Braveman Paula A, Heck Katherine, Egerter Susan, Marchi Kristen S, Dominguez Tyan Parker, Cubbin Catherine, Fingar Kathryn, Pearson Jay A, Curtis Michael
Paula A. Braveman, Katherine Heck, Susan Egerter, and Kristen S. Marchi are with the Department of Family and Community Medicine, Center on Social Disparities in Health, University of California, San Francisco. Tyan Parker Dominguez is with Virtual Academic Center, University of Southern California School of Social Work, Los Angeles. Catherine Cubbin is with Population Research Center, School of Social Work, University of Texas at Austin. Jay A. Pearson is with Sanford School of Public Policy, Duke University, Durham, NC. Michael Curtis is, and at the time of the study, Kathryn Fingar was with Surveillance, Assessment and Program Development Section, Epidemiology, Assessment and Program Development Branch, Maternal, Child and Adolescent Health Program, California Department of Public Health, Sacramento.
Am J Public Health. 2015 Apr;105(4):694-702. doi: 10.2105/AJPH.2014.302008. Epub 2014 Sep 11.
We investigated the role of socioeconomic factors in Black-White disparities in preterm birth (PTB).
We used the population-based California Maternal and Infant Health Assessment survey and birth certificate data on 10 400 US-born Black and White California residents who gave birth during 2003 to 2010 to examine rates and relative likelihoods of PTB among Black versus White women, with adjustment for multiple socioeconomic factors and covariables.
Greater socioeconomic advantage was generally associated with lower PTB rates among White but not Black women. There were no significant Black-White disparities within the most socioeconomically disadvantaged subgroups; Black-White disparities were seen only within more advantaged subgroups.
Socioeconomic factors play an important but complex role in PTB disparities. The absence of Black-White disparities in PTB within certain socioeconomic subgroups, alongside substantial disparities within others, suggests that social factors moderate the disparity. Further research should explore social factors suggested by the literature-including life course socioeconomic experiences and racism-related stress, and the biological pathways through which they operate-as potential contributors to PTB among Black and White women with different levels of social advantage.
我们研究了社会经济因素在早产（PTB）的种族差异中所起的作用。
我们使用了基于人群的加利福尼亚母婴健康评估调查以及出生证明数据，这些数据涉及2003年至2010年期间在加利福尼亚出生的10400名美国黑人及白人居民，以研究黑人与白人女性中早产的发生率及相对可能性，并对多种社会经济因素和协变量进行了调整。
较高的社会经济优势通常与白人女性较低的早产率相关，但与黑人女性无关。在社会经济最不利的亚组中，不存在显著的种族差异；种族差异仅在更具优势的亚组中出现。
社会经济因素在早产差异中起着重要但复杂的作用。在某些社会经济亚组中不存在早产的种族差异，而在其他亚组中存在显著差异，这表明社会因素会调节这种差异。进一步的研究应探讨文献中提出的社会因素，包括生命历程中的社会经济经历和与种族主义相关的压力，以及它们发挥作用的生物学途径，这些因素可能是导致具有不同社会优势水平的黑人和白人女性早产的原因。
