of Foreign-born Status and Race/Ethnicity. Epidemiology 2020; 31:649-658. [PMID: 32482947 PMCID: PMC7386866 DOI: 10.1097/ede.0000000000001217] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/20/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Foreign-born women have heavier infants than US-born women, but it is unclear whether this advantage persists across generations for all races and ethnicities. METHODS Using 1971-2015 Florida birth records, we linked records of female infants within families to assess intergenerational changes in birthweight and prevalence of low birthweight by grandmother's race/ethnicity and foreign-born status. We also assessed educational gradients in low birthweight in two generations. RESULTS Compared with daughters of US-born black women, daughters of foreign-born black women had substantially higher birthweights (3,199 vs. 3,083 g) and lower prevalence of low birthweight (7.8% vs. 11.8%). Daughters of foreign-born Hispanic women had moderately higher birthweights (3,322 vs. 3,268 grams) and lower prevalence of low birthweight (4.5% vs. 6.2%) than daughters of US-born Hispanic women. In the next generation, a Hispanic foreign-origin advantage persisted in low birthweight prevalence (6.1% vs. 7.2%), but the corresponding black foreign-origin advantage was almost eliminated (12.2% vs. 13.1%). Findings were robust to adjustment for sociodemographic and medical risk factors. In contrast to patterns for other women, the prevalence of low birthweight varied little by maternal education for foreign-born black women. However, a gradient emerged among their US-born daughters. CONCLUSIONS The convergence of birthweight between descendants of foreign-born and US-born black women is consistent with theories positing that lifetime exposure to discrimination and socioeconomic inequality is associated with adverse health outcomes for black women. The emergence of a distinct educational gradient in low birthweight prevalence between generations underscores hypothesized adverse effects of multiple dimensions of disadvantage.
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Affiliation(s)
- Theresa Andrasfay
- From the Office of Population Research, Princeton University, Princeton, NJ
| | - Noreen Goldman
- From the Office of Population Research, Princeton University, Princeton, NJ
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Murosko D, Passerella M, Lorch S. Racial Segregation and Intraventricular Hemorrhage in Preterm Infants. Pediatrics 2020; 145:e20191508. [PMID: 32381625 DOI: 10.1542/peds.2019-1508] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Intraventricular hemorrhage (IVH) disproportionately affects black neonates. Other conditions that are more common in black neonates, including low birth weight and preterm delivery, have been linked with residential racial segregation (RRS). In this study, we investigated the association between RRS and IVH. METHODS A retrospective cohort of neonates born between 24 and 32 weeks' gestation was constructed by using birth certificates linked to medical records from California, Missouri, and Pennsylvania between 1995 and 2009. Dissimilarity, a measure of RRS indicating the proportion of minorities in the census tract of the mother in comparison to the larger metropolitan area, was linked to patient data, yielding a cohort of 70 775 infants. Propensity score analysis matched infants born to mothers living in high segregation to those living in less segregated areas on the basis of race, sociodemographic factors, and medical comorbidities to compare the risk of developing IVH. RESULTS Infants born to mothers in the most segregated quartile had a greater risk of developing IVH compared with those in the lowest quartile (12.9% vs 10.4%; P < .001). In 17 918 pairs matched on propensity scores, the risk of developing IVH was greater in the group exposed to a segregated environment (risk ratio = 1.08, 95% confidence interval: 1.01-1.15). This effect was stronger for black infants alone (risk ratio = 1.16; 95% confidence interval: 1.03-1.30). CONCLUSIONS RRS is associated with an increased risk of IVH in preterm neonates, but the effect size varies by race. This association persists after balancing for community factors and birth weight, representing a novel risk factor for IVH.
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Affiliation(s)
- Daria Murosko
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts; and
| | - Molly Passerella
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Pennsylvania, Philadelphia, Pennsylvania
| | - Scott Lorch
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Pennsylvania, Philadelphia, Pennsylvania
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Richardson DM, Andrea SB, Ziring A, Robinson C, Messer LC. Pregnancy Outcomes and Documentation Status Among Latina Women: A Systematic Review. Health Equity 2020; 4:158-182. [PMID: 32440614 PMCID: PMC7241052 DOI: 10.1089/heq.2019.0126] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas. Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, Web of Science, Academic Search Premier, and Google Scholar in 2017 for relevant studies. Results: Based on stringent inclusion criteria, we retained nine studies for analysis. Conclusion: We found that evidence for the impact of documentation status on pregnancy outcomes among Latinas is not conclusive. We believe the divergence in our findings is, in part, due to variation in: conceptualization of how documentation status impacts pregnancy outcomes, sample populations, definitions of exposures and outcomes, and contextual factors included in models. Specific analytic challenges around sampling, measurement, and data analysis are identified. Suggestions for future research are offered regarding measurement of documentation status. Findings highlight the need for increased attention to documentation as an influence on Latina pregnancy outcomes.
