Hawkins Summer Sherburne, Cohen Bruce B
Boston College, Graduate School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
Division of Research and Epidemiology, Bureau of Health Information, Statistics, Research and Evaluation, Massachusetts Department of Public Health, 250 Washington St., 6th floor, Boston, MA 02108-4619, USA.
Prev Med. 2014 Aug;65:92-5. doi: 10.1016/j.ypmed.2014.05.002. Epub 2014 May 10.
This study compared maternal smoking during pregnancy between the new Patient Protection and Affordable Care Act (ACA) data collection standards and Federal Office of Management and Budget (OMB) standards.
Data were from the Massachusetts Standard Certificate of Live Births on 1,156,472 babies from 1996 to 2010. A parent reported whether the mother smoked during pregnancy (yes/no), her race (5 options) and, separately, her ethnicity (39 categories). Prenatal smoking rates were compared between the ACA and OMB standards. Detailed ethnicity from the birth certificate was then examined within all broad categories of the ACA standards: White, Black/African American, Other Hispanic, Other Asian/Pacific Islander, and Other categories.
For Hispanic/Latina and Asian mothers, the ACA standards captured the variability in smoking across and within racial/ethnic groups more than the OMB standards. However, for White and Black/African American mothers, the broad ACA categories masked striking differences in prenatal smoking. While the overall prevalence among Whites was 10.2%, this ranged from 0.8% for Iranians to 21.0% for Cape Verdeans. Among Black/African Americans (7.6%), this ranged from 0.5% for Nigerians to 12.9% for African Americans. The ACA standards also combined ethnic groups with sizeable populations into Other Hispanics and Other Asian/Pacific Islanders.
When population health surveys and other reporting tools are being revised, state and federal agencies should consider expanding all race/ethnicity categories to capture detailed ethnicity on everyone.
本研究比较了新的《患者保护与平价医疗法案》（ACA）数据收集标准与联邦管理和预算办公室（OMB）标准下的孕期母亲吸烟情况。
数据来自1996年至2010年马萨诸塞州的1,156,472例活产标准证书。父母报告母亲孕期是否吸烟（是/否）、其种族（5种选择）以及单独的族裔（39类）。比较了ACA和OMB标准下的产前吸烟率。然后在ACA标准的所有大类中检查出生证明上的详细族裔：白人、黑人/非裔美国人、其他西班牙裔、其他亚裔/太平洋岛民以及其他类别。
对于西班牙裔/拉丁裔和亚裔母亲，ACA标准比OMB标准更能体现种族/族裔群体之间及内部吸烟情况的差异。然而，对于白人和黑人/非裔美国母亲，ACA的大类掩盖了产前吸烟的显著差异。白人总体患病率为10.2%，其中伊朗人为0.8%，佛得角人为21.0%。在黑人/非裔美国人中（7.6%），尼日利亚人为0.5%，非裔美国人为12.9%。ACA标准还将人口规模较大的族裔群体合并为其他西班牙裔和其他亚裔/太平洋岛民。
在修订人口健康调查和其他报告工具时，州和联邦机构应考虑扩大所有种族/族裔类别，以获取每个人的详细族裔信息。
