Loggins Clay Shondra, Griffin Marquianna, Averhart Wanda
Counseling Center, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
Chapin Hall Center for Children, Data and Research Technology Liason, Oak Park, IL, USA.
Health Soc Care Community. 2018 Feb 28. doi: 10.1111/hsc.12565.
This paper explores racial disparities and risk factors of adverse pregnancy outcomes in Black and White pregnant women in the US. The study uses a cross-sectional approach to explore Black and White disparities using data from the 2012 National Survey on Drug Use and Health (NSDUH), which collects interview data from approximately 70,000 randomly selected participants. We included several self-reported conditions that we categorised as individual and social stressors (e.g. measures of institutionalised racism, individual health behaviours, access to quality care and social context factors). We used descriptive statistics, univariate and multivariate analyses in risk factors of adverse pregnancy outcomes between Black and White women. Black women who were pregnant had a lower socioeconomic status and experienced more measures of institutionalised racism compared to White women who were pregnant. More white women who were pregnant were married, had higher levels of educational attainment, higher income levels, and greater employment opportunities. White pregnant women also had higher levels of private health insurance and less dependency on government programmes for access to healthcare. Results from the regressions indicated that Black pregnant women were less likely to be married (OR = 0.01), less likely to have higher income levels (OR = 0.31) and less likely to be employed (OR = 0.52). However, Black pregnant women were more likely to be younger (OR = 1.82). For the health-eroding behaviours, Black pregnant women were less likely to smoke (OR = 0.53) and use alcohol (0.52). After assessing the SES Household-level stressors (access to healthcare), Black pregnant women were more likely to have Medicaid/CHIP (OR = 3.21) and health coverage through government assistant programmes (OR = 3.80); however, less likely to have private health insurance (OR = 0.38). There are differences in risk factors of adverse pregnancy outcomes between White and Black pregnant women based on measures of individual level/social stressors, institutionalised racism, health behaviours and access to care.
本文探讨了美国黑人和白人孕妇不良妊娠结局的种族差异及风险因素。该研究采用横断面研究方法，利用2012年全国药物使用和健康调查（NSDUH）的数据来探究黑人和白人之间的差异，该调查从约70000名随机选取的参与者中收集访谈数据。我们纳入了几种自我报告的状况，并将其归类为个人和社会压力源（例如制度化种族主义的衡量指标、个人健康行为、获得优质护理的机会以及社会环境因素）。我们对黑人和白人女性不良妊娠结局的风险因素进行了描述性统计、单变量和多变量分析。与白人孕妇相比，黑人孕妇的社会经济地位较低，经历的制度化种族主义衡量指标更多。更多的白人孕妇已婚，受教育程度更高，收入水平更高，就业机会更多。白人孕妇拥有私人医疗保险的比例也更高，在获得医疗保健方面对政府项目的依赖程度更低。回归结果表明，黑人孕妇结婚的可能性较小（OR = 0.01），收入水平较高的可能性较小（OR = 0.31），就业的可能性较小（OR = 0.52）。然而，黑人孕妇更有可能年龄较小（OR = 1.82）。在损害健康的行为方面，黑人孕妇吸烟（OR = 0.53）和饮酒（OR = 0.52）的可能性较小。在评估了社会经济地位家庭层面的压力源（获得医疗保健的机会）后，黑人孕妇更有可能拥有医疗补助/儿童健康保险计划（OR = 3.21）以及通过政府援助项目获得医疗保险（OR = 3.80）；然而，拥有私人医疗保险的可能性较小（OR = 0.38）。基于个人层面/社会压力源、制度化种族主义、健康行为和获得护理机会的衡量指标，黑人和白人孕妇不良妊娠结局的风险因素存在差异。
