Department of Health Studies, American University, Washington, DC.
African American Studies, University of Maryland, College Park, College Park, MD.
Ethn Dis. 2020 Jul 9;30(3):389-398. doi: 10.18865/ed.30.3.389. eCollection 2020 Summer.
Despite improvements in infant mortality rates (IMR) in the United States, racial gaps in IMR remain and may be driven by both structural racism and place. This study assesses the relationship between structural racism and race-specific IMR and the role of urban-rural classification on race-specific IMR and Black/White racial gaps in IMR.
We conducted an analysis of variance tests using 2019 County Health Rankings Data to determine differences in structural racism indicators, IMR and other co-variates by urban-rural classification. We used linear regressions to determine the associations between measures of structural racism and county-level health outcomes.
Study results suggest that racial inequities in education, work, and homeownership negatively impact Black IMR, especially in large fringe, medium, and small metro counties, and positively impact White IMR. Structural racism is also associated with Black-White gaps in IMR.
Factors related to structural racism may not be homogenous or have the same impacts on overall IMR, race-specific IMR, and racial differences in IMR across places. Understanding these differential impacts can help public health professionals and policymakers improve Black infant health and eliminate racial inequities in IMR.
尽管美国婴儿死亡率 (IMR) 有所改善，但 IMR 仍存在种族差异，这可能是由结构性种族主义和地点共同驱动的。本研究评估了结构性种族主义与特定种族 IMR 之间的关系，以及城乡分类对特定种族 IMR 和黑/白 IMR 种族差异的作用。
我们使用 2019 年县卫生排名数据进行方差分析检验，以确定城乡分类下结构性种族主义指标、IMR 和其他协变量的差异。我们使用线性回归来确定结构性种族主义衡量指标与县级健康结果之间的关联。
研究结果表明，教育、工作和住房所有权方面的种族不平等对黑人群体的 IMR 产生负面影响，尤其是在大型边缘、中型和小型大都市县，而对白人 IMR 则产生积极影响。结构性种族主义也与 IMR 中的黑/白种族差距有关。
与结构性种族主义相关的因素在总体 IMR、特定种族 IMR 和不同地区 IMR 中的种族差异方面可能不是同质的，也不会产生相同的影响。了解这些差异的影响可以帮助公共卫生专业人员和政策制定者改善黑人婴儿的健康状况，并消除 IMR 中的种族不平等。
