Department of Anthropology, Yale University, 10 Sachem St, New Haven, CT, 06511, USA.
Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA.
J Racial Ethn Health Disparities. 2019 Dec;6(6):1208-1217. doi: 10.1007/s40615-019-00622-8. Epub 2019 Aug 5.
Profound racial health disparities in maternal and infant health exist in the USA. Discrimination based on race may contribute to these disparities, but the biological pathways through which racial discrimination acts on health are not fully known. Even less is known about these pathways during development. Examining how racial discrimination becomes biology is paramount because it may shed light on how and when such social forces result in lasting biological consequences for health and wellbeing. To begin exploring this issue, we performed a systematic review of the relationships between experiences of chronic racial discrimination and relevant biomarkers measured during pregnancy among African American women. The literature search included studies published prior to August 2018 in the MEDLINE, Embase, and PsycINFO databases, and 11 studies met our inclusion criteria. We evaluated the articles based on the biological system that the authors investigated, which included the immune, neuroendocrine, and cardiovascular systems. We found that the current literature provides preliminary evidence that experiences of chronic racial discrimination are associated with changes in maternal biology during pregnancy. However, the literature was limited in both quantity and quality. We found only 11 studies that addressed this subject, four of which only provided indirect evidence, and many studies had small sample sizes. Future work in this area should develop more informative methods that consider the interaction between interpersonal and structural racial discrimination, individual variation, and sociocultural factors. We conclude researchers should continue to work in this area and focus on developing more effective study designs and larger sample sizes.
在美国，母婴健康方面存在着深刻的种族健康差异。基于种族的歧视可能是造成这些差异的原因之一，但种族歧视影响健康的生物学途径尚不完全清楚。在发育过程中，人们对这些途径的了解就更少了。研究种族歧视如何成为生物学因素至关重要，因为这可能揭示了社会力量如何以及何时对健康和幸福产生持久的生物学后果。为了开始探索这个问题，我们对非裔美国女性在怀孕期间经历的慢性种族歧视与相关生物标志物之间的关系进行了系统综述。文献检索包括截至 2018 年 8 月在 MEDLINE、Embase 和 PsycINFO 数据库中发表的研究，有 11 项研究符合我们的纳入标准。我们根据作者研究的生物学系统对这些文章进行了评估，其中包括免疫系统、神经内分泌系统和心血管系统。我们发现，目前的文献提供了初步证据，表明慢性种族歧视经历与孕妇在怀孕期间的母体生物学变化有关。然而，文献在数量和质量上都存在局限性。我们只找到了 11 项针对这一主题的研究，其中 4 项仅提供了间接证据，而且许多研究的样本量都很小。该领域的未来研究应开发更具信息量的方法，考虑到人际和结构性种族歧视、个体差异和社会文化因素之间的相互作用。我们的结论是，研究人员应该继续在这一领域开展工作，并专注于开发更有效的研究设计和更大的样本量。