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Affiliation(s)
- Dawn M Richardson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Sarah B Andrea
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Amber Ziring
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Cassandra Robinson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Lynne C Messer
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
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Yang S, Dahhou M, Bushnik T, Wilkins R, Kaufman JS, Sheppard AJ, Kramer MS. Perinatal health among foreign versus native-born mothers in Canada: variations across outcomes and cohorts. J Public Health (Oxf) 2020; 42:e26-e33. [PMID: 30715416 DOI: 10.1093/pubmed/fdz006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 12/13/2018] [Accepted: 01/07/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To examine perinatal health differences between foreign-born and native-born mothers in Canada across multiple outcomes and two cohorts 10 years apart. METHODS Using 94 896 and 131 271 births in the 1996 and 2006 Canadian Census-Birth Cohort, respectively, we estimated risk ratios and risk differences of preterm birth (PTB), small-for-gestational age (SGA), large-for-gestational age (LGA), stillbirth and infant mortality between foreign-born and Canadian-born mothers. RESULTS In the 1996 cohort, we observed no important differences in adverse outcomes between foreign-born and native-born mothers. In the 2006 cohort, however, foreign-born mothers had lower risks of PTB, LGA, stillbirth, and infant mortality and a higher risk of SGA on both the relative and absolute scales. Lowered risk of PTB among foreign-born mothers in the 2006 cohort was also observed within Caucasian, East Asian, Southeast Asian and South Asian mothers. Favourable outcomes associated with foreign-born status in the 2006 cohort were negatively graded by duration of residence in Canada among immigrant mothers. CONCLUSIONS Differences in perinatal health by maternal foreign-born status varied across cohorts and a more pronounced 'healthy migrant' effect was observed among more recent migrants. The native-born mothers' perinatal health over time and a more restrictive/selective immigration policy in recent years would explain our results.
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Affiliation(s)
- Seungmi Yang
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Mourad Dahhou
- Department of Pediatrics, McGill University, Montreal, Canada
| | - Tracey Bushnik
- Health Analysis Division, Statistics Canada, Ottawa, Canada
| | - Russell Wilkins
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Amanda J Sheppard
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Michael S Kramer
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Department of Pediatrics, McGill University, Montreal, Canada
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Ro A, Bruckner TA, Duquette-Rury L. Immigrant apprehensions and birth outcomes: Evidence from California birth records 2008-2015. Soc Sci Med 2020; 249:112849. [PMID: 32087487 DOI: 10.1016/j.socscimed.2020.112849] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/11/2019] [Accepted: 02/09/2020] [Indexed: 11/26/2022]
Abstract
While several studies find adverse birth outcomes among Latina mothers after discrete immigration enforcement events, it is unknown whether day-to-day enforcement activities precede adverse birth outcomes. This study examines birth outcomes among Latinas following local immigrant apprehensions-48-h holds on suspected undocumented immigrants by local law enforcement-over an 8-year period. County-level apprehensions, scaled to 1000 of the population, were averaged across the third trimester. We analyzed the association between county-level apprehensions and low birth weight (LBW) and preterm birth (PTB) between 2008 and 2015 in California using spline logistic regression models with knots at the quartiles of apprehensions and included covariates, county fixed-effects, and a time propensity variable to account for trend and seasonality in LBW and PTB. We performed these regressions for non-Hispanic White, all Latina, and foreign-born (FB) Latina mothers. There were no significant associations between apprehensions and LBW. For all Latina women, there were no differences in PTB between zero apprehensions and levels that were below the median. Latina mothers exposed to moderately high apprehensions had lower odds for PTB compared to zero apprehensions. At the highest levels of apprehensions, however, Latina women showed significantly elevated odds of PTB (at 0.71 apprehensions: OR = 1.06, 95% CI 1.01-1.12). PTB responded differentially to localized enforcement threats. At lower and moderate levels, Latino communities may have mobilized in ways that reduced the risk for PTB. Risks emerged at the highest levels of enforcement, underlying the intense fear and anxiety in hyper-surveilled areas.
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Affiliation(s)
- Annie Ro
- Program in Public Health, University of California, Irvine, Irvine, CA, USA.
