Holloway Kayla R, Radack Joshua, Barreto Alejandra, Chaiyachati Barbara H, Montoya-Williams Diana, Ellison Angela M, Burris Heather H
School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA.
Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Perinatol. 2025 Mar;45(3):372-377. doi: 10.1038/s41372-024-02123-x. Epub 2024 Sep 20.
Not all individuals self-identify with race categories on birth certificates, selecting "Other" and writing in identities. Our hypothesis was that curating write-in responses in the "Other" race category would contribute to understanding preterm birth inequities.
We analyzed Pennsylvania birth certificates (2006-2014). Two independent coders reviewed each write-in response among those who selected "Other" race. We compared preterm birth rates across subpopulations within "Other" race category using a Monte Carlo simulated Chi-square test.
Among 1,196,125 singleton births, 72,891 (6.1%) exclusively selected "Other" race; Hispanic more often than non-Hispanic individuals (54.5% vs 0.7%), p < 0.0001). Only 545 (0.8%) of Hispanic individuals wrote in responses aligned with preestablished race categories compared to 2,601 (33.2%) of non-Hispanic individuals. Preterm birth rates varied significantly across identities within the "Other" group (P < 0.001).
Utilizing combinations of self-identified race, ethnicity, and continental origin may facilitate public health efforts focused on birth outcome equity.
并非所有个体在出生证明上都会按照种族类别进行自我认定，有些人会选择“其他”并填写自己的身份信息。我们的假设是，整理“其他”种族类别中的手写回复将有助于理解早产方面的不平等现象。
我们分析了宾夕法尼亚州的出生证明（2006 - 2014年）。两名独立编码员对选择“其他”种族的人的每份手写回复进行了审查。我们使用蒙特卡罗模拟卡方检验比较了“其他”种族类别中各亚群体的早产率。
在1,196,125例单胎出生中，72,891例（6.1%）仅选择了“其他”种族；西班牙裔比非西班牙裔个体更常这样选择（54.5%对0.7%），p < 0.0001）。与2,601例（33.2%）非西班牙裔个体相比，只有545例（0.8%）西班牙裔个体填写的回复与既定种族类别一致。“其他”组内不同身份的早产率差异显著（P < 0.001）。
利用自我认定的种族、族裔和大陆血统的组合可能有助于聚焦出生结局公平性的公共卫生工作。