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, Irvine, CA, USA
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Borrell LN, Rodríguez-Álvarez E, Dallo FJ. Racial/ethnic inequities in the associations of allostatic load with all-cause and cardiovascular-specific mortality risk in U.S. adults. PLoS One 2020; 15:e0228336. [PMID: 32053626 PMCID: PMC7018050 DOI: 10.1371/journal.pone.0228336] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/13/2020] [Indexed: 11/19/2022] Open
Abstract
Non-Hispanic blacks have higher mortality rates than non-Hispanic whites whereas Hispanics have similar or lower mortality rates than non-Hispanic blacks and whites despite Hispanics' lower education and access to health insurance coverage. This study examines whether allostatic load, a proxy for cumulative biological risk, is associated with all-cause and cardiovascular (CVD)-specific mortality risks in US adults; and whether these associations vary with race/ethnicity and further with age, sex and education across racial/ethnic groups. Data from the third National Health and Nutritional Examination Survey (NHANES III, 1988-1994) and the 2015 Linked Mortality File were used for adults 25 years or older (n = 13,673 with 6,026 deaths). Cox proportional hazards regression was used to estimate the associations of allostatic load scores (2 and ≥3 relative to ≤1) with a) all-cause and b) CVD-specific mortality risk among NHANES III participants before and after controlling for selected characteristics. Allostatic load scores are associated with higher all-cause and CVD-specific mortality rates among U.S. adults aged 25 years or older, with stronger rates observed for CVD-specific mortality. All-cause mortality rates for each racial/ethnic group differed with age and education whereas for CVD-specific mortality rates, this difference was observed for sex. Our findings of high allostatic load scores associated with all-cause and CVD-specific mortality among US adults call attention to monitor conditions associated with the allostatic load's biomarkers to identify high-risk groups to help monitor social inequities in mortality risk, especially premature mortality.
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Affiliation(s)
- Luisa N. Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, New York, United States of America
- OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- Department of Surgery, Medical and Social Science, University of Alcalá, Madrid, Spain
| | - Elena Rodríguez-Álvarez
- OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - Florence J. Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, Michigan, United States of America
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Fishman SH, Hummer RA, Sierra G, Hargrove T, Powers DA, Rogers RG. Race/ethnicity, maternal educational attainment, and infant mortality in the United States. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 66:1-26. [PMID: 33682572 PMCID: PMC7951143 DOI: 10.1080/19485565.2020.1793659] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study examines patterns of and explanations for racial/ethnic-education disparities in infant mortality in the United States. Using linked birth and death data (2007-2010), we find that while education-specific infant mortality rates are similar for Mexican Americans and Whites, infants of college-educated African American women experience 3.1 more deaths per 1,000 live births (Rate Ratio = 1.46) than infants of White women with a high school degree or less. The high mortality rates among infants born to African American women of all educational attainment levels are fully accounted for by shorter gestational lengths. Supplementary analyses of data from the National Longitudinal Study of Adolescent to Adult Health show that college-educated African American women exhibit similar socioeconomic, contextual, psychosocial, and health disadvantages as White women with a high school degree or less. Together, these results demonstrate African American-White infant mortality and socioeconomic, health, and contextual disparities within education levels, suggesting the role of life course socioeconomic disadvantage and stress processes in the poorer infant health outcomes of African Americans relative to Whites.
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Affiliation(s)
- Samuel H. Fishman
- Department of Sociology, Duke University, 276 Soc/Psych Building, 417 Chapel Dr., Durham, North Carolina 27708, USA
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gracia Sierra
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Taylor Hargrove
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel A. Powers
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Richard G. Rogers
- Department of Sociology and Population Program, IBS, University of Colorado Boulder, Boulder, Colorado, USA
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Eskild A, Sommerfelt S, Skau I, Grytten J. Offspring birthweight and placental weight in immigrant women from conflict-zone countries; does length of residence in the host country matter? A population study in Norway. Acta Obstet Gynecol Scand 2019; 99:615-622. [PMID: 31774545 DOI: 10.1111/aogs.13777] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/18/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION We aimed to estimate differences in offspring birthweight and placental weight between Norwegian women and immigrants in Norway from countries with armed conflicts. We also studied whether length of residence in Norway was associated with offspring birthweight and placental weight. MATERIAL AND METHODS We included in our study all singleton births in Norway at gestational week 28 or beyond during the years 1999-2014, to mothers who were born in Somalia, Afghanistan, Iraq (total immigrants n = 18 817), or Norway (n = 668 439). Data were obtained from The Medical Birth Registry of Norway and the Central Person Registry of Norway. We estimated the differences between Norwegian and immigrant women in mean offspring birthweight and mean placental weight by applying linear regression analyses. Adjustments were made for maternal age, parity, year of delivery, gestational age at delivery, preeclampsia, and diabetes. RESULTS The immigrant women had 206 g (95% CI 199 to 213 g) lower mean offspring birthweight and 16 g (95% CI 14 to 18 g) lower mean placental weight than Norwegian women. Immigrant women with ≥5 years of residence in Norway had higher offspring birthweight (40 g) and higher placental weight (17 g) than immigrant women with <5 years of residence. CONCLUSIONS Immigrant mothers from Somalia, Afghanistan, and Iraq gave birth to infants and placentas with lower weight than Norwegian women. However, the difference between Norwegian women and immigrant women was reduced by length of residence in Norway.
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Affiliation(s)
- Anne Eskild
- Division of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Silje Sommerfelt
- Division of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Irene Skau
- Department of Community Dentistry, University of Oslo, Oslo, Norway
| | - Jostein Grytten
- Division of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.,Department of Community Dentistry, University of Oslo, Oslo, Norway
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